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George noticed too. When rehearsal ended, Szell called Fleisher to his study. That was it.
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Fleisher was His life had evaporated. There were doctors: orthopedists, neurologists, a hand surgeon, psychiatrists. There were injections, x-rays, medications, acupuncture, aromatherapy. All failed. All useless. I started conducting, playing the left-handed repertory, and teaching at the Peabody Conservatory.
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There was, it should be noted, a brief respite in when the condition seemed to improve. Fleisher played at the opening of the Meyerhoff Hall in Baltimore. Afterward I broke down backstage. A grown man weeping After decades a diagnosis emerged. Fleisher was afflicted with focal dystonia, a misfiring of the brain that causes muscles to contract into abnormal, and sometimes painful, positions. The disorder often strikes those who depend on small motor skills: musicians, writers, surgeons. At last relief seemed possible.
He was referred to a clinical trial at the National Institutes of Health, where botulinum toxin was being tested as a remedy for the disabling contractions. Botulinum toxin is produced from the bacterium Clostridium botulinum , one of the most poisonous substances known.
A gram of botulinum toxin, if dispersed and ingested, could kill 20 million people. The toxin produces a protein that blocks the release of acetylcholine, a transmitter that tells a muscle to contract. In extremely dilute form the poison, delivered in the drug Botox, has proved effective and safe in medical applications ranging from the softening of wrinkles, to the relief of migraines, to a cure for crossed eyes, to a treatment for the spastic contractions of multiple sclerosis and cerebral palsy. Botulinum toxin relieves symptoms without curing the condition, so Fleisher receives an injection every six months or so.
But the six-month miracle is a miracle no less. For each there is cause to celebrate, but maybe most of all for the ninth. He is performing and touring again, and recently released his first two-handed recording in 40 years. Artur Schnabel, Fleisher's mentor, whose teacher's teacher was Beethoven himself, once said that life is about ascendancy. A conductor beats up. A ballet dancer lifts up.
We grow up and outward. Rye infected with ergot, a toxic fungus, has caused devastating epidemics through history. Symptoms include tremors and hallucinations; the hysteria of those accused of witchcraft in the 17th century may have been ergot poisoning.
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Spies were sometimes issued lethal pills hidden in objects like eyeglasses to use if captured. A popcorn cat poisoned several New England children in , when levels of orange food coloring reached toxic levels due to poor manufacturing controls. Victims recovered, and the manufacturer recalled the other cats.
The National Cancer Institute evaluates marine-animal toxins for potential cancer drugs. Animals with no armor and limited mobility rely on poison for defense. NCI scientist David Newman calls it "animal chemical warfare. Georgi Markov, a Bulgarian dissident, was assassinated in London in when a man approached and jabbed him with an umbrella modified to fire a pellet with ricin, a deadly toxin.
This replica is cut away to show the firing mechanism. In a man in Bedford, New York, died of botulinum poisoning after eating vichyssoise made by the Bon Vivant Company. Over a million cans of possibly under—:processed soup were recalled.
The company filed for bankruptcy. Meet the fugu, aka Takifugu rubripes , a fish with the thick-lipped, thuggish face of a Chicago gangster. Fugu, or puffer fish, as it is commonly known, is a delicacy in Japan. It can also be deadly. Those who eat the liver, ovaries, gonads, intestines, or skin swallow tetrodotoxin, a powerful neurotoxin that jams the flow of sodium ions into nerve cells and stops nerve impulses dead in their tracks.
They run the risk of suffering the fate of the famous Kabuki actor Mitsugoro Bando, who in spent a night feasting on fugu liver because he enjoyed the pleasant tingling it created on his tongue and lips.
The tingling was followed by paralysis of his arms and legs, difficulty breathing, then, eight hours later—death. There is no known antidote. Fortunately, these days the making of a fugu chef is a carefully controlled and licensed enterprise. Of the hopefuls who took last year's exam, 63 percent passed.
The source of the fugu's poison is a subject of debate. Tamao Noguchi, a researcher at Nagasaki University, believes the secret lies in the fugu's diet. Puffer fish, he explains, ingest toxins from small organisms—mollusks, worms, or shellfish—that have in turn ingested a toxic bacterium known as vibrio. In experiments, Noguchi has raised fugu in cages, controlled their diet, and produced toxin-free fish. He hopes his research will result in the state-sanctioned sale of fugu liver.
Japan has forbidden the sale of fugu liver since ; before the ban, deaths of those who overindulged in the liver, or ate it by mistake, numbered in the hundreds. If Noguchi succeeds in his efforts, gourmands may have cause to cheer, though the fish itself, he speculates, may have cause to mourn. He says the fugu's toxicity comes from poison glands beneath its skin. Some fugu are poisonous, he says, some aren't, but even experts can't tell which is which.
Place your bets.
Matsumura has never eaten fugu. However, Noguchi considers it the ne plus ultra of fine dining. She oversees the medical investigation of all violent, suspicious, and unnatural deaths in Virginia, and she inspired the character Kay Scarpetta in Patricia Cornwell's crime novels. Alphonse Poklis is director of toxicology and professor of pathology, chemistry, forensics, pharmacology, and toxicology at VCU.
He works with Fierro to analyze medical evidence in homicide cases and testifies as an expert in court. MF: There are a couple of presentations. If someone takes a huge overdose of something toxic, you expect a classic range of symptoms even a first-year resident can pick up on. Chronic poisonings—when toxins are fed slowly, continuously—are easier to misdiagnose.
Antifreeze in the Gatorade was a recent case. A common warning sign is when the clinical history is florid. For example, lots of trips to the internist for weird symptoms or stomach pains. The victim doesn't feel well; it's diffuse, nonspecific. Of course over time classic elements of poisoning may present: He doesn't eat, he's losing weight, he's sounding more teched each day. It looks like natural disease, but isn't. MF: We see any death that is sudden, unexpected, violent, or where there is allegation of foul play.