"Alekhine's death – an unresolved mystery?"

http://www.chessbase.com/newsdetail...

(by Frederic Friedel)

Fischer: "I don't play old chess...but obviously if I did, I would be the best."

The famous 'death photo' of Alekhine has always looked staged to me...very orderly for a fellow who choked on a piece of meat for - most likely - several minutes.

(by Frederic Friedel)>

I see dead people. All the time.

Joking aside, the picture of Alekhine's body in a sitting position looks contrived. When a patient becomes unconscious from a stroke or heart attack, they fall to the floor. Always. (At least I have never heard otherwise.) They don't remain sitting peacefully on chairs.

And what about choking to death? That's really weird. The only patients I have seen that actually choked (or aspirated) to death immediately in front of my eyes are those with strokes or injuries involving their brainstem, which impairs their gag reflex. Even an unconscious person gags and coughs, usually throwing out whatever is blocking their airway; and thus does not die immediately. I have heard of news about this or that person choking to death, but I always suspect that such persons have some other medical illnesses that for some reason impairs their gag reflex. (If pushed, I would say anything is possible and there probably have indeed been very rare cases of a healthy person choking to death.)

Even for the sake of argument, a conscious person with an intact and functioning brainstem and gag reflex chokes to death, he would struggle. He certainly would not end up in a 'calmly' sitting position.

I'm sure what you say is true. I know you speak from experience. It does seem improbable that a man who was choking to death wouldn't pitch to the ground. But if the photograph is staged, what was the motive? A valuable photograph? Murder?

As for heart attacks, I must tell you that the man I found (from the post you quoted) was sitting on a sofa with his chin on his chest as if he had fallen asleep watching TV. His fingertips were purple though. I was told it was a heart attack.

Was he half sitting and half lying down?

If he were mostly sitting, then he would indeed be a very rare case. From what I have heard from relatives, a patient who loses consciousness tends to sag down to a fully reclining or half reclining position.

Were his fingers also swollen aside from being cyanotic? He could have died of a congestive heart failure (CHF). In such cases, a patient develops difficulty of breathing; not enough oxygen gets transported to their tissues. Such patients may tend to elevate their upper torso to ease breathing, in a kind of sitting position. In such cases, the scenario you described seems feasible.

Now that is interesting. Why?

The picture looks totally staged, with the food in front of him and a chessboard, arranged very neatly.

I really doubt if he died of a stroke. Most stroke patients who die suddenly actually die of what is termed as herniation, wherein successive parts of the brain get compressed by an expanding hemorrhage. As this happens, the body undergoes reflex posturing (or contortions), and so would tend to fall down.

An embolic or thrombo-embolic infarct or even a thrombotic infarct located right in the brainstem could also cause sudden loss of consciousness, but for some reason, every story I have heard of from relatives says that the patient was either found lying unarousable in bed/sofa in some lying down or reclining position, and not sitting up.

Well, I didn't examine him. In fact, I got out of there as fast as I could.

Definitely not half lying down. Slumped but still sitting.

Funny thing. The old man (Reg was his name) was getting a little paranoid in his last years. A few days before he died he told me somebody had tried to break into his room while he was in bed. The locks were cheap so he was afraid this guy might come back and smash the door in. To set his mind at ease I rigged up a barricade made of two-by-fours that he could set in postion when he went to bed.

So it's possible then, for a patient to die in a sitting position.

It does seem improbable that a man who was choking to death wouldn't pitch to the ground. But if the photograph is staged, what was the motive? A valuable photograph? Murder?>

If true, that would mean that Alekhine is the first chess World Champion to have been murdered.

having a meal with that bulky coat on?

The chair is large enough to accomodate his body for him not to drop to the floor.<visayanbraindoctor> i remember one patient of mine while im at iloilo doctors hospital, his watching tv and talking to me when all of a sudden he drop dead, , defibrallator did correct the cardiac ryhtm but he just live for another week in the intensive care unit and died.

I experience that just before the era of advance cardiac life support was introduced.

Happened two times to me, drastically. In each case, there was a cerebellum pressing on the brainstem. One was a cerebellar abscess, the other a cerebellar tumor. The patients were talking to me, then they just died. Kind of dropped dead, their last sentences incomplete. Naturally I immediately took the VS - and they were an immediate BP 0 HR 0 RR 0. Brainstem (medulla) compression when a cerebellar tonsil herniates through the foramen magnum could cause such a thing to happen.

Perhaps, if they were in AAA's chair, they could arguably be in that posture.

However, choking to death in a conscious patient without signs of struggle seems just incredible.

He died March 25, 1946. It could be very cold in rooms like that. I wouldn't be surprised if he slept in that coat too.