About 8:15 in the evening on February 19, 1994, paramedics wheeled a young woman into the emergency room of General Hospital in the southern California city of Riverside. They shot through two sets of double glass doors, veered to their left, and parked her in a small curtained space marked trauma room one. The woman, clad in shorts and a T-shirt, was awake, but 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, recalls Maureen Welch, a respiratory therapist who was assisting in the trauma room that night. Most patients who show up in an emergency room with such symptoms are elderly people, Welch says. This woman, the paramedics reported, was 31 years old and had cervical cancer. Her name was Gloria Ramirez.
The medical staff hovering over Ramirez injected her with a host of fast-acting drugs that were part of the standard protocol for her condition: Valium, Versed, and Ativan to sedate her, and agents such as lidocaine and Bretylium to quell her aberrant heartbeat. Welch, meanwhile, forced air into Ramirez’s lungs with an Ambu-bag, a football-size rubber bladder connected to a plastic mask that’s placed over the patient’s nose and mouth, serving 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 shirt and pressed 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.
To obtain blood for analysis, a registered nurse named Susan Kane swabbed Ramirez’s right arm with rubbing alcohol, inserted a catheter, and attached a syringe. And that’s when the frenetic yet orderly routine of the emergency room began to break down. As the syringe filled, Kane noticed a chemical smell to the blood. Kane handed the syringe to Welch and leaned closer to the dying woman to try to trace the odor’s source. Welch sniffed the syringe and smelled something, too: I thought it would smell like chemotherapy, the way the blood smells putrid when people are taking some of those drugs. Instead, Welch says, it smelled like ammonia. She passed the syringe to Julie Gorchynski, a medical resident who noticed unusual manila-colored particles floating in the blood — an observation echoed by Humberto Ochoa, the doctor in charge of the emergency room, who was helping treat Ramirez.
Kane turned toward the door of the trauma room and swayed. Catch her! someone shouted. Ochoa lunged for Kane, caught her, and gently guided her limp body to the floor. Kane said that her face was burning, and she was put on a gurney and taken from trauma one. Gorchynski too began feeling queasy. Complaining that she was light-headed, she left the trauma room and sat at a nurse’s desk. A staff member asked Gorchynski if she was okay, but before she could respond she slumped to the floor. She was now the second member of the Riverside emergency room staff being wheeled away from the trauma room on a gurney. Gorchynski shook intermittently; over and over again she would stop breathing for several seconds, take a few breaths, then stop breathing again — a condition known as apnea. Meanwhile, back in trauma one, Welch became the third to succumb. I remember hearing someone scream, Welch says. Then when I woke up, I couldn’t control the movements of my limbs.
That surreal night would throw Riverside General Hospital into newspapers 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 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 have beaten the rap, except for one extraordinary hypothesis: a team of researchers think that a chain of chemical reactions may essentially have turned Gloria Ramirez’s body into a canister of nerve gas.
