Tuesday, May 10, 2011

Problems for recent bin Laden Death (Given his Medical History)

By: Dr. J. P. Hubert

There are a number of seemingly inexplicable problems which need to be surmounted if it is to be credibly established that Osama bin Laden was only very recently killed. These arise after a careful consideration of his alleged medical history.

First, Bin Laden purportedly had renal failure in 2000-2001—he reportedly received medical treatment for a urological problem at the American Hospital in Dubai in July of 2001. His physician at the American Hospital in July 2001 was, reportedly, Dr Terry Callaway. The CIA station chief who met bin Laden in the hospital in July 2001 was, reportedly, Larry Mitchell. According to a CBS report by Dan Rather and Barry Petersen, 28 Jan 2002, Osama bin Laden was in a Pakistani Military hospital in Rawalpindi on 10th September 2001, the day before the Attacks on America. While none of these reports prove that bin Laden had dialysis dependent renal failure in 2001, the report in Le figaro that "according to authorized sources, bin Laden had mobile dialysis equipment shipped to his hideout in Kandahar in the first part of 2000" are strongly suggestive of it. It would be much better of course, if more precise medical record information could be obtained.

In any case, the important thing to remember is that patients with dialysis dependent chronic renal failure have an extremely high 10 year mortality rate if they do not obtain a kidney transplant. There is no evidence that bin Laden ever had a kidney transplant. Based on that alone, if bin Laden was dialysis dependent or was suffering from severe kidney failure, he would be extremely unlikely to have survived till 2011 given his need to remain in hiding.

Second, according to Former Deputy Assistant Secretary of State under three different administrations Steve R. Pieczenik MD, Bin Laden suffered from Marfan’s Syndrome. The mortality rate for a 40 year old man in whom a diagnosis of symptomatic Marfan’s Syndrome is made is 100% within 10 years of the initial diagnosis if not treated with aortic root replacement surgery. The mortality rate for asymptomatic individuals of that age group in whom a diagnosis of Marfan’s Syndrome is made is dependent on multiple factors including; the size of the aortic root at the time of diagnosis, presence or absence of significant aortic regurgitation, whether the patient is treated with beta and or calcium channel blocker medication from the time of diagnosis and the aggressiveness of medical follow-up delivered to name just a few. Ideally, it would be best if medical records could be located proving that a diagnosis of Marfan's Syndrome had actually been made. Perhaps Dr. Pieczenik has more information in that regard.

Third, Bin Laden allegedly had diabetes and a foot injury that might have been related to the development of a chronic diabetic foot ulcer secondary to diabetic induced arterial vascular insufficiency. Over an extended period of time, this could have required amputation particularly if he lacked access to aggressive medical treatment for same. If not, he could easily have died of gangrene and generalized sepsis if the necrotic extremity was not amputated in a timely manner, all of which would have been difficult for a “man on the run.” Currently however, I am not sure how solid the data is that a diagnosis of diabetes mellitus was made in Osama bin Laden.

Fourth, Bin Laden purportedly was injured during the battle of Tora Bora. Subsequent videos showed an alleged bin Laden who appeared to have a totally paralyzed left arm--it has always been assumed that this was the biological/original bin Laden. The anatomic pattern suggested a severe shrapnel injury of his left brachial plexus similar to the trauma that former Senator Bob Dole sustained in WWII. Dole never recovered useful function of the affected upper extremity. Moreover, it underwent atrophy and marked deformity over time. Bin Laden would likely have had a similar prognosis over the subsequent 10 year period, if he remained alive. The most recent alleged bin Laden videos show a man with normal upper extremities bilaterally.

In summary, if the admittedly abbreviated medical history of Osama bin Laden is correct that he suffered from renal failure, diabetes, Marfan's Syndrome and was seriously wounded in the battle of Tora Bora, it is very unlikely that he survived until recently in the absence of superb medical and surgical treatment. If he had access to state of the art health care (as might be the case if he had been protected by a nation-state), he would be more likely to have survived but still would have faced considerable mortality risk. When this is combined with all of the other evidence strongly suggesting that bin Laden died in December of 2001, any other outcome seems exceedingly improbable.

Relevant Medical References:

1) Baumgartner F, Omari B, Arnell T. Surgery of the aorta in Marfan’s Syndrome. Contemp Surg. 1998; 53:158–166.

2) Finkbohner R, Johnston D, Crawford ES, Coselli J, Milewicz M. Marfan syndrome: long-term survival and complications after aortic aneurysm repair. Circulation. 1995;91:728–733.

3) Gott VL, et al. The Marfan syndrome and the cardiovascular surgeon. Eur J Cardio-thoracic Surg. 1996; 10:149–158.

4) Gott VL, Greene PS, Alejo DE. Replacement of aortic root in patients with Marfan’s syndrome. N Engl J Med. 1999; 340:1307–1313.

5) Leggett ME, Unger TA, O’Sullivan CK. Aortic root complications in Marfan’s syndrome: identification of a lower risk group. Heart. 1996;75:389–395.

6) Shores J, Berger KR, Murphy EA, Peyritz RE. Progression of aortic dilatation and the benefit of long-term beta adrenergic blockade in Marfan’s syndrome. N Engl J Med. 1994;330:1335–1341.

7) Silverman DI, Burton KJ, Gray J. Life expectancy in the Marfan syndrome. Am J Cardiol. 1995;75: 157–160.

8) Murdoch JL, Walker BA, Halpern BL, Kuzma JW, McKusick VA. Life expectancy and causes of death in the Marfan syndrome. N Engl J Med. 1972; 286:

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