Friday, February 23, 2018

The Monster Of Glamis. (PC Version)

Glamis Castle

We are rather good at castles.  Here is the one that belongs to the Bowes Lyons- or the family of the Queen Mother as  they are better known.   It's been there since the 10th Century and the family keep adding bits on.

All these pictures are from the same room in the castle. Something is happening there on Saturday, a huge crime writing event called Crime At The Castle. We Scots like to do what is says on the tin. 

I'll tell you more about the castle later, all the bits and bobs and who killed who and why and who got  the blame. ( Usually the English).

The Glamis ( pronounced Glayms) is famous for one thing.

And the thing that it's most famous for was not mentioned at all during the private tour we had last Sunday.

Not even hinted at!

And the secret lies in this room.

But as I am a crime writer I am not going to tell you that story for a few weeks yet. I am going to tell you the story that we were told  as we were walking round the castle. And it is all about this very room. 

I couldn't bear to keep quiet about this.

The castle is famous for having one more window on the outside than on the inside. 

It does have over 170 rooms and a lot of very small windows.

The story now is that  the duke ( somewhere around 1500 give or take a century or so) was fond of playing cards, Gambling in fact.

It was his pleasure to gamble away  a Saturday night in the company of his friends, in a room to the rear of this suit of armour.

A butler type person would come and get him at 11.59 on a Saturday night as gambling is forbidden on the Sabbath.

On this particular night he was winning a lot of money and as his butler told him the time, the Duke looked down at his winning hand and said 'Turn Back The Clock.' 

So he did, and the duke played on, and on, winning and winning..

Then there was a knock at the door of the castle...

A tall dark stranger strode up the stairs and into the hall, asking to join the  game..

He did, and  they played on, drinking whisky, dealing the cards...

 the tall dark man was the devil of course

 they are still in there, playing cards, winning the money
 the duke and the devil

 they are walled up in a room  at this part of the castle. you can see the different brick where the door was sealed by the devil himself.....
  and we could still hear them you know...
in there...

 That is the PC version. The real, true version is much more poignant.
More next week.
Now, where are my playing cards, and my sledgehammer...

Caro Ramsay 23 02 2018

Thursday, February 22, 2018

Murder and Contagion

Alex for Michael - Thursday

I enjoy medical thrillers. Often the puzzle is as much in the medical aspects as in the whodunnit which adds to the interest. I 'met' Alex Lettau through a round table forum  for ITW a few months ago, and he had amazing things to say about malaria and other tropical diseases. Not really surprising since he's been practising in the area for thirty years, has several specialities including tropical medicine, has published multiple professional papers, and has been a medical missionary in Malawi, Nicaragua, and Papua New Guinea. Perhaps more surprising is that he  also writes fast-paced thrillers around Kris Jensen a medical detective with CDC. The first in the series is Yellow Death. I recommend you get a copy, not only because it's a really good, intriguing thriller, and not just because it won a National INDIE Excellence Award, but because, as you'll see below, Dr. Lettau is definitely not a person you want to cross!

It was just about the saddest day of my 37 year career in Infectious Diseases after I got the news that my patient, a 24 year-old woman who had contracted falciparum malaria on a mission trip to Liberia, had collapsed at home and died in the emergency room.  Two days earlier I had decided to treat her as an outpatient because she only had minimal symptomatology and had an extremely light parasitemia. Cause of death was spontaneous rupture of the spleen – rare in malaria and then almost always due to vivax rather than falciparum. 

