Otto Warmbier, was totally unconscious when he was carried off a flight from North Korea where authorities agreed to return him to the U.S. He’s been comatose since March of 2016.

According to Trump administration officials, information about Warmbier’s condition was transmitted on June 6 by North Korea’s ambassador to the United Nations to Joseph Yun, the State Department’s special representative for North Korea, at a meeting in New York.

Notice how Otto is barely conscious in this video below as police officers walk him to and from the court. The police officers seem to be holding him up and his eyes are barely open. 

That meeting followed an earlier, secret meeting last month between Yun and high-level North Korean officials in Oslo. At that time, North Korea agreed that Swedish diplomates in Pyongyang, who handle U.S. affairs there, would be allowed for the first time to visit four Americans imprisoned by the North, including Warmbier.

It was after the Swedish consular visit — confirming Warmbier’s condition — that North Korea urgently requested to meet with Yun in New York last week.

Yun immediately informed Secretary of State Rex Tillerson of the situation, according to the officials, who spoke on condition of anonymity about the still-secret arrangements.

Tillerson, they said, consulted with President Trump, and Yun was instructed to prepare to travel to Pyongyang with the intention of bringing Warmbier back to the United States. A medical team and aircraft were organized, and North Korea was informed that a delegation would travel there.

Yun arrived in Pyongyang early Monday and immediately requested that North Korean officials take him and two American physicians to Warmbier. It was the first time the United States was able to confirm his status since he was sentenced.

Yun insisted on Warmbier’s immediate release on humanitarian grounds, officials said, and the North Koreans agreed.

Tillerson called Trump at 8:35 a.m. Tuesday to inform him that Warmbier was on an airplane en route to the United States, an official said. The last instruction the president left Tillerson was: “Take care of Otto,” the official said.

“We are thankful that he is on his way home,” said Heather Nauert, State Department spokeswoman. “We look forward to him being back in the arms of his parents in Ohio.”

At the time of his arrest, Warmbier had been on a stopover tour in North Korea, en route to Hong Kong, where he was to do a January 2016 study-abroad trip.

But on his final night in Pyongyang — New Year’s Eve — he apparently went to a staff-only floor of his hotel and attempted to take down a large propaganda sign lauding the regime.

He was charged with “hostile acts against the state.” After an hour-long trial in March 2016, he was sentenced to 15 years in prison with hard labor.

He had not been seen in public since. Swedish diplomats, who represent U.S. interests in North Korea because the United States has no diplomatic relations with the country, had been denied access to him until late last month, following Yun’s Oslo meeting.

North Korea has woefully inadequate medical care, and it is not clear how North Korean doctors had been caring for Warmbier for more than a year in an unconscious state.

Warmbier was flown out of North Korea on the same day that Dennis Rodman, the controversial former basketball star, arrived for his fifth visit in Pyongyang. Rodman’s trip caused a media frenzy because of heightened tensions between North Korea and the United States, but it also raised speculation that he might be going as an envoy to secure the release of Warmbier and three other Americans being detained.

 

According to an official North Korean report, the University of Virginia student contracted foodborne botulism shortly after his March 2016 court appearance. The report said he fell into a coma after taking a sleeping pill and had not woken up by the time he was medically evacuated from North Korea.

So what exactly is botulism?

“Botulism is caused by a bacteria known as clostridium. This bacteria produces a toxin known as botulinum toxin. This toxin can be ingested by eating improperly canned foods, which allow the toxin to grow,” Dr. Sara Siavoshi, a California neuroscientist. “It acts as toxin to the nervous system where it paralyses muscles.”

Common symptoms include a very flaccid paralysis of the arms and/or legs, difficulty breathing because of respiratory muscle weakness and blurred vision. In severe cases, it can cause respiratory failure and even cause cardiac issues. Botulism is classified as “rare” by the World Health Organization and fatal in around 3 percent to 5 percent of cases.

According to Siavoshi, there are antitoxins available to be administered to individuals who have developed botulism.

“A mainstay of therapy, however, is observing the patient for any breathing difficulties to avoid respiratory failure,” she explained. “If this does occur, they would be treated with a mechanical ventilator to help them breathe until they regain strength of their respiratory muscles.”

While Warmbier is said to have contracted his condition through food, botulism can also be contracted through wounds.

“IV drug users and cocaine users are at risk of this. Infants can contract it by being fed raw honey. Lastly, bioterrorism by spreading the toxin in the air is a rare but known cause.” Siavoshi noted.

Botulinum is also the paralyzing nerve toxin used in highly diluted amounts for the popular cosmetic anti-wrinkle solution known as Botox. It can also be used to treat heavy sweating and migraines.

However, several officials and experts have thrown skepticism on botulism, topped with a sleeping pill, as the cause of Warmbier’s coma.

“We know that if a patient does develop signs or symptoms of botulism, they usually do not become comatose from the toxin alone,” Siavoshi said. “The toxin tends to affect the muscles and peripheral nervous system, not so much the brain. However, if one does contract botulism and already has difficulty breathing and is then administered a sedative agent on top of this, they may develop frank respiratory failure and fall into a coma due to oxygen no longer perfusing the brain.”

Last year, Warmbier was sentenced to 15 years hard labor after allegedly attempting to steal a propaganda poster from a hotel in the country’s capital, Pyongyang. An American delegation, led by a State Department representative, flew to North Korea over the weekend and insisted he be released on humanitarian grounds amid ailing health. His current state remains unknown.

“If he has actually been in a coma for months, a full neurological evaluation would have to be made to assess the degree of brain damage. An MRI of the brain can tell how much structural damage there is,” Siavoshi added. “If he exhibits some degree of intact cognition, an extensive amount of physical and perhaps speech therapy will aid in recovery.”

Pragmatically speaking… How much brain activity can be expected of anyone that has been in a coma since March of 2016? 

It’s time for western tourists to stop visiting North Korea thinking it’s a “vacation spot.” It is not. Rules created to honor and respect North Korea’s leader.  Travel agencies based in China who are known to set up trips to North Korea, do not teach vacationers what they may or may not do that could land them in prison before the vacationers arrive in North Korea.

To fold a simple newspaper while reading it for instance, and creating a “fold line” on the face of the country’s leader is considered an actionable offense that will land the vacationer in prison.

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