Friday, 19 October 2007

The Killer Among Us

An arsenic poisoning sends a small New England church into turmoil.

By Max Alexander

Possible Food Poisoning
The potato fields that roll up to the edge of New Sweden were still dusted with snow on Sunday, April 27, 2003. Even by the standards of northern Maine it had been a tough winter, and the old furnace in the parsonage of the Gustaf Adolph Evangelical Lutheran Church was giving up the ghost. The church council had gathered after services to decide who would install a new heater.
Council member Dick Ruggles, a 64-year-old retired ironworker, grabbed a cup of coffee and headed into the meeting.

He lasted about five minutes. "I asked a question of one of the members," says Ruggles, "and before he could answer, I had to leave and go to the men's room." When the vomiting briefly let up, Ruggles staggered out to find his wife, who had been chatting over coffee in the kitchen with Erich Margeson. "Fran," he said, "I have to go home now!"

Home was a white clapboard farmhouse just up the road, but Fran had to stop the car twice for Dick. Once there, the violent nausea continued, and severe diarrhea added to Dick's woes. When Fran went into the bedroom to change out of her church clothes, she suddenly felt sick herself. "I didn't make it back to the bathroom," she says. "I just could not stop vomiting."

Sometime between three and four that afternoon, the phone rang. It was Erich Margeson's wife, Alana, calling to say she'd just taken Erich to the hospital. Erich, a 30-year-old potato farmer, was also violently ill. Soon came another call: Dale Anderson, who had been at church, was sick too. When Barb Bondeson called around five, Dick and Fran were too ill to speak. Barb called Fran's sister, Julie Adler, who had skipped church that day. She raced over with her son, who had to carry Dick to the car.

With a population that hovers just over 600, New Sweden has no hospital of its own. Fortunately, an emergency room is just eight miles away, in the town of Caribou. Staffers at the Cary Medical Center take pride in their high-tech, point-of-care service. But Cary's greatest asset is its close relationship with the community. Its doctors know their patients from the local cross-country ski trails, not the medical charts. With only 37 beds and a small staff of nurses, Cary is set up for car accidents and cardiac arrests -- not outbreaks of violent illness.

Yet an outbreak is exactly what Cary had by Sunday evening, as a total of 12 church members showed up retching and gasping. Patty Carson, the hospital's infection control officer, remembers, "My first thought was, 'Some poor old lady who made the potato salad is gonna be so upset.' " Thinking fast, Carson alerted the state's Bureau of Health to a possible food poisoning in New Sweden. Then she grabbed a notepad and headed for the patient wards, looking for answers.

It didn't take long for Carson to change her mind about the cause of the outbreak. The patients had eaten a variety of food in the church kitchen -- tuna sandwiches, sponge cake, banana bread with icing -- most of it left over from a bake sale the day before. The only common denominator was the coffee; every patient had sipped a cup, and they all recalled it tasted funny --"bitter," "metallic" or just plain "bad." And all got sick within an hour of drinking the brew. As a microbiologist, Carson knew that food-borne organisms typically take several hours or more to cause illness. And she doubted that any dangerous bacteria could thrive in the hot, acidic environment of a coffee urn.

Dr. Daniel Harrigan, the ER physician on duty, was coming to the same conclusion. "These people had blood pressures that were much lower than you would expect from food poisoning," he says. The most critical patient was Reid Morrill, the church's head usher and a beloved local character known for his homemade ice cream and for once hitting a hole in one at the Caribou Country Club. Morrill, 78, was still recovering from cardiac bypass surgery earlier in the year. Dr. Harrigan golfed with Morrill; now his links partner was hooked up to a ventilator. Recalls Harrigan: "I told Patty that this has to be a poisoning of some sort, and to call the poison center."

Morrill was one of four patients, including Fran Ruggles, admitted to Cary that night. Margeson and four others felt well enough after a few hours to go home. Convinced they were not contagious (and facing a shortage of beds), the hospital released them. Three additional patients, Dick Ruggles among them, needed more serious care but were stable enough to be transferred to the closest acute-care facility, Eastern Maine Medical Center in Bangor, 170 miles south.

The Unthinkable
As the hospital in Bangor was preparing to receive the patients, another medical team was swinging into action at the Northern New England Poison Center in Portland, 300 miles downstate. The center's medical director, Dr. Anthony Tomassoni, had been studying the charts of all the New Sweden patients. It was a little after three o'clock Monday morning when he called Dr. Harrigan. "I'm thinking heavy metals," he said. The toxicologist thought some New Sweden patients were experiencing a condition known as acidosis, resulting from the body's inability to use oxygen effectively. That could be caused by lead or antimony (an element in batteries), but arsenic was at the top of his list. "At the same time," remembers Tomassoni, "we thought, jeez, arsenic in northern Maine, what are the chances?"

