The fatal shooting in Moscow last week of a Russian opposition leader, Boris Y. Nemtsov, has prompted comparisons with the 2006 poisoning of Alexander V. Litvinenko, another foe of President Vladimir V. Putin, who fled to Britain in 2000 and secured British citizenship weeks before he died of what was almost the perfect poisoning.
On Monday, the 18th day of testimony in a public inquiry into Litvinenko's death in November 2006, physicians gave a detailed chronology of Litvinenko's inexorable decline, reinforcing previous assessments that the cause of his death may never have been discovered if it had not been for tests carried out at a top-secret British facility hours before he died.
The symptoms, one specialist said, resembled those of a cancer patient battling the side-effects of chemotherapy and radiation. Some doctors thought the cause of Litvinenko's illness was thallium poisoning, and treated him with an antidote called Prussian blue. But the patient's heart weakened and his liver and kidneys stopped functioning.
"It's a different way to kill a person," Litvinenko's widow, Marina, told the BBC last weekend, referring to Nemtsov's death, perhaps at the hands of political opponents, "but a way to present that anybody who will try to say something against us will be killed."
"I was becoming convinced that it was not thallium poisoning, but didn't know what it was," said Dr. Amit Nathwani, a consultant at the University College Hospital in London where Litvinenko was transferred after initial treatment at Barnet in north London.
The identification of the isotope was critical since it enabled the police to follow what became known as the "polonium trail," linking Litvinenko to two Russians accused of killing him, Andrei K. Lugovoi and Dmitri V. Kovtun, who both deny the charge. The British police say that Litvinenko was poisoned after drinking green tea laced with polonium at a bar in central London where he met Lugovoi, a former KGB bodyguard, and Kovtun, a former Red Army soldier, on Nov. 1, 2006.
The delay in discovering polonium resulted from a feature of the isotope itself. Polonium emits mainly alpha radiation while the Geiger counter used to check Litvinenko for radiation poisoning detected gamma radiation.
As physicians investigated the collapse of Litvinenko's bone marrow, Nathwani said, "we were fishing for diagnoses." But, he said, organ systems failed one after the other, because "polonium from the gut was being transferred to various parts of the body."
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