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Tetrodotoxin is a powerful neurotoxin found in puffer fish and is 10,000 times more lethal than cyanide. Twenty-five milligrams could kill a 165-pound man. There are no known antidotes for the toxin, which kills by causing respiratory failure. For 70% of the victims, death follows within four to 24 hours. The toxin works by shutting down electrical signaling in nerves. Nonlethal dosages can produce dizziness, headaches, and hallucinatory effects.

The last two words jumped out at Zack as he glared at his laptop later that evening.

He was staring at three options:

Behind Door One: He was brain-damaged and had hallucinated murder scenes. Door Two: He was an actual killer who murdered two strangers while in a trance. Door Three: He had crossed over and linked up with some homicidal psyche.

In spite of Elizabeth Luria’s pleas, even Morris Stern’s concession that he may have had out-of-the-body experiences, Zack did not buy the supernatural, no matter what their fancy MRI recorded. He didn’t believe in ghosts. And he didn’t think he was nuts.

That left the puffer fish toxin.

And there it was: “Nonlethal dosages can produce dizziness, headaches, and hallucinatory effects.”

He had gotten nearly 470,000 hits from Googling “tetrodotoxin.” Aside from all the data on how it was probably the deadliest substance in the natural world, he learned that the prime source, the puffer fish, though outlawed as a menu item in America, was a coveted Japanese delicacy called fugo that when prepared by an expert sushi chef produced a psychedelic high for the diner. “In the skilled hands of an expert fugo chef, if just enough tetrodotoxin is left in, the preparation of puffer fish flesh leaves the customer with a pleasant tingling sensation to the lips and a slightly mind-altering buzz.”

“A thrill without the kill,” proclaimed one fugo blogger.

Before he logged off, he noticed a link to The Boston Globe. Dated four months ago, the story described a homeless man murdered by another with a baseball bat on the Harvard Bridge. According to a witness, the murder appeared to be a bizarre mercy killing. The Massachusetts State Crime Lab reported traces of tetrodotoxin in his blood. Either the guy had exotic taste and a bad cook or a new drug had hit the streets. Yet a Boston Police Department spokesman said, “I don’t know how a homeless man ended up with puffer fish toxin in his liver. It’s a first for us.”

According to another site, a nonlethal dosage dropped one’s temperature and blood pressure to the point of inducing a deep coma. In a few accidental food-poisoning cases in Japan, victims recovered days later after being declared dead. In Haiti, tetrodotoxin was known as the “zombie drug,” used by voodoo priests to fake the deaths of victims who were revived hours later to the dismay of others.

In the United States, tetrodotoxin was on the “select agents” list of the Department of Health and Human Services, meaning that the drug could be used only by registered research scientists.


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