The Mysterious Death of the Toxic Lady

Just over 30 years ago, two dozen emergency room staff were mysteriously felled by fumes emanating from a dying young woman. Investigations turned up nothing — until a team of chemists from a nuclear weapons lab got involved. They claimed to have solved the mystery of what killed Gloria Ramirez and hospitalized the staff attempting to save her. But did they?

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Episode Transcript

Speaker 1 (00:32):
Hey, Hey, welcome back to Autumn's oddities. I'm Autumn. Just
aheads up, the episodes might be late or released at
a different time than I usually release them. For the
next couple of weeks. My manager has been on maternity leave,
and the person filling in for her has been giving
me my schedule with sometimes less than twenty four hours

(00:54):
notice of what city that I'm going to be in.
You know, what time the school starts, what time the
school ends. I work in public schools all over the state.
They don't all start at the same time, and I'm
getting less than twenty four hours notice. Sometimes it makes
it extremely difficult to plan when I'll be able to record.
My manager is supposed to be to be back from

(01:15):
leave sometime in October, so hopefully I'll be able to
plan a little better, you know, when I have the
ability to do so. All right, Well, today's case I've
heard of, but I've never done a deep dive. I've
only done like a cursory glance of the details. I've
seen lots of people cover it. I don't know how
deep they've dived into it, but I indeed did do

(01:39):
a deep dive. So let's get into it. Just over
thirty years ago, two dozen emergency room staff were mysteriously
filled by fumes emanating from a dying woman. Investigations turned
up nothing until a team of chemists from a nuclear

(01:59):
weapon lab got involved. They claimed to have solve the
mystery of what killed Gloria Ramirez and hospitalized the staff
attempting to save her life. But did they? I don't know.
Got to listen to the end to find out, don't you,
or you could google it. Don't google it, just listen. Please,
thank you. At around eight fifteen on the evening of

(02:19):
February nineteenth, nineteen ninety four, paramedics wield a woman into
the emergency room of General Hospital in the southern California
city of Riverside. They pushed through two sets of double
glass doors, veered to their left, and parked her in
a small curtain space marked Trauma Room one. The woman,
clad in shorts and a T shirt, was awake, but

(02:41):
she responded to questions with only brief and sometimes incoherent utterances.
She was taking shallow, rapid breaths. Her heart was beating
too rapidly to allow its chambers to fill before they pumped,
so her blood pressure was plummeting. The only thing unusual
about her was her age. Recalled Maureen Welch, a res

(03:03):
a respiratory therapist. Sorry, it was assisting in the trauma
room that night. And again this was thirty years ago.
They the people that were involved in this case could
still be working. Maybe they were retired. I hope for
them that they were retired. But at the time, this
is what they were doing, this is where they were working,
YadA YadA. So most patients who show up in an

(03:24):
emergency room with such symptoms are elderly people, Welch said.
This woman, the paramedics reported, was just thirty one years
old and had cervical cancer. Her name was Gloria Ramirez.
The medical staff hovering over Ramirez injected her with the
host of fast acting drugs that were part of the

(03:44):
standard protocol for her condition, valium, versaid and adaban to
sedate her, and agents such as lyda kine and bretilium
to quell her aberrant heartbeat. Welch meanwhile forced air into
Ramirez's lungs with an amboo bag, which is you've probably
seen it before. It's like a football size rubber bladder.

(04:04):
It's connected to a plastic mask that's placed over the
patient's mouth and nose, and it serves as a sanitary
alternative to mouth to mouth resuscitation. When it became clear
that Ramirez was responding poorly to treatment, the staff tried
to defibrillate her heart with electricity. They stripped off her

(04:26):
shirt and put padded electrodes against her chest. At that point,
several people saw an oily sheen covering Ramirez's body, and
some noticed a fruity, garlicky odor that they thought was
coming from her mouth. And I can't like, what in
the hell would At that point, several people saw an

(04:47):
oily sheen covering Ramirez's body, and some noticed a fruity,
garlicky odor that they thought was coming from her mouth.
To obtain blood for analysis, a registered nurse named Susan
Kin swabbed Ramirez his right arm with rubbing alcohol, inserted
a catheter, and attached a syringe. And that's when the

(05:08):
frenetic yet orderly routine of the emergency room began to
break down. As the syringe filled, Kin noticed a chemical
smell kind of coming from the blood from the vial.
Cain handed the syringe to Welch and leaned closer to
the dying woman to trace the odor's source. Welch sniffed

(05:29):
the syringe and smelled something too. She said that she
thought it would smell like chemotherapy, you know the way
the blood smells putrid, and this is her speaking when
people are taking some of those drugs. Instead, Welch said
it smelled like ammonia. She passed the syringe to Julia Gorcynski,
a medical residence or resident, who noticed unusual manila colored

(05:52):
particles floating in the blood, an observation echoed by Umberto Ochoa,
the doctor in charge of the emergence sea room. He
was also helping treat Ramirez. Kin turned toward the door
of the trauma room and began to sway catch her.
Someone shouted, Ochoa lunged for Kin, caught her and gently
guided her limp body to the floor. Cain said that

(06:15):
her face was burning, and she was put on a
gurney and taken from trauma room one. Gorzynski, too began
feeling queasy, sing that she felt lightheaded. She left the
trauma room and sat at a nurse's desk. A staff
member asked Grzyinsky if she was okay, but before she
could respond, she slumped to the ground. She was now

(06:36):
the second member of the Riverside emergency room staff. Being
wheeled away from the trauma room on a gurney, Gorzyinsky
shook intermittently, over and over again. She would stop breathing
for several seconds, take a few breaths, and then stop
breathing again, which is a condition known as apnea, and
it's not just for sleep. Meanwhile, back in trauma, I

(06:57):
Welch became the third to succumb I remember hearing someone's scream,
Welch said. Then when I woke up, I couldn't control
the movements of my limbs. The surreal night would throw
Riverside General Hospital into newspaper and TV news broadcasts for
weeks as the frightening possibility of a human body releasing
toxic fumes captured the public's imagination. It also triggered one

