In July of this year I mentioned that I would discuss Tutankhamen’s CT scans in the next Hot Issues article but I had to admit in August that Tom Friedman’s theory of the “Flat earth,” i.e. unlimited instant access to information, applies only to some privileged people rather than to most of the rest of us. Since I was unable to fulfill my promise in August I wrote instead “The Plame Affair,” which has now become grist for the mills of the mainstream media and TV pundits. I also mentioned in August that I shall discuss the CT scans either when more definitive information has become available or “it has become obvious that further waiting is fruitless.” This is now the case. Although the drama which is currently unfolding in Washington would deserve discussion this can wait until December.

In “The Saga of Tutankhamen’s Skull X-Rays” (October 17, 2002) I presented in considerable detail the difficulties we had encountered in obtaining a copy of the X-rays that had been taken in 1968 by a team from the University of Liverpool under the leadership of the late Professor Harrison. The reason why I had persevered over a long period of time was because the X-rays were purported to have shown a skull fracture and/or subdural hematoma (blood clot on the brain). This in turn had given rise to a widely reported theory that the pharaoh had been murdered by a blow to the head.

After having had an opportunity to study the actual X-rays, rather than photographs, upon which a book which endorsed the murder theory had been written, my colleagues and I concluded that the X-rays were normal, apart from post-mortem artifacts introduced by the ancient embalmers as well as by the Carter-Derry autopsy in 1925. These conclusions were published in The American Journal of Neuroradiology in the June/July 2003 issue and this was the first time that an assessment of these radiographs had been presented to the medical community. Previous publications by Dr. Harrison had addressed themselves to the general public or archeologists.

Although skull X-rays can demonstrate bony changes they cannot determine possible soft tissue damage which might be apparent on a CT scan. When I learned that Professor Griggs of Brigham Young University in nearby Provo had a license from the Egyptian authorities not only to perform archeological excavations but also DNA analyses on mummies with his colleague Professor Scott Woodward, I visited with them. I was told that they had not only obtained samples from a large grave site at El - Faiyum but they had also been able to obtain some from royal mummies in the Cairo museum in order to establish possible lineages within members of the XVIIIth dynasty and they planned to examine Tutankhamen. I suggested immediately that when the sarcophagus is opened for that purpose we ought to also obtain a CT scan to settle the head injury question once and for all. This suggestion was well received and I was asked to write a proposal to that effect because funding and permissions would have to be obtained. I prepared a document that outlined the need for the investigation as well as potential funding sources and submitted it to Dr. Griggs on 0ctober 3, 1996. There was no reply but since the archeological season in Egypt is limited to the winter months he may have already been in Egypt on other excavations. Nevertheless, the hope remained that we might get something done for the next season. But although I kept calling Dr. Griggs over the next few years on a regular basis nothing came of the attempt because there were either other priorities or some hurdles from the Egyptian authorities. Nevertheless, I was assured that the project was not dead it would just take a little longer than what had been hoped for. After a while phone calls were no longer returned and I issued a mental death certificate for it.

Then in the fall of 2001 the events which are documented in the “Saga” took place and as mentioned the scientific paper was published in 2003. At that point I thought I was done with Tut because I felt that the political conditions in Egypt simply were not conducive to good scientific work, especially since a scan would have to be obtained at the tomb in the Valley of the Kings because a transport to Cairo seemed unrealistic. But January of this year brought to my great surprise the news that a CT scan had been performed on the pharaoh’s mutilated remains under the auspices of the Secretary General of Egypt’s Supreme Council for Antiquities Dr. Zahi Hawass.

The early reports indicated that the project had been funded by the National Geographic Society and Siemens of Germany had made the scanner available, but as Dr. Hawass kept re-iterating the actual work of data gathering and initial interpretation was all done by Egyptians and only Egyptians. On March 8, 2005 there appeared the official Press Release where the world was told that the scientific team, headed by Dr. Zahi Hawass, had reviewed over 17,000 images and that it had included radiologists, pathologists and anatomists under the oversight of Dr. Madiha Khattab, Dean of Medicine at Cairo University. Important aspects of the report were that the team found no evidence to support a murder theory; the king was about 19 years old at time of death; of slender stature about five and a half feet tall; well nourished and in good general health. The slight curvature of the spine that had been noted in Harrison’s X-ray was within normal limits and had probably resulted from positioning at the time of embalming. The missing sternum (breastbone) was probably the result of Carter-Derry’s removal of the famous mask which had be firmly glued to the body, rather than having resulted from a crushing injury to the chest as had been posited by Dennis Forbes in 1992. The only disagreement among the scientists was the nature of a fracture of the lower end of the left femur (thighbone). Some regarded it as a wound that had occurred during life and might have been a cause of death because open fractures would lead to infection and blood poisoning which was untreatable in those days. Others felt that the fracture was another post-mortem event and the question was not resolved.

So far so good but as usual the devil is in the details and these already appear on the first page of the report.

“Lead radiologist Dr. Marvat Shafik and the rest of the team requested that three international experts, two from Italy and one from Switzerland, be permitted to review the images. ‘We need our opinion to be international, since people all over the world are waiting for the results of this important scan,’ said Dr. Shafik,”

But Dr. Hawass did not seem to be enthused about international cooperation because the report goes on to state:

“Dr. Hawass also said: ‘The Egyptian team worked on the images for two months. The foreign team came for several days at the end to review the work of the Egyptian team. The foreign consultants confirmed the results of the Egyptian team, and joined us to make the announcement internationally. All of us are proud to announce these findings, the first CT examination of a securely identified royal mummy from ancient Egypt.