The spleen, called “an organ of mystery” by the Greek physician Galen two centuries ago, is a fist-sized, highly vascular organ in the left upper abdomen tucked under and protected by the rib cage. Because of its rich blood supply, rupture of the normal spleen by severe blunt force abdominal trauma may cause fatal internal bleeding. However when the spleen enlarges, most commonly due to an infection such as mononucleosis or malaria, it emerges out from under the left rib cage and is susceptible to rupture from much milder direct trauma or even can rupture spontaneously. Chronic malaria may lead to a huge spleen as pictured, referred to as the tropical splenomegaly syndrome. Large spleens are also seen in visceral leishmaniasis and bilharzia.                                                              
Man with badly enlarged spleen
It has been known for centuries that an intentional targeted blow (mild enough to leave no mark) can easily cause a fatal rupture of a big spleen (thus it is also an organ of murder mystery!).  A specific weapon and method used in the Celebes was reported in the British Medical Journal November 24, 1951 (p 1281).                                                    

As mentioned by the author of the BMJ report, the Thugee cult of India also used this method to murder travelers, prior to stealing their possessions although their primary method of killing was by strangulation. The Thugees were an organized gang of professional assassins active in 13th-19th century India who acted in the name of Bali, the Hindu goddess of destruction. Their mission was to kill travelers by non-blood-letting methods prior to robbing them and it is estimated that they murdered a million or more before the British colonial government put an end to it!

So nowadays, leaving mass bioterrorism out of the discussion, how easy is it in real life to take advantage of an infectious disease or to utilize a micro-organism to murder a specific person (the “target”) and to get away with it? Short answer: It’s hard. The micro-organism needs to be a highly lethal, preferably untreatable infectious agent. The murderer also needs a source that supplies the agent and a means of delivery to infect the target, ideally without the target being aware of the exposure and even better if the infection is never specifically diagnosed. For the remainder of my guest blog, I will focus on rabies virus as a potential murder weapon.

Rabies is essentially 100% fatal once it reaches the brain to cause encephalitis. One problem is the long incubation period. After exposure say on the foot, rabies virus travels along nerve trunks and may take months to reach the brain. If the exposure is recognized, this delay allows for post-exposure rabies prevention using rabies immune globulin and vaccine. So the trick is to expose the target without their knowledge and then sit back and wait. I keep thinking I read once that the Mossad offed a target with a rabies-contaminated needle but I haven’t been able to find an internet reference.

Rabies virus is not a Tier 1 bioterrorism agent that is U.S government-controlled so it’s not illegal to possess a rabid animal carcass as a source of virus. Most countries outside of Western Europe and England have animal rabies. Worldwide, stray dogs are most commonly affected while in the US it’s the raccoon.                                                                 
Maybe not as cute as we thought...
Needlestick awareness of the target is an obstacle to overcome. If the target had significant neuropathy of the feet, an injection may not be sensed at all. The needlestick could also be set up to be “accidental”, perhaps purported to be a discarded needle from a drug abuser in which case the focus would be diverted to risk of hepatitis B and C and HIV.

There are non-needlestick options. Simple topical application of rabies-contaminated material onto an open wound such as a foot ulcer may transmit the virus. Intravenous injection would work if such an access were available. Presumed transmission of rabies by aerosol has been documented in two spelunkers after they visited a cave full of bats, but spritzing an extract of rabid raccoon saliva up the nose of the target is at best of unknown effectiveness because rabies virus does not attach to nasal mucosal lining cells. Oral exposure does not work either.

One advantage for the murderer is that rabies encephalitis is rare – I’ve yet to see a case in 37 years of practice. For that reason, it may not be looked for and therefore remain undiagnosed especially without an index of suspicion which would be low in the absence of a known animal exposure. The presumption would be that the target died of a more common type of encephalitis such as due to West Nile virus. Autopsies nowadays are rarely done. We recently cared for a woman in her 40’s without prior lung disease who became ill with cough, congestion, and fever just after a trip to Mexico. Four days later, she died of an overwhelming viral-type pneumonia. Multiple tests for influenza were negative. She did test positive for metapneumovirus which normally only causes common cold-type symptoms in patients without underlying lung disease or a weak immune system. She had neither but we had no real reason to refer her case to the Medical Examiner. A private autopsy would have cost the family 5000 U.S. dollars which they elected not to do.