(07:22):
of the most extensive investigations in forensic history. Medical detectives
from ten local, state, and federal outfits examined dozens of
potential culprits, from poisonous sewer gas to mass hysteria. So far,
all the suspects seem to have beaten the wrap except
for one extraordinary hypothesis, A team of researchers thinks that

(07:47):
a chain of chemical reactions may essentially have turned Gloria
Ramirez's body into a canister of nerve gas. Like, really,
how does that happen? I'm gonna get a little into it.
I understand some of it, some of it I don't.
It's it's all very scientific. Anyways. Several other staff members

(08:09):
began to say they felt ill, and hospital administrators declared
an internal emergency. They're like, just let's get everybody out
of here. Let's play it safe. You know something's going on,
don't know what, Let's just get everyone out, and Ochoa
ordered the staff to evacuate all emergency room patients to
the parking lot outside the hospital. A skeleton crew stayed

(08:30):
behind to help him. In a desperate struggle to save
Ramirez his life, her blood pressure continued to drop and
her pulse was growing fainter. Ochoa and three others repeatedly
administered electric shocks and drugs, but their efforts to stabilize
Gloria Ramirez failed at eight fifty in the At eight

(08:56):
fifty pm, Ochoa pronounced her dead. Two staff members moved
the body to an isolation room adjacent to trama one
because they're like, I don't know what the hell happened.
I don't know what killed this woman. I don't know
what's making everyone who treats her ill. But she needs
to be isolated and quarantined. I know that's the exact
same word. Immediately, and they did that. Outside in the

(09:19):
parking lot, hospital staff were treating patients and ill colleagues
under the dull orange glow of sulfur lamps. Because of
concern that the stricken staff had been felled by a
noxious chemical, which it did kind of seem like that's
what it was. They were stripped down to their underwear
and their clothes were bundled into plastic bags. They're like,

(09:39):
we don't know what's on here. We don't know if
it's like radiation, nerve gas, whatever. You got to get
the clothes off, you know, they got to go bye bye.
They could be contaminated. Gorchinski continued to experience tremors in apnea.
Cain flailed her arms and kicked, and her face still burned. Meanwhile,
Sally Baldaris, a vocational nurse who had gone back inside

(10:01):
to help take Ramirez's body into the isolation room, began
wretching and felt a burning sensation on her skin. Soon
she was in such bad shape that she too, was
laid out on a gurney. In all, twenty three of
the thirty seven emergency room staff members experienced at least
one symptom. Five were hospitalized for the rest of the night.

(10:24):
Baldarez endured bounts of apnea during a ten day hospitalization. Korchinsky,
the most severely ill, spent two weeks in intensive care, where,
in addition to apna, she suffered from hepatitis, pancreatitis, and
a vascular necrosis, a condition in which bone tissue is

(10:47):
starved of blood and begins to die. Like what in
the hell happened here? In her case, the avascular necrosis
attacked her knees, restricting her two crutches for months. It
takes a really potent toxin to do all that, said
Shelton Wagner, a clinical toxicologist at Oregon State University. Like

(11:11):
really truly what it gave her? Hepatatim it caused her
liver to fail, and pancreatitis that it caused multiple organs
to fail in this woman's body. Who was this doctor's
body who was just treating a patient. First on the scene.
Arriving at the hospital at around eleven PM was a
Riverside County Hazardous Materials team. The HASMAT team was after

(11:33):
a smoking gun. You know, they're like, what causes There's
got to be something like really obvious, some volatile toxicant
that might yet be lurking in the air of the
emergency room. They searched for any of a number of
noxious chemicals, including hydrogen sulfide, also known as sewer gas.
You know, it's stinky, it smells like farts, smells like eggs.

(11:57):
It's it's the sulfur, which you know, it's an insane
as poison, smells like rotten eggs. Has a high concentration
of sulfur that accounts for the smell, and at high
concentrations can kill a person after one or two whiffs.
And foster gene, which is a gas with a dual identity,
on the one hand, a law abiding ingredient used in

(12:19):
the preparation of many organic chemicals, and on the other
a terrible weapon for chemical warfare that tears up capillaries
and the lungs just rip them open, drowning Its victim
in their own blood. Yeah, that sounds really really horrendous.
To the relief of hospital administrators, the hasmat crew detected

(12:43):
none of these chemicals in the emergency room. I mean,
it would be a relief, but then you'd also be like, well,
what did happen? The hasmat team's lack of suspects was
not a relief to the Riverside Coroner's office, whose pathologists
were now let with the unnerving task of performing an
autopsy on Ramirez without a clue as to what the

(13:06):
body was harboring, perhaps a fugitive pathogen, a toxic chemical,
or nothing at all. Yeah, I'd be like, I don't
want to do this. This is one I don't want
to do. I'd be like, I'm gonna not no. So
they took no chances and they put on air tight
like you know, moon suits, something you'd see in a
movie when there is an outbreak the movie outbreak. In fact,

(13:29):
they put on these you know suits and disappeared into
a sealed examining chamber to work on the body. They
emerged ninety minutes later with samples of blood and tissue,
along with air from the body bag and an aluminum
crate holding the body itself. The coroner's office remained tight

(13:49):
lipped about the analysis that conducted in the days that followed.
One thing, however, is certain. Several days after the autopsy,
the Riverside Coroner had still found nothing remarkable and had
begun to solicit help. One consulting group was an obscure
outfit at the time called the Forensic Science Center at

(14:11):
the Lawrence Livermore National Laboratory. Livermore, situated about sixty miles
east of San Francisco, is rooted in the nuclear arms
build up that started shortly after World War Two, But
in the decades that followed, as the production of nuclear
weapons tapered off. You know that's what they want you
to think, Livermore and its fellow labs attempted to find

(14:32):
an identity better suited to a post Cold War world.
That goal fostered the creation in nineteen ninety of the
Forensic Center, a clearinghouse that would allow state and federal
law enforcement forensic teams to enlist high tech aid from
scientists at Livermore and other Department of Energy labs. And