Plenty, it turned out. Arsenic was once commonly used in potato farming as a so-called topkiller. A week before the harvest, farmers would spray a dilution of inorganic arsenic on the plants' bushy green tops to kill them off -- allowing the potato skins to toughen. Today farmers use less poisonous herbicides, but it would not be unusual to find jars of powdered arsenic in barns around potato country.

Shortly after Harrigan and Tomassoni got off the phone, Reid Morrill died. Louise Beaupre, wife of another victim, recalled that only a week before, Morrill, still ailing from heart surgery, had said, "I don't know if I'm ever gonna feel okay." She had responded, "Of course you will." The next Sunday, she says, "He was all pink cheeks, smiling and laughing. I said 'I think somebody's feeling better!' And he said 'Yep, I am.' And I can still see him standing there with a cup of coffee in his hand."

Morrill's death triggered the attention of the state medical examiner, as well as the national news media. The case was gaining urgency.

Arsenic can be identified only with specialized equipment. The nearest lab with that capability was the state's Health and Environmental Testing Laboratory in the capital of Augusta -- 230 miles south of Caribou. Early Monday morning, a state trooper left Cary Medical Center with the patients' fluid samples, his siren wailing down Interstate 95. Also in the back of his cruiser was the coffee urn from the Gustaf Adolph Lutheran Church.

The results came back at about eight o'clock Monday night: Inconceivably high levels of arsenic were found in all the patient samples, as well as the coffee. Dr. Tomassoni was too shocked to congratulate himself on his diagnosis. "I never thought I would see something like this in my career," he says. That's when the state police were notified.

Lieutenant Dennis Appleton of the Maine State Police Criminal Investigation Division is not the type to jump to conclusions. Rather than assume the worst, he hoped his investigation would uncover an innocent, albeit tragic, explanation. On Tuesday, Appleton had the church sealed off and a team of detectives on-site. The search was unsettling. "After several days of examining the church from basement to attic," Appleton recalls, "we found nothing that would have contributed to an accidental poisoning -- no jar of arsenic in the cupboard that had been mistaken for the sugar bowl."

When Fran Ruggles heard she had been poisoned with arsenic, she assumed it was environmental: "We'd had a lot of rain and snow. I thought it must be in the water." Tomassoni knew otherwise, estimating the level of poison would have required "a fistful or two" of pure powdered arsenic dumped directly into the coffee urn.

Detectives began interviewing patients -- now victims -- about possible motives. None of them had a clue. Recalls Fran, "I just could not accept the fact that this was done deliberately."

She wasn't alone. In a state famous for insular small towns, New Sweden is in a class by itself. The community was founded in 1870 by 50 Swedish homesteaders, lured across the sea by the promise of free land and a new life. New Sweden is still largely populated by descendants of those settlers; about half of the 16 arsenic victims are Swedish. With its Midsommar celebration and fiskare frukosts (fisherman's breakfasts), the town retains closer ties to Sweden than to mainstream America.

Even tighter than the community is the congregation at the Gustaf Adolph church, built on a hill overlooking New Sweden by the original settlers in 1880. The picturesque chapel, with its steeple rising above farm and forest, is the oldest active Lutheran church in Maine. To many, the idea that a member of the small congregation (46 people attended church that Sunday) had poisoned them was unthinkable. Fran Ruggles echoed the feeling of the group when she told detectives, "You're going to have to prove it to me."

Doctors at Cary Medical Center had little time to ponder motivation. Once arsenic was diagnosed, all the patients who were released the night before had to be called back for additional treatment. And as the day progressed, new patients started showing up -- some who had sipped a tiny bit of coffee and not gotten sick (tests showed potentially fatal doses of arsenic in them as well), and others, like carpenter Lester Beaupre, 53, who initially thought he had the flu.

An Excruciating Ordeal
Beaupre, a Vietnam veteran who once spent nine weeks in the hospital with meningitis, wasn't about to go to the emergency room for a little stomach bug. He spent Sunday night at home, his wife, Louise (who has never tasted coffee in her life), keeping him hydrated with Gatorade. On Monday, says Louise, "when they called and told me about Reid's death, I said to Lester, 'Okay, this is it. Put your clothes on.' " On the way to the hospital, Lester remembers, the snowbanks looked purple. "That's when I knew this was serious," he recalls.

