A plausible poisoning, but 'Mentalist' tampers with brain science

The premise

During a neuroscience symposium at the Stutzer Institute at Leyland State University, the featured speaker, Alex Nelson, is drinking from a water bottle when his vision becomes blurry, and he collapses and dies. The police determine that his water was laced with 10% hydrogen cyanide solution. Investigators suspect that animal activists have targeted Alex because he was an associate of Dr. Louis Stutzer, one of the world's top neuroscientists.

Stutzer believes he has discovered the brain's "morality center" in the cingulate gyrus (part of the limbic system of the forebrain involved in emotion and memory formation). He begins to test human subjects, inducing both good and evil responses, and soon his lab assistant, Carrie, is found dead at home beside a water bottle. The coroner says her pink color indicates hydrogen cyanide.

The medical questions

Is a solution with 10% hydrogen cyanide an effective and rapid poison? How does it work and what are the usual symptoms? Is blurry vision common? Is there an antidote? Is a pink color at the time of death indicative of cyanide poisoning? Are neuroscientists researching a "morality" center in the brain that can be manipulated to alter responses?

The reality

"Ten-percent cyanide would be very concentrated. It would take only a small sip to reach a lethal dose," says Dr. Lewis Nelson, associate director of the NYC Poison Control Center. The victim would collapse rapidly after inhaling the hydrogen cyanide gas released from the surface of the solution, he says, but a sip would actually kill him.

Dr. Herb Samuels, chairman of pharmacology at the NYU Langone Medical Center, says that cyanide displaces oxygen in the engine of cells (mitochondria), resulting in a sharp drop in energy production and rapid cell death. Symptoms of cyanide toxicity include rapid heart rate, headache, drowsiness and low blood pressure, adds Jim Adams, associate professor of pharmacology at USC. Blurry vision could also be a sign of acute poisoning from cyanide.

To save a poisoning victim, Adams and Samuels agree that immediate oxygen is essential, followed by the rapid use of antidotes. Two types of antidotes can save cyanide poisoning victims, one by detoxifying cyanide, the other by altering hemoglobin to latch on to the poison and keep it from the cells. Given the potency of the show's poison, it is very unlikely that any antidote would have proved effective.