(14:53):
this was nineteen ninety, so I'm sure they've just grown
in leaps and Bounds Forensic Center took up the Ramirez
case in early March when a Sacramento criminologist put the
Riverside Coroner's Office in touch with the center's deputy director,
Pat Grant. On March twenty fifth, after some preliminary discussions,

(15:14):
the office officially requested Livermore's help and shipped autopsy samples
on dry ice, of course, to the lab. And again,
I'd be like, not touching it. So alry, nobody knows
what killed this woman, hospitalized twenty something people in an
emergency room, and you're telling me there's absolutely nothing wrong
with her. I call not it. They said. We had

(15:36):
a meeting on the very last day of the month
to determine our exact game plan. This is according to
Brian Anderson, the center's director at the time. The plan
they developed was straightforward. Analyzed the compounds both organic and inorganic,
in the blood, bile, and tissues from Ramirez's organs, including
her heart, liver, lungs, brain, and kidneys. The team would

(15:58):
also check for any gases that may have off into
the samples or off of the samples into the headspace,
which is the pocket of air separating the samples from
the tops of their containers. They're like, all these people
got sick. They weren't exposed to like liquid or bodily
fluid really, so it's got to be a gas, right,

(16:18):
you know, should maybe something evaporated off of her blood.
That's when the first person got sick. Anderson suspected that
the headspace would be a likely retreat for a noxious gas,
particularly in the container holding the bile, which is a
yellowish secretion of the liver where poisons often concentrate. Isn't
the human body fun Not horrifying at all. But when

(16:42):
he warmed the bile to body temperature, you know, to
pull out any gases that might still be lurking in it,
all he found was nitrogen, oxygen, carbon dioxide, and argon,
which are normal constituents of air. I was hoping to
see a chemical, some small molecule that's going to knock
everybody down, but nothing was showing up there, he said,

(17:05):
next Anderson and next. Anderson analyzed the samples using a
high powered tool known as well. At the time, it
was very high powered. I'm sure it's way more high
powered now if they even still use it. Known as
a computer guided combined gas chromatograph, mass spectrometer. The procedure

(17:30):
was as follows. First, Anderson inserted a drop of a
prepared sample into the chromatograph. The drop, containing hundreds of chemicals,
was vaporized and shunted into a chromatography column, where it
was slowly heated to five hundred and seventy degrees. As
the vapors grew warmer, chemicals began to migrate along the column,

(17:54):
sorting out along the way according to their electric charge
and vapor pressure. You remember, if you didn't ever take
a past high school, you're probably like, I don't remember
any of this. I recently took a class where I did. Indeed,
UH have to touch again on chemistry and yikes. The
electrons shatter the molecules into all types of pieces, said Anderson.

(18:18):
The shattering pattern, unique to every substance, is called a
mass spectrum. By studying the mass spectra, andersen to find
the identity of a number of compounds that have been
circulating in ramirez system just before her death. Among them
were the drugs lydakane, thaile and all codeine and one

(18:38):
I have not heard of, tigan teagan and anti nausea medication. Yeah.
Usually I've done lots and lots of sedation surgeries, and yeah,
I don't remember using that drug as an anti nause
and they've they've since switched to another drug. Maybe that's
what replaced it, so Andersen. All So found a lot

(19:00):
of hydrocarbons chemicals that had leached into the samples from
their steril plastic containers. Medical personnel think of sterile as
being without bugs, not without chemicals, so the products they
use are super clean and sterilized, but of course covered
in chemicals. Literally, anything of matter, made of matter, consisting

(19:21):
of matter is some form of chemical. A trained forensic
eye can quickly dismiss such misleading signals, so they account
for that. Ignoring the red herrings, Anderson found a few
interesting anomalies. One was an unidentified a mean, a derivative
of ammonia that may have contributed to the ammonia like

(19:41):
smell that was noted in the emergency room. The investigation
by the National Institute for Occupational Safety and Health had
also found this amine and had suggested that it was
a possible culprit despite its very minuscule levels in the
autopsy samples. Anderson's team had more likely explanation for the amine.

(20:02):
They said, that it formed as Ramirez's body broke down
the anti nausea drug tagan. Huh, so maybe that's why
they don't use it anymore. A second peculiar find was nicotinamide. Yeah,
I just said that word, nicotinamide. I haven't seen that
one before. A compound like phosgene with a dual personality.

(20:24):
It's a B vitamin crucial to human health, but it's
also mixed into illegal drugs like methanphetamines. We always find
a way to fuck it up, don't we. Since nicotinamide
is relatively inexpensive and can cause euphoria, dealers can extend
their expensive drugs with it and make a larger profit.

(20:44):
Now they use ventanyl. I wish they would go back
to whatever this is. It's an unusual compound for someone
to be taking if they're very, very sick, said Anderson.
A third odd chemical signal defied being pigeonholed as either
trivial or important. Dimethyl sulfone. Dimethyl sulfone is a molecule

(21:06):
almost said sull phone. Did I say sulfone? Dimethyl sulfone
not dimethyl sull phone is a molecule composed of one
sulfur atom, two carbons, six hydrogens, and two oxygens. It
is manufactured as an industrial solvent, but it also sometimes
produced naturally in our bodies from amino acids that contain

(21:29):
sulfur broken down by the liver. Dimethyl sulfone has a
half life in the body of less than three days,
so healthy people never have measurable amounts in their system.
But in Ramirez's blood and tissues there was a hefty
concentration of tens of micrograms per milliliter, which is about

(21:51):
three times higher than the codeine that was also found
in her blood and body tissue samples. At this point
in the mystery, the only unusual thing we're seeing is
dimethyl sul phone, said Anderson. But dimethyl sul phone itself,
did I say cell phone again? Damn it? But dimethyl

(22:13):
cull phone itself could not knock out an emergency room.
So when Anderson flew to Riverside on April twelfth to
brief the coroner, he concluded that he had found nothing
that looked like a poison. Anderson recalled some anxious questioning
by the coroner's office, you know, of course, in hopes
of finding a smoking gun. But he insisted that it

