The death of Karen Wetterhahn: if she had known immediately, what could have been done?

Karen Wetterhahn was a chemistry professor who died in 1997 from exposure to dimethyl mercury. People were shocked because she had taken all of the recommended safety precautions, and yet the couple of drops she spilled on her latex glove seeped through and poisoned her.

Interestingly, she didn’t develop symptoms until about six months after exposure. The Wikipedia article says:

The implication is that had she realized right away, something could possibly have been done to save her life. What could have been done for her at that point?

You always hear about chelation as a treatment for heavy metal poisoning, generally the earlier that happens the better.

Why is earlier better? If you take a poison orally, early treatment is better because you can catch it before it goes from your stomach to your bloodstream. But in this case, the poison was immediately in her bloodstream. What was happening to her body during the six months between exposure and onset of symptoms?

I don’t necessarily think I should go further since I’m not a doctor or scientist and this is GQ. But I would say some toxins basically damage the body over time by wrecking important structures and etc. Chelating agents the earlier delivered would minimize the harm done.

I know that mercury poisoning in general, mercury reacts with elements in the body that are used in processes that reverse ordinary “wear and tear” type damage so I would say the longer the mercury is present at high levels the more ordinary “wear and tear” type damage is left unrepaired and the more damage occurs to the body.

Dimethylmercury is nasty stuff, worse than simple mercury poisoning. Early detection may not have helped, but they could have tried.

One particularly grim element in her case:

That’s a classic safety error (not necessarily on her part, but “the system’s”) – assuming, but failing to verify through testing, that a given safety measure will prevent a particular hazard. The chemists who worked with dimethyl mercury knew it was a small molecule; they knew that small molecules can pass through some barriers; apparently, nobody tested the gloves until AFTER a death.

Methylmercury compounds are firstly neurotoxic. They harm astrocytes and neurons, even at low concentrations for short exposure times. If the mercury is not removed from the body (which chelation therapy does) it will continue to damage cells. Methylmercury is soluble in fats and will accumulate in the brain and other fatty tissues.

Methylmercury causes damage through oxidative stress. I did research years ago that showed mitochondria were damaged in immune cells with even very low concentrations of organic mercury. (Not my paper, but the basic gist of it: Low-level methylmercury exposure causes human T-cells to undergo apoptosis: evidence of mitochondrial dysfunction. Shenker BJ. Guo TL. Shapiro IM. Environmental Research. 77(2):149-59, 1998 May.) IIRC, similar mechanisms damage brain cells. So even before the mercury accumulates in the brain, it will damage other tissues on its way there.

Poisons usually attack quickly; they’re designed* to interfere with a specific biological function. Some poisons are horribly fatal to certain families of insects, but you could drink it like wine. Some “poisons” temporarily paralyze, others close airways, and some mess with critical chemical paths.

Oral poisons do not need to get into your bloodstream, and there’s virtually no way for a poison to get into your bloodstream from the stomach. This is why snakes and scorpions bite and sting.

Heavy metals (and radiation) are not like that. These are only dangerous because of basic chemistry; they do sustained damage to the body over time because they aren’t focused on critical biological necessities. They will tend to hurt you in very general ways over a long period of time, as a degenerative force rather than an acute attack.

That being the case, with poison you usually try to weaken it quickly, making the poison less deadly and making the effects less deadly, or stretched over a longer period. For example, if bitten by a snake, most basic treatments involve lots of rest: you slow the heart and let the poison work its way through without fdamaging the body. With heavy metals (and radiation), you get it out of the body fast. This lets you halt the damage before it becomes serious. We have things like chelation therapy and radio-binders to try to do this.

*Designed by evolutionary forces etc. etc. Let’s not get into that level of pedantry here.

Heh. Checking out TriPolar’s link, I see a further irony. Part that I cut out of my Wikipedia quote from the Wetterhahn article for brevity:

But the dimethyl mercury page itself says this:

Apparently Neoprene itself is no protection either.

That is essentially correct. However, dimethyl mercury, with the mercury atom being attached to two methyl groups, is especially insideous as it forms complexes with amino acids and can thus become embedded in cellular material, interfering with reduction reactions by enzymes using selenium and inhibiting repair of myelin sheathes, resulting in neural dysfunction. There was probably little to be done for Dr. Wetterhahn even if the exposure was known.


Getting back to the OP, would amputating her hand have saved her if done PDQ?

Unlikely, but I doubt anybody has tested it. The poison didn’t enter only the bloodstream and use it as some sort of highway to reach its target cells: the target cells are nerve cells, which for those substances able to enter them form their own road system (a nerve cell goes all the way from wherever its tail is to the central nervous system). By the time an amputation could be arranged and performed, part of the poison would already be beyond any feasible amputation point and would have needed to be removed through chelation.

Surgery is valid only for things that are contained in a specific volume - it’s not usually the recommended action for poisoning.