In fiction, a targeted death by infection is much more doable. In one of my novels in progress (“Death by Full Moon”) a mad virologist serial killer is offing homeless people with a hybrid virus (rabies plus vesicular stomatitis virus – VSV). VSV is a logical (fictional) partner with rabies as it is a real virus in the same Rhabdovirus family as rabies and has receptors for nasal mucosal cells. The killer inoculates this hybrid virus into the nasal passages of the targeted victims on the pretense that he is administering a nasal spray influenza vaccine. The hybrid virus attaches and travels the short distance to the brain via the olfactory nerve leading to florid encephalitis in 2 days. The killer is rather obsessed with the full moon and times the exposures so that the victim goes mad on the night of a full moon. My series protagonist Dr. Kris Jensen, a specialist in Infectious diseases and former CDC epidemiologist investigates the deaths and tracks the killer down. Per the construct of thrillers, things go from bad to worse before the final battle between good and evil.  

There are certainly other infectious agents which could be used as a murder
weapon such as anthrax, cholera, Ebola virus, and H7N9 bird influenza. The feasibility will vary greatly around the world depending on factors such as the disease prevalence and the degree of sophistication of medical care, public health support and criminal investigation.

As to the future, a valid concern is that bioengineering will eventually be able to genetically tailor a lethal infectious agent to target a single individual. There is a fascinating lengthy story on that topic published in 2012 in The Atlantic (“Hacking thePresident’s DNA”). If someone could do that, they could easily add on genes for resistance to all antimicrobial drugs. That would be a truly frightening scenario.                                            

Wednesday, February 21, 2018

Travelling while vegan

Leye- Every other Wednesday

I’ve now been on a vegan diet everyday of 2018, so far, and it’s been great. My smugness level keeps increasing, which is exciting. I’ve also noticed other effects of the diet. For one, my sense of smell has greatly improved. I can smell bacon and egg sandwich from a mile away. I can even tell if the customer has gone for the cheeky extra bacon. If you’ve had steak, I can tell several hours later. I can even tell how you had it cooked: rare, medium rare, or, you-do-not-deserve-this-meat. I can also walk into a restaurant and tell you what delicious cuts of beef they have on the menu. My sense of smell has greatly improved.

I’ve also lost some weight, not that I was overweight, to start with. Where someone sees a big stomach on me, I see fat reserves for a rainy day. My 36-inch trousers now gather under the belt, which is kind of annoying. And last year, before this vegan madness, I reluctantly accepted reality and bought my first XL shirt. It now feels like an XXL shirt and I’m upset because I haven’t worn my money’s worth out of it.

Another interesting result of my strictly vegan diet is a renewed efficiency of my digestive system. Which can be inconvenient as I’m one of those people who prefer to do at home, those things that cannot be delegated.

I’m also learning things about myself. For example, I am not vegan. Yes, I’m on a vegan diet, and yes I care for the wellbeing of animals, but I am not throwing away my non-vegan shoes and belts and bags. I recently bought a new leather sofa. It’s yet to be delivered, and when it is, I’ll have no qualms packing my derrière on it. It’s a lovely sofa. You should come visit when it arrives.

I’m also learning important lessons that do not apply to anyone who is not vegan. For example, travelling while vegan requires planning.

Twice this so far this year, I’ve experienced the harsh realities of traveling while vegan. The first time was a three-day trip to Spain for the 2018 Barcelona Negra, a lovely festival where I got to meet and take a picture with THE James Ellroy.

My lovely hotel in Barcelona had a vegan friendly menu. Ratatouille without the advertised poached egg. I ate the same meal each day till I discovered a place on Las Ramblas where they were happy to fix me a vegan paella. It tasted like heaven - till my hunger was sorted, then the rest of it tasted wrong.

The second time I’ve travelled while vegan is just last week. I was in France for Les Mots du Monde à Nantes. This time it was a four-day trip. It was lovely. I enjoyed every day of the festival under the artistic directorship of the amazing Alain Mabanckou, the best-dressed writer in the world as far as I’m concerned.

I enjoyed the city of Nantes. I even did the tourist thing, which I hardly ever do unless there’s promise of wine on the route. Anyway, this time the authors had food vouchers for each day of the festival. The restaurant serving the food also catered for people dumb enough to switch to a vegan diet. They had rice and vegetables. This, my friends, was the only thing I ate, lunch and dinner, for the entire time I was in Nantes.  I don’t do breakfast.

