Ripped from the headlines: a poison plot with twists
“Law & Order: Criminal Intent,” NBC, Feb. 27, 9 p.m., “30.”
The premise: After journalist Josh Lemle (Lee Tergesen) develops weakness and coughs up blood, he goes to the hospital where doctors discover he has been poisoned by polonium-210, a radioactive material. They predict he will die within a week. Josh contacts the crime-solving Major Case Squad and his old friend, Det. Mike Logan (Chris Noth). Josh later develops irreversible multisystem organ failure, has trouble breathing, loses his hair, develops severe ulcerations to his skin and dies.
During the investigation, a hazmat team wears radiation suits when near “hot” areas for polonium-type radiation. But the Major Case Squad believes that -- though this poisoning “is 5 million times more toxic than cyanide” -- damage can occur only from ingestion, inhalation or through open cuts, not from casual exposure, as when Josh’s family members share his drinking glass.
The medical questions: Can multisystem organ failure and time of death be predicted from degree of exposure to polonium-210 as the show suggests? Are the medical symptoms and signs accurately demonstrated? Is second-hand exposure harmless?
The reality: “Law & Order: CI” accurately presents polonium-210 as one of the most toxic radioactive materials known, and correctly shows that it must be inhaled or ingested to work effectively as a poison. (It would take approximately 20 days for a man weighing about 155 pounds to die after ingesting 0.7 micrograms, according to the U.S. Health Physics Society.)
The show is less accurate when it describes the physical effects of an ingested dose on the body. Lemle appears to cough up blood and have trouble breathing, but in real life he would more likely suffer from gastrointestinal distress, anemia and internal organ failure. It is unlikely the full effects of the poison, or the time of death, could be predicted so accurately. The effects of high doses of polonium-210 have been compared to the external radiation encountered after World War II’s Hiroshima blast. Lemle’s loss of hair and skin peeling seem accurate, but the epidermal craters are for dramatic effect.
The use of alpha detectors to trace the source is more realistic, as is downplaying the risk of casual exposure. In real life, the U.K.’s Health Protection Agency has been following those who may have been exposed to polonium-210 in late 2006 in the aftermath of the poisoning of former KGB agent Alexander Litvinenko, but testing of blood and urine has not shown significant enough amounts in those tested to be a threat to health. Litvinenko is believed to be the first person to die of acute alpha radiation poisoning, and there have been no known U.S. cases.
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Dr. Marc Siegel is an internist and an associate professor of medicine at New York University’s School of Medicine. He is also the author of “False Alarm: The Truth About the Epidemic of Fear.” He can be reached at marc@doctorsiegel.com.