(22:34):
appeared Ramirez had simply taken a lot of codeine and thailand,
all which in large sustained doses can indeed cause liver damage.
But like a lot, like taken a lot takes a lot. Uh,
let me say it again, it takes a lot. I
feel like I said it way too many times, so
I had to add one more to it, just to
be obnoxious. He also highlighted the findings that had intrigued him,

(22:57):
the amine that might have caused the ammonia like oh,
or the nicotinamide or you know that's the one, and
the dimethyl cell phone. There clearly was something unusual going on,
but nothing that could have resulted in ramirez Is death
or the emergency room symptoms. According to Anderson, he was
discouraged and said, I remember thinking, how could I spend

(23:19):
this much time and not find anything. I would be
too I'd be like, oh God, I want to solve this.
This is crazy. This is like something that's on house
or bones or one of those you know, like medical
mystery shows where some highly intelligent, ultra specialized scientists figures
out something that absolutely no one can figure out, and
probably you know it's a freak thing that will never

(23:39):
ever happen again. So the Riverside Coroner's office felt it
had reached the end of the road. They're like, I
don't know, we don't have anything else, And at a
press conference on April twenty ninth, they revealed the autopsy results.
Coroner Scottie Hill announced that Gloria Ramirez had died of
cardiac dysarrhythmia trigger by kidney failure stemming from her cervical cancer.

(24:05):
The investigation into her death, Hill said, was finished. As
for the illness in the hospital workers and how that
might be linked to Ramirez, this is obnoxious. Hill concluded,
the exhaustive toxicological studies had not identified any external toxic
substances that would have contributed to her death. And when

(24:26):
I said that's obnoxious, I'm prefacing a theory that comes
up soon, the mass hysteria theory, which I don't like
at all. Although the books on Ramirez's death were officially closed,
there was no explanation for the outbreak of illness among
the hospital staff. The county health department called in California's

(24:47):
Department of Health and Human Services, which put two of
its top scientists on the case doctors Anna Maria Osorio
and Kirsten Waller. They interviewed thirty four hospital staff who
had been working in the emergency room on February nineteenth.
Using a standard questionnaire, Osorio and Waller found that the

(25:08):
people who had developed severe symptoms, such as loss of consciousness,
shortness of breath, and muscle spasms tended to have certain
things in common. Perhaps unsurprisingly, people who had worked within
two feet of Ramirez and had handled her intravenious lines
had been at high risk, but other factors that correlated

(25:28):
with severe symptoms didn't seem to match a scenario in
which fumes had been released. The survey found that those
affected tended to be women rather than men, as well
as people who had skipped dinner that evening rather than
those who had a full stomach. And that again, that's
so lazy to me. They're like, Okay, it's mostly women
and they didn't eat dinner. Have you considered that that's

(25:50):
what caused all of this. It's like somebody had liver
failure and pancreatic like pancreatitis and people were paralyzed, Like,
what are you talking about? They didn't because they didn't
eat dinner. Those symptoms did not develop from that. Give
me a fucking break. Those findings, coupled with the autopsy results,
the hazmat analysis, and the unremarkable blood tests you know

(26:14):
from the stricken hospital staff, led to an official report
that the Health Department released on September second, the conclusion
the hospital staff most likely experienced an outbreak of mass
sociogenic illness, perhaps triggered by an odor. In other words,
they'd been felled by stress and anxiety. Give me a break.

(26:36):
In support of this mass hysteria theory, Osorio and Waller
cited the lack of evidence for a poison and the
fact that women were more likely to suffer severe symptoms,
both hallmark signs of mass hysteria, because whenever anything happens
to a group of women, you know, it's always made up.
It's always we're crazy. We're hysterical, not in a fun way.

(27:00):
In addition, they pointed out neither paramedic who treated Ramirez
in the ambulance became ill, despite the close quarters and
their having touched her skin and some of her blood
after starting an intravenious line. However, Osorio and Waller did
not rule out the possibility that the substance had poisoned
emergency room staff who had worked directly over Ramirez. Yeah,

(27:24):
there's a lot of factors there that they're not taking
into consideration. So the Health Department's report triggered another flurry
of news reports. These featured Gorzensky and her lawyer, physician
Russell Cusman, who denounced the massesteria conclusion. It's like, bitch,
she is a doctor, Like, give me a break. By

(27:47):
that time, Gorzensky had filed lawsuit and I would too,
against Riverside General Hospital, the Coroner's office, and several others,
seeking six million dollars in damages. A report suggesting that
Gorzyinsky experienced psychosomat symptoms would certainly not play well for
her in court. The report may be based on you know,
politics or straight up ignorance, but it's not based in science.

(28:10):
Custom to hold the New York Times, these are all
professional emergency room workers. They don't become hysterical because of
a heart attack. Yeah, and when he puts it that way,
you're like, oh, that does sound dumb as hell. These
two women came in from the Department of you know,
Health and Human Services, and they're like, well, it was
a lot of women and they didn't eat, and you

(28:32):
know what happens when we don't eat, we get hysterical.
It's like, I feel like the Department sent two women
for that very reason, so that if they had said,
you know, if they'd sent two men, and the men
had come up with that conclusion, they would have been like,
you know, of course, you guys are misogynists and sexists
who are just you know, repeating antiquated theories about women.

(28:56):
But so they sent two women. They probably sent them
ahead of time, and we're just like, oh, okay, if
you can't find anything like glaringly obvious, let's just say
like it was in these women's heads, like maybe they're
all in their periods. Did you ask? Because that's science,
right anyway. The state report also angered some of the
emergency room staff, including Welch. She was convinced that neither

(29:18):
she nor anyone else that night had been party to
mass hysteria. She wanted someone to look at the case
more closely, and in her opinion, Livermore was the only
laboratory involved without a vested interest. Yeah you know this.
Of course the state is going to say, no, it's
totally fine, don't freak out, there's nothing causing nervous system

(29:42):
chemical gas to occur in a human body that isn't
happening in California. It was just you know, crazy women again.
They'd just be passing out. They'd be fake and pancreatitis
and liver failure. They do it every day, women be
shopping like this was the that theory probably probably would