The lesson I have learnt from these sojourns, as a person on a vegan diet, is this: do not, whatever you do, let the other authors at the festival know that you are on a vegan diet. Don’t. Trust me. They will find the most creative ways to taunt you over your insane choice of diet. They will let it slip into the questions they ask while you’re on a panel. They will make jokes with the waiters – in French, so you’re not even sure what they’ve said. (I should brush up on my primary school French). And they will never stop offering you a slice of their juicy, smells-so-delicious, full of umami, medium rare sirloin steak. What a mean bunch.

Tuesday, February 20, 2018

in the footsteps of Maigret...kind of

In the footsteps of Inspector Maigret...kind of

It’s all about connections in France. A friend’s high school classmate knows a man who knows the person you want to meet. Connections get you his phone number. But introductions, I’ve discovered after many painful botched attempts, will get you in the door. In this case the wide portal of 36 Quai des Orfevrés home of the Paris Police Prefecture. Also the haunt of George Simenon’s Inspector Maigret fictionally in charge of the Suréte homicide. Now it’s called Brigade Criminelle, the elite homicide division on the fifth floor.

But I’d been there, visited ‘Maigret’s office’ and seen the photos of Simenon visiting the real Inspector he based Maigret on. I saw the intake desk, the holding cells, climbed the winding back stairways and saw messy paper piled desks. But this time I had an introduction to the Crime Scene Investigation Unit. The team who arrived at the scene of the crime, assembled the evidence, handed it to the Brigade Criminelle detectives and particular to the Prefecture, exclusively handled the fingerprints of each case.

My friend Anne, who founded an association with rape victims and their families to promote legislation for penal re-education and pyschological programs for offenders, met François at the sentry gate. François, seventeen years in the Brigade Criminelle and now running the Crime Scene Unit, puffed on his pipe with a nod to Maigret and flashed his ID at the sentry. The we were in the famed courtyard and seconds later mounting the staircase into the heart of ’36’. Magistrates and avocats, wearing black robes and white ermine around their necks bustled past since the Tribunal, court, adjoins the Prefecture.

One stop shopping, I thought, since a suspect is booked on the third floor, held in gard à vue in a cell in the basement then within twenty four to forty eight hours taken back up to the third floor crosses the corridor and into the courtroom to be arraigned. After that the suspect either bids adieu or if the Brigade Criminelle’s assembled enough evidence and the la Procurer - like the DA - has enough to try her/him he’s back downstairs to the basement cells.
After the quick tour through the clogged Tribunal corridor - I mean how many black robed Magistrates does it take to block a wide high ceilinged 18th century corridor? Enough I discovered as they huddled discussing cases, we again crossed the courtyard, past ‘flic’s, cops, smoking in the corners, down more steps and into another courtyard and then into another. Now we were in a courtyard surrounded by a soot-stained wing of the Tribunal and facing ugly tan portables. The ‘heartbeat’ of the Crime Scene Unit.

I’d hoped for a more picturesque building but here François - off to a case - handed us to Remy who was in charge of the division. Remy, orange pants, matching tie and little English smiled. “I’ll show you the father of modern forensics, Bertillion, this was his lab and office.” Here I wondered? But Remy led us to the next building, through a warren of hallways and we were back in the old part. Somehow this complex at ’36’ on the Ile de la Cité all connected. We saw Bertillon’s early instruments and how he developed in the late 1890’s what everyone still uses today - the techniques of fingerprinting and identification. In 2000 the fingerprint division connected to APHIS the fingerprint database but they still use the old fingerprint cards to identify a hit on APHIS and keep to the standards of a 12 point match up on the fingerprint pad.