Arsenic travels rapidly to every organ in the body, where it slows the conversion of oxygen to energy. Without energy, the heart's electrical activity falters, lungs fill with fluid, kidneys fail, nerve tissue is damaged, and the brain starts to short-circuit. Arsenic can affect almost anything and everything in the anatomy, which is why symptoms can range from cardiac arrest to seeing purple snow.

The most effective proven antidote is a drug known as British anti-lewisite, or BAL. It attaches to the arsenic molecules, drawing them out of the bloodstream and into the urine. It's a nasty drug to administer; the only way to ingest BAL is by mixing it with peanut oil, then injecting the greasy solution directly into muscle tissue -- an excruciating ordeal.

It's also expensive, costing hundreds of dollars per dose. The price, and the rarity of arsenic poisoning, explains why BAL is not lying around on hospital pharmacy shelves. But with foresight that now seems miraculous, in the wake of the 2001 terrorist attacks Dr. Tomassoni had persuaded Maine's Bureau of Health to purchase BAL doses for the state's largest hospitals.

As the victims endured painful treatment and round-the-clock fluid testing, more bad news came on Friday: Church member Daniel Bondeson, a 53-year-old bachelor potato farmer, nurse's aide and high school ski coach, fatally shot himself in the chest. In his farmhouse, where he was discovered by his brother Carl, was a note in which he implicated himself in the tragedy, according to police.

The victims were stunned. "Danny was a friend of ours," says Dick Ruggles. Lester Beaupre had gone to high school with Bondeson; he still describes him as "probably the nicest person you'll ever meet."

Bondeson, a former member of the church council, was a quiet man, but active in the community. Dr. Harrigan had run in races with him. Another victim, Ralph Ostlund, often skied with him. Says Erich Margeson, "Danny was always interested in helping people if they had a problem." Louise Beaupre, who describes Bondeson as "pleasant but shy," says, "My feeling is he just snapped. There's no logical reason. It's beyond comprehension."

But why?

"We're all scratching our heads," Erich explains. Police have not released the text of Bondeson's suicide letter. But Alan Harding, an attorney representing Bondeson's estate, told local newspapers that in the note Bondeson said he wanted to give five church members a "bellyache" like they had given him. Harding also said the note indicated Bondeson did not know the poison was arsenic. Lieutenant Appleton won't comment on Harding's statements except to stress that the lawyer has not personally seen the letter. One theory is that Bondeson was angry because his family had given the church a communion table that wasn't being used. "There were some hurt feelings," says one church member. But arsenic? "It's hard to think about," says Erich Margeson.

As the community struggled to understand, police dropped another bomb: Bondeson, they said, without offering additional details, did not act alone. Church members say they have no idea why police would have come to this conclusion. Anyone could have entered the unlocked church kitchen during the Saturday bake sale or before Sunday service. When residents of New Sweden, many of whom didn't even own keys, were advised to start locking their doors, and a police guard was posted at the hospital, Alana Margeson says, "the air in the community was so heavy."

Months later, New Sweden hasn't lightened up much, and detectives are no closer to an arrest, although they say they have one or more suspects.

Meanwhile, doctors can only speculate on the survivors' long-term prognosis; elevated cancer risk is one scary possibility. Fran Ruggles had a painful outbreak of shingles that lasted weeks. Dick still has back pain that might be nerve-related. And many survivors deal daily with crushing fatigue. Lester Beaupre was the last victim to be released from the hospital, almost five weeks after the poisoning. The tubes that kept him alive injured his throat, and he had a tracheotomy during his hospital stay. He still feels numbness in his face and extremities.

The community is also numb. "We're not innocent anymore," says Louise Beaupre. Healing, in every sense of the word, will take time. On a bright summer Sunday four months after the poisoning, victims were again gathering with their neighbors to pray at Gustaf Adolph church. Fran Ruggles helped serve communion as sunlight filtered through the church's stained-glass windows. Erich Margeson, Lester Beaupre and other victims recited from the Book of Psalms: "Who among you loves life and desires long life to enjoy prosperity?" At the bottom of the day's prayer list was the simple line "For the arsenic victims." And resting on the counter of the adjoining kitchen, plainly visible from the pews, was a new coffee urn.

It is an uncomfortable reminder of the tragedy, but more visceral is the knowledge that Danny Bondeson's accomplice could be in the next pew. That makes worship understandably difficult, even for the most forgiving of souls. Admits Lester Beaupre, "You look around at church and wonder who did it."


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