(30:03):
have flown pretty freaking well. Welch called Anderson at Livermore
and implored him to take another look. Wow, I said
that weird look. To help lure him back to the case,
she sent him a copy of a scrapbook of material
she had accumulated, including news stories, the Riverside Coroner's report,
legal briefs, and toxicology reports. Anderson asked Grant, his deputy director,

(30:28):
to sift through the file to refresh Grant's memory of
the case. He also should showed him his own results,
including the puzzling compounds he had identified. Anderson laid out
a paper with the gas chromatography, mass spectrometry vivid spectrometry
results and a graph with spikes similar to earthquake readings

(30:50):
on a seismograph, and pointed at the dimethyl sulfone peak
Grant was a bit hesitant. I'm a nuclear chemist. In
my organic chemist knowledge, truthfully is minuscule, he said. Grant
mistook dimethyl sulphone for dimethyl sulfoxide or dmso. The only
difference between the two chemicals is that dmso has one

(31:13):
oxygen atom, not two. Grant was more familiar with DMSO
because he said, I'd use dmso in a former life
as an athlete. Here's where it gets pretty interesting. Apparently, dmso,
I don't think anymore, but then was sold in a
gel form at hardware stores as a heavy duty de
greaser and has long been a folk remedy among athletes

(31:37):
for achy muscles and joints. Oh Anderson corrected him, saying
the spike was actually dimethyl sulphone. Grant didn't get to
Welsh's file until a few days later, when he was
on a flight to a business meeting in Washington, DC.
There were a lot of things we hadn't seen before,
he said. One thing that particularly struck him was a

(31:59):
spa in the autopsy report about the source of the
garlicy odor on Ramirez's body, and of course the oilychene
dmso so. This chemical DMSO has a checkered past. During
the mid nineteen sixties, a flurry of research showed that

(32:20):
it had remarkable healing powers, easing intractable pain and reducing anxiety.
But the rise of this potential wonder drug was cut
short when animal tests showed that prolonged exposure to DMSO
altered the lens of the eye. And that's something you
don't want to do. I'm not a doctor, but you don't.

(32:40):
You don't want to do that. I feel like. Fearing
that a DMSO drug might ruin people's vision, the Food
and Drug Administration, or the FDA, ordered companies to cease
clinical trials of the drug in nineteen sixty five. The
FDA later relaxed that policy and in nineteen seventy eight
approved a fifty percent solution of DMSO as a treatment

(33:03):
for interstitial cystitis, a condition marked by painful urinary tract
lesions that occurs predominantly in women. And so they're guinea
pigging us. Yet again, I'm sure that didn't have any
harmful consequences. Nothing bad happened, I'm sure. Meanwhile, over the
thirty years that followed, DMSO gained an underground following as

(33:24):
a home remedy even back then. Huh. Not only did
Grant use it, but Anderson as well remembers the DMSO
rage from his days during the nineteen seventies as a
pharmacology professor at Ohio State University. It seemed that everybody
in the athletic department was using DMSO on injuries. You

(33:44):
were called nor But its use was not just limited
to athletes. People use it for a variety of ailments,
from arthritis to muscular strains, said George Rutherford, California State
epidemiologist at the time. But given its potential side effects,
it's a dangerous remedy because in its readily available hardware

(34:07):
store grease cutting form, it is ninety nine percent pure.
Don't do that, like the God taking pure stuff? Like?
Does that ever go well for anybody? Does it alarmed
by growing? Seriously? Does it ever alarmed by the growing
cult of DMSO users. The FDA issued a warning to

(34:30):
physicians in nineteen eighty counsel patients against purchasing DMSO of
unknown quality and medicating themselves. Yeah. Uh, it doesn't sound
like anything good happens when you use it, especially something
that's almost one hundred percent pure. But even if Ramirez
had been applying dmso to her body to ease her pain,

(34:53):
and even if it had combined with oxygen to form
dimethyl sulfone, Anderson had found that still bill didn't explain
the outbreak among the hospital staff. Grant decided to find
out more about dmso and dimethyl sulfhone, so when he
got back to Livermore, he looked up the two compounds
in the MRK Index, which is a chemist's bible that

(35:15):
describes the characteristics of more than ten thousand chemicals, drugs,
and biological substances. Since dmso can react with oxygen and
form dimethyl sulfone, Grant began to wonder what other compounds
might be formed when oxygen is added to the chemical.
Let's find out, isn't it horrifying? On the same page

(35:36):
of the index that he had been reading, he found
the answer, dimethyl sulfate. It was one of those deals
that was pretty fortuitous. According to Grant, in chemistry, little
changes can sometimes lead to very big results, very dangerous results.
Add one oxygen atom to dmso and you get dimethyl soulfhone.

(36:00):
You change one solvent to another. Now add two oxygen
atoms to dimethyl sulfone, which in chemical notation is written
CH three two S two, and you get dimethyl sulfate,
which is written as H three two S four. A
truly nasty chemical. Vapors of dimethyl sulfate, the Index explained,

(36:26):
kill cells in exposed tissues such as the eyes, mouth,
and lungs. When absorbed into the body, dimethyl sulfate causes convulsions,
delirium paralysis, coma, and delayed damage to the kidneys, liver,
and heart. In severe cases, the vapors kill. Like many

(36:47):
other chemicals, dimethyl sulfate has a good side and a
really really bad side. Industries use dimethyl sulfate to tack
methyl groups onto organic chemicals, but the index also bo
said dimethyl sulfate is a war gas. Yeah. Here, finally
was a chemical that could cause some real damage. Realizing

(37:09):
dimethyl sulfate was their best lead, Richard Whipple and Jeffrey Haas,
chemists at the Forensic Center, searched among the thousands of
papers that had been written about these compounds. One reference
was particularly enlightening if grizzly, A classified Department of Defense
document issued in nineteen eighty seven, called the Reference Book

(37:32):
on Chemical warfare information. It reported that a ten minute
exposure to half a gram of dimethyl sulfate dispersed in
a cubic meter of air can kill a person. It's
not a lot, is it. Although dimethyl sulfate has been
tested as a nerve gas, it has apparently never been
manufactured for use in war. Let's don't give anybody any ideas, okay.

