The Blue Prussian (eBook)

CHAPTER ONE

The Antidote

“You have thallium poisoning.”

The world seemed to tilt as my doctor delivered the devastating news. My head spun, and my knees buckled. I dropped into a chair and stared blankly out the window. The sweeping view of the East River from my sunny Beekman Place apartment normally brought me serenity. But in that moment, I struggled to bring the scenery into focus.

“Are you there, Blake?” asked Dr. Silver.

I wanted to answer him, but I couldn’t grasp any words. I closed my eyes and tried to stop the spinning feeling. I could feel my heart racing.

“Are you okay? Just try to breathe and speak slowly when you can.”

I inhaled and exhaled sharply. “Yes, Dr. Silver. I’m here.”

“I apologize for giving you the lab results over the phone, but I felt you needed to know the diagnosis immediately. I am afraid this is as serious as it gets.” His formal voice registered a gravity I had never heard before in our conversations. It was filled with distress, which was uncharacteristic of the unflappable physician.

“I understand. Could you just give me a moment?”

“Of course. I’ll stay on the line; just let me know when you’re ready to hear the rest.”

I eked out a thank you and accidentally dropped my phone. It fell to the herringbone floor with a clamor. As I reached down to retrieve it, the wood pattern appeared to rotate. It was just my mind playing tricks on me, but it made me dizzy. I felt like I was falling down the rabbit hole all over again. I had been pulled back into the dark and twisted world I lived in during my marriage to a Machiavellian. The lies, deceit, and betrayal were behind me, and before me was the return of grace. Or so I had thought.

I had just moved back to my beloved New York City from San Francisco, having escaped a soulless marriage to a soulless man—a man who possessed what I first thought were endearing eccentricities but later came to understand were massive gaping holes of decency and morality that registered as psychopathy. My return to Manhattan did not feel triumphant in a way worthy of an Alicia Keys verse, but I knew my having survived him was. For that I thanked the heavens each morning and night.

Yet, I had been poisoned with thallium. Thallium was a lethal neurotoxin and more dangerous than the more common heavy metals like lead and mercury. I remembered news stories reporting that thallium was the murder weapon of choice for politically motivated poisonings. Thallium was used as an agent of death by the Stasi, the FSB, and Saddam Hussein to dispense with dissidents and defectors. It conjured tales of Russian spies and defectors of certain dictatorial regimes. It also evoked stories from nineteenth century England of rampant familial poisonings by thallium, arsenic, and other heavy metals. I recalled the nefarious plot of The Pale Horse by Agatha Christie, in which thallium played a starring role.

I knew what thallium was, and I knew who had poisoned me. The fear and adrenaline response surged over me like it had during every toxic episode from my marriage. In the beginning it had taken me longer to recover from the cruelty and malice as I had been so shocked by my then-husband’s behavior. Not that I ever got used to it, because I never did. I don’t think normal, empathic people ever can. Instead, I learned that to survive I needed to change how I responded to danger. I had to compartmentalize the evil and shift my focus on how to protect myself from it. Because it had been a prolonged campaign of psychological terror, I had to dodge attacks continuously while trying to figure out how to survive.

But I had survived. And I was determined to keep doing just that. I had been to hell and back before in my life, and I could do it again. Losing my parents at an early age to tragedy had forged my character and my grit. I relied on both to guide me and help me persevere through my subsequent years as a top college athlete, through law school, in my present daily life as an executive leading a global team at an innovative green energy company, and in extricating myself from my doomed marriage. I needed to go into problem-solving mode. That is how I had handled every crisis, no matter how grueling or complex.

I took a few deep breaths and regained my bearings. The sun sparkling off the river outside came into crystalline picture. Petals from the cherry blossoms floated to the ground on Roosevelt Island. I focused on that marvelous image and steeled myself for what was to come. I grabbed my phone. “Dr. Silver, I’m back. I’m focused now, or as much as I can be. I know that thallium is a neurotoxin. What should I expect going forward?”

He spoke solemnly. “It affects the human nervous system, heart, liver, lungs, and kidneys. The primary symptoms of thallium poisoning are neurological, causing grave damage to the brain, spine, and nerves. Thallium is one of the most dangerous and effective poisons on the planet.” He paused to let that sink in. “If we hadn’t caught it, the thallium would have remained in your body and caused prolonged suffering and degeneration of the central nervous system, psychosis, multiple organ failure, and, ultimately, death. It is what has been making you sick and causing your neurological symptoms such as the ataxia and the tremor, as well as your mental fragmentation and the musculoskeletal pain.”

“Will I recover?”

“There is an antidote, but you must know it is not a cure.”

“Meaning it will remove the thallium but not reverse the damage already done?”

“Yes, I am afraid so.”

“What is the name of the antidote?”

“The antidote is Prussian blue.”

“As in the pigment?” I asked, as the intense deep-blue color came to mind.

“Yes, the synthetic pigment used in painting. Despite all the advances of modern medicine, the only known antidote to thallium poisoning is Prussian blue in its insoluble form.”

“Wow. Okay. How is it administered?”

“In powder form packed into capsules. You will take eighteen capsules—that’s six capsules three times per day—for thirty days.”

“What does the antidote do exactly?”

“Prussian blue binds to thallium in the gastrointestinal tract and is excreted from the body via the liver. It is exceedingly difficult for the body to rid itself of thallium on its own. That is why the antidote must be taken. Without it, the human body continues to recirculate it and continues to degenerate. If it works, the antidote will remove the thallium from your system so that it cannot do any more harm. However, as you deduced, it won’t reverse the neurological harm already done.”

Prussian blue might not have been a cure, but I was grateful that an antidote existed to stave off what sounded like an excruciating decline and certain death. “Is there any other way to remediate the damage already done?” I wondered if others had been able to do the same.

“Patients with high levels of thallium toxicity rarely survive, so there isn’t much of a body of research. They typically present to an emergency room. Many perish before the medical team can figure out the culprit. You are in a much better condition than most other thallium patients. I expect you will no longer regress and that you will improve once we start you on the antidote. But you need to know that the neurological loss you have incurred up to this point may be permanent.”

That felt like a leveling blow. But I would fight with everything I had to reverse the damage. “How prevalent is thallium poisoning? I have seen the political cases in the news. And I know it lives in novels and movies of pop culture, but how many cases are there in real life?”

“It is exceedingly rare. Most doctors are familiar with the common heavy metals such as lead and mercury but not thallium. Most haven’t seen it present clinically, so they don’t think to check for it.”

“You did.”

“We are lucky we caught it,” Dr. Silver said with his usual humility.

***

It all made terribly perfect sense. Things had become blurry months ago. Until then I had been quick-minded, which had served me well in school and in my career. But I had been having trouble ordering and vocalizing my thoughts as rapidly as I used to. My ataxia wasn’t so marked that most people would notice. But I had. And I attributed it to the hell of the past few years. I had visited several doctors, but my symptoms were always left unanswered. The responses I received were the same that so many other women had heard: “Oh, it’s just stress,” “You’ll be fine,” or my favorite, “Just take a trip around the world.” Argh.

I wanted to take notes on the information that Dr. Silver was relaying, but it would have been just illegible scribbles on paper. A tremor had developed in my hands, which made holding a pen and writing difficult. At least now I knew what caused that distressing neurological symptom. My health and wellness had always been important to me. I was adept at monitoring and adjusting my body as needed, but nothing I had...