Polite Dissent

Ex Machina #18 “March to War, Chapter 2″
Brian K. Vaughan, writer
Tony Harris, penciler

In the end of issue #17, Mayor Hundred’s former aide Journal is attending a peace rally when she and hundreds of other protestors are exposed to some form of chemical toxin. In issue #18, the effects of the poison and the number of casualties becomes known. Journal is one of the victims: in the hospital and not expected to survive.

The Mayor’s security detail suspects sarin, but the Department of Homeland Security suspects that the toxin is ricin.

Sarin is a liquid nerve toxin that was developed in Germany prior to World War II as a pesticide. Poisoning can occur from skin exposure, eye exposure, or breathing sarin vapor. The toxin works on the communication between nerve cells. There are many symptoms of exposure including runny nose, watery eyes, blurred vision, drooling, and nausea. Symptoms usually appear within seconds of exposure, but may take several hours. Large doses can lead to loss of consciousness, paralysis, respiratory failure, and death. There are antidotes, but they work best if given early. Other than that, the best medical treatment is supportive.

Ricin is a toxin made from the castor bean. It is one of the most potent poisons known, and less than a milligram can kill a person. It works by disrupting the protein synthesis within a cell. It is a powder that can be inhaled, swallowed, or injected. If inhaled — as in the story — victims would develop shortness of breath, cough, and nausea within a few hours of exposure. Later, they would develop pulmonary edema (fluid building up in the lungs). A dangerously low blood pressure and respiratory failure may follow, leading to death. There is no antidote to ricin, and the best treatment medically is to provide as much support as possible and hope the patient pulls through.

When the mayor visits Journal in the hospital, the doctor refers to ricin poisoning. However, if you look at the time course (seconds vs. hours) and the symptoms, you’ll see that sarin fits the scenario better.

Journal’s treatment is a little suspect as well. The doctor is right that there’s no known treatment for ricin poisoning, and even survivors face a good chance of organ damage. However, someone as sick as Journal needs more than just an (incorrectly drawn) nasal canula and a single IV. They would need intubation and mechanical ventilation. Special medications such as dopamine would be needed to raise the blood pressure. Intensive care admission would be a must.

One last thought, Police Commissioner Angiotti refers to Ricin as “Schedule I”, but I’m not entirely certain what she means by that. At first I thought she meant it was a DEA schedule I drug — but ricin is not on the DEA list at all. However, it is listed as a Schedule I Controlled Substance according to the international 1997 Chemical Weapons Convention, so I guess this is what she is referring to. A strange thing for NYC cop to know off the top of her head.

• A belated thanks to Aaron for suggesting I take a look at this issue. In addition to my concerns, he notes the excellently drawn ventilator next to Journal in the hospital — which is strange as she’s not being ventilated. He also points out what appears to appear a tire gauge in the doctor’s pocket (image coming later).