(37:56):
The Livermore team was able to call details about the
symptom of dimethyl sulfate exposure from the reference book, as
well as from a safety sheet that accompanies any dimethyl
sulfate purchased by any industry. A leader of dimethyl sulfate
sold at the time for around thirty two dollars. The
match between the symptoms experienced by the hospital staff and

(38:18):
the symptoms of dimethyl sulfate exposure was uncanny. Of the
twenty types of symptoms reported by the staff, from the
fainting to the convulsions to Gorchinsky's hepatitis, only one nausea
and vomiting is not a symptom of dimethyl sulfate exposure,
Which you're like, how the two simplest things really, When

(38:40):
there was such a nice match on the symptoms that
was the first indication that we might really have had something,
Grant said. Still, the forensic team realized they needed to
answer some tough questions, and of course they needed to
do an experiment before they would feel comfortable explaining their
theory to the Riverside coroner. Despite their desire to press forward,

(39:02):
they had to put the Ramira's case on the back
burner for the rest of September. The Livermore scientists had
been working on the case for free as a public service,
after hours and on the weekends. Now they were under
the gun to finish a technical report to the organization
paying their bills, the US Department of Energy, Livermore's parent agency,

(39:22):
by September thirtieth. They're like, okay, we don't want to.
In early October, when the Livermore scientists took up the
Ramirez case again, they first had to decide whether her
body could have generated the dimethyl sulfate that Anderson had found.
Evidence of dimethyl sulfone in Ramire's blood, and Organs pointed

(39:46):
to her having first been exposed to DSMO or dmso wrong.
One other precursors of dimethyl sulfate, like sulfur bearing amino
acids probably couldn't produce enough of the chemical to wreak
so much havoc. The researchers could think of two scenarios
that might explain how Ramirez had been exposed to DMSO.

(40:08):
I don't know why. That's so hard for me to
say right now. In one, Ramirez spread a cream on
her skin that contained a finn cyclodine known as PCP.
I'd never remember the whole name for PCP, but apparently
it's fin cyclodine better known as PCP or angel dust

(40:29):
dissolved in a DMSO carrier base, which apparently is a
common way to take the drug. I don't know, never
done that. According to an August report on the Riverside
incident by Tam Smallstig, an industrial hygienist with California's Department
of Industrial Relations, the Riverside Coroner's office had told the department,

(40:49):
without elaborating, that Ramirez's body had indications consistent with finn
cyclodine use, and they're like, all right, this lady's take
in PCP, okay. This scenario would explain the presence of
the nicotinamide that Anderson had found in Ramirez's blood and tissues.
It had been mixed in with the PCP to extend it. Sure, right,

(41:12):
But if Ramirez had taken PCP, someone should have found
traces of the drug itself. No one did, and so
the Livermore team decided that this scenario was impossible. This
lady's dying. You think she's out there taking PCP and
like adding it to a base of another chemical and
you no good God. Rather, the Livermore team thought the

(41:35):
more likely event was that Ramirez had rubbed DMSO on
herself to relieve the pain from her cancer. That would
account for the oily sheen and garlicy odor observed by
the staff. Ramirez's family has since denied that she was
using either DMSO or PCP before her death, but if
she did use a DMSO gel for her pain, it

(41:58):
would have been far from unusual. It's been estimated that
at the time, two thirds of cancer patients used some
sort of an unprescribed home remedy for their disease. And
probably still do anything really that might help, I understand
wanting to try. When Ramirez collapsed, presumably from cancer related

(42:19):
kidney failure, and was put in an ambulance, the paramedics
put an oxygen mask on her face. Oxygen molecules flooded
her bloodstream, combining with the DMSO in her system. The
researchers hypothesized to form high levels of dimethyl sulfone. The
higher the concentrations of the ingredients required, the more efficiently

(42:40):
chemicals or chemical reactions will run. Thus, with so much oxygen,
no dmso was left untransformed. Now, the Livermore team needed
to figure out the next step how the relatively harmless
dimethyl sulfone could have converted to the the wildly harmful

(43:02):
dimethyl sulfate. This is where we were afraid we might
find a showstopper that would kill the theory, said Grant.
They conducted an experiment to see how much dimethyl sulfone
could accumulate in the blood at normal body temperature. They
dissolved the compound in a transparent liquid called Ringer's solution,
which is basically all the ingredients of blood minus red

(43:24):
blood cells. We found we could load it up in
the Ringer solution to an applicable extent without any sweat,
said Grant. The autopsy, the researcher's note had found that
Ramirez had a urinary tract blockage that could have aggravated
the buildup of dimethyl sulfone by preventing it from being
flushed out of her system. When they cooled a vial

(43:47):
of this ringer solution crammed with dimethyl sulfone to room
temperature roughly seventy degrees, they were greeted by a good sign.
The solution became supersaturated and dimethyl sulfone began to form
white crystals, said Whipple, who experimented with Grant. In real life,
those crystals might have appeared Manila colored or tannish. Thus,

(44:11):
this process could have produced the crystals that had been
observed in the syringe in the hospital, particularly since the
emergency room or emergency rooms in general, tend to be
cooler than most rooms about sixty six degrees. So so far,
so good, right, But how did the dimethyl sulphone convert

(44:31):
the nerve gas or convert to the nerve gas dimethyl
sulfate the Livermore chemists envision a reaction which hasn't yet
been observed, but you know that's science, baby, in which
some of the molecules of dimethyl sulfone in Ramirez's blood
broke apart. What had been h three two s two

(44:52):
became ZH three, H three and SO two sulfates, which
have the chemical makeup SO four and that's sulfur oxygen
four four molecules of oxygen molecule of my god sulfur
are common in the body. So the two H three
molecules or carbon and three hydrogen molecules may have linked

(45:14):
up to form them may have linked up with them
to form H three twos four, which is dimethyl sulfate.
But in her warm blood, the dimethyl sulfate was unstable
and quickly fell apart into its hydrocarbon and sulfate components.

