The New York Times reports that a team of American doctors flew secretly to Vienna in mid-December to assist in the care of the poisoned Ukrainian presidential candidate, Viktor A. Yushchenko, who later triumphed in a contentious election and became Ukraine's president, doctors involved in the case said last week.
The doctors, from the University of Virginia, went at the invitation of the Austrian physicians treating Mr. Yushchenko. But the Europeans started consulting other international specialists in toxicology and bioterrorism months earlier, after they became convinced that Mr. Yushchenko, who fell ill in early September, was a victim of foul play.
"We were able to stabilize him, but we just didn't like how the case fit together," said Michael Zimpfer, president of the Rudolfinerhaus Clinic in Vienna. "So we gave a written document to the patient saying we had the feeling that this was an act of poisoning or bioterrorism and asked for permission to get international help."
They first consulted with doctors at a federal poison control center in Washington, and later with specialists at the University of Virginia. Mr. Yushchenko, who was campaigning in Ukraine, was first seen by the American specialists in December, when he was briefly admitted to the Vienna hospital for follow-up tests.
The Austrian doctors also consulted several European laboratories that specialize in toxic compounds. Those labs eventually performed the blood tests proving that Mr. Yushchenko had been poisoned by unknowingly consuming a highly toxic form of the chemical dioxin.
The involvement of American doctors, first reported in The Washington Post, had been kept secret during the Ukrainian campaign, in part at the request of Mr. Yushchenko's family, people familiar with his care said. Opponents in Ukraine criticized him for being too pro-American; his wife is an American citizen.
Because of the Kremlin's sensitivity to the United States' influence in the Ukrainian political crisis, Dr. Zimpfer said, the American physicians declined to take part in the December news conference announcing that the candidate had definitely been poisoned.
The American medical team consisted of Dr. Gregory Saathoff, head of the University of Virginia's critical incident analysis group; a toxicologist; and a neurologist.
United States officials helped "facilitate" the visit, said a person close to the case. Austrian officials were not involved.
Dr. Zimpfer, a professor of critical care medicine, said the foreign opinions had been helpful in solving the unusual poisoning. "You know, you can recognize that something's a car, but not be able to identify a car you've never seen before," he said.
John Henry, a British toxicologist, proposed that dioxin - a common industrial waste product - was a likely culprit, after seeing pictures of Mr. Yushchenko's disfigured face on television, marked by welts and cysts. His assessment was shared by Dr. Christopher Holstege, the toxicologist on the American team.
In late November, the Austrian doctors secretly obtained blood samples from Mr. Yushchenko. The day the United States team arrived, those tests came back positive for very high levels of dioxin.
The case remains under investigation. Mr. Yushchenko is recovering well under the care of doctors in Ukraine.
He has consulted a dermatologist in Geneva regarding treatment of his facial cysts. The condition, called chloracne, can persist for months or years after poisoning.
But Dr. Zimpfer said he "looked very well" at his inauguration and the party that followed, to which the doctors were invited.
Dioxin is nasty stuff. Look at his before photo:
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