But forget the technical for a moment, I was struck by the camaraderie among the technicians at their computers, the joking and quips and comments as they stood comparing old brown files, or in the lab room pulling out graphite powder and testing for indentations on paper, or in another the fingerprints on counterfeit Euros. Like a family. Everyone time we met someone it was handshakes or kisses hello...ok, it’s France even in the workplace people double cheek kiss when they meet. But it added a human touch not found at the FBI. Even a Christmas tree near Bertillion’s old lab. One of the highlights was the reconstruction room. A room in the base of the 15th century tower where the team re-enacts the crime scene. The new in the old, and with their cramped headquarters every bit is used. So after an illuminating four hours and with a nod to Maigret, double cheeked kisses to his descendent Remy we left ’36’ and headed across the street to Cafe Soleil d’Or, where the ‘flic’s’ eat lunch. Supposedly Maigret 'ate' there, too.

PS Update this post is from 2009 - the Brigade Criminelle has moved and the building is a bit empty and lonely.
In May I'm visiting their new headquarters and will take you on a virtual 'visit'!

Cara - Tuesday

Monday, February 19, 2018

Africa 2018: Splendid Places, People, and Surprises

 Annamaria in Kenya and Tanzania

My week in Kenya ended with two fascinating days.

Through the good offices of Facebook connections, I made a new friend, who herself became an instant conduit for magical connections. Her name is Lydia.

On this past December 6th, I posted this picture on Facebook,
as an example of what settler life was like in early Twentieth
Century British East Africa.  I took the picture off the internet and
had no idea who the people were.

When I met Lydia and told her about my research, she offered to introduce me to her friend Calvin Cottar.  She made a date for us to meet with him for a coffee on Sunday morning.  To prepare for that meeting, she sent me a link to an internet interview with Calvin, who is the premier private safari guide in Kenya today.  There, at the top of the article, was the very picture above.  The man in the sun helmet on the right is Calvin's great-grandfather--Chas Cottar, who founded Cottar's Safari Service right at the time I am writing about. Calvin now heads it.

Me, Calvin, and Lydia

Calvin allowed me to take pictures of
his period family photos.  This one of Chas's
son.  Chas was an American from Oklahoma
 who immigrated.  My guess this was a 4th of July
 celebration.  You think? 

After our visit with Calvin, Lydia and her friend Jess took me to the Nairobi National Park for a picnic.  

Impala against the skyline of Nairobi 

Hartebeest, ditto
The next evening I had the chance to host a dinner for Lydia and my friend Michael Lenaimado, a leading Kenyan anti-poaching and conservation ranger.  During the course of our dinner conversation, it came out that Lydia and Michael have a friend in common - Calvin Cottar!

Michael, Lydia, and me

As Michael explained his work to Lydia, while discussing the dangers of anti-poaching work, Michael lamented the loss of rangers to snakebite.  "Wait," Lydia said, "my sister-in-law and her husband run a snake-bite prevention and treatment effort here in Kenya."  Bingo!  Thanks to this chance encounter, Lydia has put Michael in touch with the people who can supply anti-venom serum ad help save the lives of his men.  And I got to sit there and listen as this this took place.  I ask you: Are you surprised that my life feels like magic to me? 

The very name Kilimanjaro Airport denotes adventure to me, even still.
The next day I was on my way to Arusha, Tanzania and The Emusoi Center.  That's me at the very  top of this post, with the new girls, who are being prepared to take their school entrance exams and set themselves on a path to eduction, instead of being sold into early marriage.  Hooray for the education for girls!!

I got to make a little magic of my own for the Emusoi girls with a gizmo I acquired in Italy. With the help of Sister Mary, Emusoi's founder, and Sister Jerine, a teacher, we launched it.  Here are two very short films.  The take off and a few second of how the girls reacted.

 Then it was on to Lake Manyara.  I was the only passenger on the flight from Arusha Airport, a first for me.

Harry, the pilot.

Your reporter amongst the empty seats

A glance at the Rift Valley during the descent.

 The ride from the airport to the lodge was a marvel of game watching.

Here are some highlights of the sightings over the past couple of days.


Lions at sunrise

And zebras

This close!!!!

A gazillion flamingos and me!
Magical!  All magical!