(45:36):
There was not yet of the There was not yet
a sufficient amount of nerve gas to harm the paramedics.
Makes sense. When Susan Kin drew blood at the hospital, However,
the cool temperature had slowed the breakdown of the dimethyl sulfate.
Appreciable amounts of it built up in the syringe, and

(45:57):
some of it vaporized out of the blood. This was
the gas that poisoned the emergency room staff. Dimethyl sulfate
does not vaporize easily. The Mark Index lists its boiling
points at three hundred and seventy degrees. It's a lot. Nevertheless,
According to Grant and other chemists, some fraction will still

(46:17):
vaporize at room temperature. The crystals of dimethyl sulfone turned
into dimethyl sulfate as well, and they vanished from sight.
In the end, all of the dimethyl sulfate either vaporized
or broke back down into the blood of its constituents,
and thus the macabre chemistry of that night hid most

(46:41):
of its traces from investigators. It's a really clever piece
of detective work, said Oregon State toxicologist Frank Dast. It
would seem to me that it would take a hell
of a lot of DMSO, but in that stage of
fighting for her life, Ramirez may have really overloaded on it,
he said. Riverside Coroner's Office apparently agreed. It released the

(47:03):
Livermore report, hailing its conclusion as the probable cause of
the hospital worker symptoms. You don't want to go with
mass hysteria in the women, are you sure? In the
women doctors and the women folk. That's not what you
want to go with. Okay, cool, But the theory, of course,
provoked a backlash from other scientists. Several organic chemists have

(47:25):
scoffed at the step by step change of DMSO into
airborne dimethyl sulfate. I'm pretty skeptical, said I'm pretty scriptical,
said Hans Reich, an organic chemist at the University of
Wisconsin at Madison. Reich doubts the dimethyl sulfone would split
apart in the human body's relatively cool environment. I've used

(47:47):
it as a solvent up to at least three hundred degrees,
he said. Other scientists don't see a match between the
symptoms of the hospital staff and some of the symptoms
of industrial workers who have been accidentally exposed to dimethyl sulfate.
The stuff is like teargas, said Jack de Latour, a
physiologist and professor of neurosurgery at the University of New Mexico.

(48:10):
When you're exposed to dimethyl sulfate vapors, the first thing
that happens is it makes you cry. None of the
hospital staff reported tearing or other eye irritation. Furthermore, many
other known effects of dimethyl sulfate usually takes several hours
to hit, and yet the fainting spells and other symptoms
at the hospital began to occur minutes after the supposed exposure.

(48:34):
One of the harshest critics of the Livermore theory is
a scientist who did much of the clinical research on
DMSO in the early nineteen sixties. Stanley Jacob, a physician
and medical researcher then Anyway at the Oregon Health Sciences
University in Portland, doubts the significant quantities of the suspect
chemicals could have produced or could have been produced from DMSO.

(48:58):
In fact, Jacob said, the Livermore scientists should have never
allowed the Riverside coroner to release the report. It's like
that silliness with cold fusion, except I don't know what
he's talking about, except this has the potential to hurt people.
He said, what's silliness of cold fusion? I don't know.
His office has received dozens of calls from worried women

(49:19):
being treated with dms SO for interstitial sostiitis, and I
guarantee they don't use it to treat that anymore. I
just tell them that dimethyl sulfate theory is a chemical impossibility,
says Jacob. I don't think you can call it an
impossibility because, quite literally, if you add a couple of molecules,
or take a couple of molecules of oxygen away from

(49:41):
one of the compounds. It does indeed convert from one
to the other, and just because no one's ever seen
it happen in nature before doesn't mean it can't. But
other scientists come to Livermore's defense. Mark mccausey, director of
the National Museum of Health and Medicine in Washington, DC,
is one mccausey. He's a forensic pathologist who has helped

(50:02):
investigate dozens of unusual deaths. He points out that forensic
investigations often failed to find the actual smoking gun, but
they can still come to valid conclusions. No one clue
gives a perfect fit to explain to death, but when
all the clues are added up, you get a pattern.
Sometimes it's a pattern that we've never seen before, he said,

(50:23):
such as the Riverside case. But even though there's no
way to prove Livermore scenario, I think they gave us
a report that's quite interesting and analytical, he said. And
I agree. Anderson thinks some of the backlash was avoidable.
We just wanted the coroner's office's opinion, and they took
it and said this is the answer. It caught us

(50:43):
way off guard. We've never said that this is what happened,
just that people should look into it, and people still
go nuts. Nevertheless, he thinks the hypothesis is a good one.
I've gotten messages on my answering machine from chemists who
say it's an impossible conclusion, said Anderson. But most hadn't
even read our report, and some of them change their

(51:04):
minds after I explain our hypothesis. It is true. He
noted that no one has done experiments, at least at
the time, to show that dimethyl sulfate is produced when
dimethyl sulphone breaks apart and recombines with the body sulfates.
Yet chemists have on several occasions discovered that seemingly impossible

(51:24):
reactions turn out to be quite possible. Yet Oi Anderson's
team is going to or said they were going to
conduct more experiments and check Ramirez's blood again. They hope
to turn in another preliminary report and you know, submit
their findings in a paper and then submit that to
a forensic journal. He also said that then, thanks to

(51:52):
the publicity of the Riverside case, they'll have no problem
shifting from one Eldritch tail to another. They're swamped with
calls and letters urging them to get to the bottom
of a host of mysteries at the time. You know,
Gulf War syndrome, the symptoms suffered by some US soldiers
who fought in the Persian Gulf golf do I say
golf golf two sudden infant death syndrome, which there still

(52:14):
has not been really any progress on. People are frustrated
and want us to look at these cases from a
chemistry point of view, said Anderson. Fourteen months after the incident.
The Riverside cases legacy remained peculiar and shadowy, and to
this day pretty much the same. If Anderson's team was correct,

(52:35):
one has to wonder whether the outbreak was unique. But
you know, researchers at the time still could not find
similar poisoning in the medical annals, nor could they say
whether hospitals should fret about future cases. I couldn't find
any cases since then. But again that doesn't mean it
didn't happen. It just could have been a perfect chemical storm.

(52:57):
The Livermore scientists do offer a cautionary note in their report,
which recommended that hospitals be made aware of the possible
consequences of such a chemical reaction occurring in their emergency room.
Other scientists are more convinced that the action is necessary.
This is likely to occur again dmso is not uncommon,

(53:18):
asserted Barry Taylor, a microbiologist at Low Melinda University of
Medicine who followed the case closely. In the end, though,
the river Side case leaves us with a warning and
a puzzle. The warning is that the human body can
be a place where bizarre and potentially deadly chemistry and

(53:39):
chemical reactions can occur. The puzzle is that if the
Livermore investigators are wrong, then what did happen in the
Riverside emergency room on February nineteenth, nineteen ninety four. And
to that, I say, what the fuck happened? I got
nothing got go with seemingly Okham's raiser here that some

(54:05):
strange chemical reaction took place, literally a perfect storm of
chemical reactions and chain reactions took place, and she quite
literally became filled with some sort of a toxic gas.
Whether it's you know, the exact toxic gas that they
thought it was at the time, I don't know, And

(54:28):
i've you know, looked into it since then. Really there
have not been There hasn't been anything more conclusive proven
about her. Gloria Ramirez and her death and what may
have caused it. Since the nineties, I've seen a lot
of articles written and you know, news story saying that

(54:51):
the cause of her death was dimethyl sulfoxide or sulfone.
But I just don't know. I think it's a good theory.
I think it's a good, you know, working theory. Are
they ever going to be able to recreate it? Probably not,
because you know, with an experiment, you have to have

(55:11):
the same controls in place. So it would have to
be a clone of Gloria Ramirez the exact same time,
the exact same location, the exact same everything, the exact
same life experiences, the exact same exposure to environment, medication, food, drink,

(55:33):
literally everything. It would have to be a clone who
had had the exact same life, who had done everything
exactly the same way as Gloria Ramirez up until that day,
and then she would have to receive the exact same
medical treatment in order for that result to be reproducible,
because I mean, you just can't. You can't reproduce that result.
They don't know what she was taking. They didn't find

(55:55):
anything illicit in her body, like you know, there was codeine,
but she was I'm sure prescribed that for pain. Yeah,
I don't think you could ever tested that again. And
that's why nobody's been able to reproduce the result or
approve or disprove the theory one way or another, because
I think it was indeed a perfect storm of chemical reactions.

(56:17):
Like I don't really feel like there's any other explanation.
It would have to be something that would dissipate as
a gas. And like they said, the particular chemical that
they thought was released into the air has a half
life of only a couple of days, So they wouldn't
have found that in her system. They wouldn't have found
that in any of the other patient's system, you know,

(56:39):
any of the emergency room staff. They wouldn't have found it.
It would have been dissipated from her body. When it
turned into gas. They would have inhaled it and had
their reaction, and I feel like it would have been
much less noxious when it entered their bodies. And they're like, oh, well,
the paramedics didn't have any issues. Well, that was at
the very beginning, and they introduced oxygen, which seems to

(57:02):
be the catalyst to the chemical reaction that caused a
noxious gas to come out of her body. Is that
what killed Gloria Ramirez. I don't know. It sounds like
she already had, sounds like she was close to death already,
and just the introduction of the additional oxygen just being
flooded into her system. I feel, you know, again, I'm

(57:26):
not this kind of scientist I am, and I'm not.
I do have a degree in biology, and part of
that I did have to take a lot of chemistry. Uh,
but I'm not like super good at chemical reactions because
I suck at math. I fucking hate math. I'm pretty
sure I have I don't remember what it's called. This
calcula or this calculus something like that. It's like it's
like dyslexia for math, like really truly, I look at

(57:50):
like complex math anything past, like you know, multiplication, division,
all that stuff, algebra. I look at it and it
just angers me. I can do chemical reactions, all right,
because it's not like super complicated, But I don't know
if that's possible. It seems in theory that it is possible.
And again, like people can argue all they want about it,

(58:11):
you can't reproduce it. You won't be like nobody would
be able to. Like I said, you would have to
have literally several clones that all grew up, did the
exact same things, had the exact same experiences every single day, eat, drink,
live the same way. Have that literally everything would have

(58:33):
to be the same. You have to use the same
kind of products on your skin and in your hair.
You would have to take the same medications. You would
have to go the same place. You have to live
the same place the exact same place, be drinking the
same water, driving the same car, breathing in the same atmosphere,
all of it. So they're really in order to then

(58:54):
introduce later down the line a ton of oxygen into
their blood streams to see if again this gas could
be created, which again that's just not gonna happen. So
their guests is as good as anyone else's, really, all right,
I'll stop speculating. Science is crazy, the human body is crazy.

(59:17):
Weird shit doing weird shit, And hopefully I never become
a toxic lady myself. And the only toxic lady that
I'm into is Britney Spears. And if you don't get
that reference, Jesus, you are young and I love you,
sweet sweet baby. It's a song. Go look it up.
There's a dance. Britney Spears is not just a you know,

(59:39):
an unstable lady that Instagram has made her out to be. Now,
she is a she's a star, She is a pop star,
she is an icon, she is everything, and she is
my favorite toxic lady. All right. If you like what
you hear, you can hear more episodes hopefully every Friday.
We're released on old podcast platforms if I can get

(59:59):
off schedule. I love my job, I love my job anyway,
released on all podcast platforms. On social media, you can
find me on Instagram and threads at Autumn's odd Cast,
on Facebook at autumnsodities, and I'm patreon at Autumnsodities. Any
level of subscription offsets the cost of me writing and

(01:00:23):
recording these episodes and the software that I use and
all that good stuff, and just really would be appreciated.
It would make me feel very, very appreciated and very loved.
That said, you know that I love all of you.
Don't become toxic ladies if you can help it, and
toxic gentlemen and toxic others. Try not to be toxic.

(01:00:44):
Try not to use anything that might convert your blood
into a nerve gas. You know, it's just good advice
to follow in your life. As always, I appreciate you listening,
and remember, if it's creepy and weird, you'll find it here.