I believe these results will close the case of Tutankhamun, and the king will not need to be examined again. We should now leave him at rest. I am proud that this work was done, and done well, by a completely Egyptian team.”

When we strip away exalted language one gains the impression that the Europeans were not regarded by Dr. Hawass as full partners in the assessment of the data but they may have been expected to merely rubber stamp the findings of their Egyptian colleagues.

Inasmuch as Dr. Boyer and I had a long standing interest in actually examining the CT scans rather than merely taking somebody else’s word as to what they do or do not show a new chapter in the Saga began. My main problem was that the report had not addressed itself to two aspects of Derry’s findings. One was the nature of the “rounded depression, which has slightly raised edges, the skin filling it, resembling a scab” on the left check and the other the “pronounced bulging of the left side of the occiput [back of the head].” In addition there was, of course, the unresolved question of the possible left femur fracture.

The press release did provide the names but not the addresses of the members of the Egyptian as well as European team. There were 3 radiologists on the Egyptian team and 1 on the European. The latter was Dr. Paul Gostner from Bolzano Italy. But every Austrian knows that Bolzano used to be called Bozen, was the capital city of South Tyrol and our esteemed President Wilson had handed the entire province to the Italians after WWI. Self- determination of nations, as proclaimed in his 14 points, had its limits when it came to the vanquished ones. The Austrians of South Tyrol were abandoned to the Italians and those of the Sudetenland to the Czechs. Wilson’s motive was to get his League of Nations approved by the Brits, French and Italians regardless of the cost to actual people who suddenly lost their homeland. This tit for tat was also part of the cause for WWII. There were obviously bad feelings for some time between Austrians and Italians on that score but these were overcome in subsequent decades and amiable relationships exist now between the two countries.

At any rate, I felt a sudden sense of kinship and the potential to get more information about the scans. I did not have Dr. Gostner’s e-mail address but most of us have scientific articles to our names and PubMed is one of the best examples of our tax dollars at work. It is available to the general public and comes up immediately on search engines. Thereafter one needs only the last name and the initial of the author and all the papers arrive within milliseconds. The first paper on the list was authored by Dr W. Murphy from Houston Texas with the title: “The Iceman: Discovery and Imaging” and was published in Radiology in 2003. The abstract also had Dr. Murphy’s e-mail address and he was kind enough to immediately supply me with that of Dr. Gostner which led to a very fruitful correspondence. He told me that he had read our report in the AJNR before going to Egypt and it was fully vindicated by the CT results. A scientific publication of their findings was planned but it needed the cooperation of the Egyptians which was slow in forthcoming, and that he would be happy to collaborate with us in any further data evaluation.

This took place at the end of June and since Europeans have the good sense to get out of their hot cities during the summer we postponed further discussions until the fall. In the meantime I thought that since National Geographic had put up the money, and as a long time member I had partially paid for that scan too, they should be able to put me in touch with the Egyptians so that one might be able to expedite the situation somewhat. I sent off an e-mail to the Magazine requesting the address of A.R. Williams who had written “The New Face of King Tut His Life and Death” for the June issue. Back came four pages of “Thank you for contacting the National Geographic society …” and this was followed by links to frequently asked questions which obviously were not related to my problem. But the message also mentioned that questions which do not appear on the form would be answered within two weeks. Lo and behold a week later the assistant to Ms Williams wrote back stating that “The Society and Siemens have an explicit agreement with the Supreme Council of Antiquities that the CT data is theirs to use as they see fit. Thus all we can suggest is that you take your case directly to Dr. Hawass and the SCA.” She then provided the contact information and an e-mail address. This was on July 21 and the following day I wrote to Dr. Hawass explaining why we would like to see the scans and offered any help in publication of the data, that he might desire. The message did not come back as undeliverable but there was no reply.

As a sailor I took another tack and tried to establish contact with one of the Egyptian radiologists who had worked on the scans. Dr. Essam Ismail, an Egyptian radiologist who currently works in Kuwait, was very helpful in establishing contact with Dr. Ashraf Selim, Professor of Radiology at Cairo University, who was a member of the examining team. Dr. Selim wrote a very pleasant letter back stating that he had also read our paper agreed with its conclusions and “I'd love to communicate and share our knowledge.” 

When I replied I mentioned not only the reasons why we would be interested in seeing the scans but also that it might have been useful to obtain DNA samples at the time of the scanning.  Dr. Selim agreed that:

 “DNA tests would have been definitely useful for answering many questions but unfortunately we work under the supreme council of antiquities who rejected this idea. . . . .  Regarding the issue of sending some of the CT pictures to you I personally agree but I have to take the approval of Dr. Hawass first according to the protocol of confidentiality that we signed with him before taking any further steps.”

Since this still looked promising I replied that “May be I could write to Dr. Hawass personally, if you think it were to be useful.”  The answer came back immediately:

“Dear Dr. Rodin:     

I really don’t think it's necessary now, let me contact him first and then we decide what to do, regards.”

            Well, it doesn’t take much imagination to ascertain what happened here. The abrupt change in tone clearly suggests that word came down from the top: “don’t get involved with foreigners.”  This impression was confirmed in the subsequent correspondence with Dr. Gostner. Earlier last month he told me that he and his two other colleagues had repeatedly tried to continue the collaboration with the Egyptian scientists in order to proceed with a publication but their efforts were thwarted. He also told me that Dr. Frank Ruehli of Switzerland (Anatomist and Paleopathologist, Zurich University, and member of the evaluation team) had suggested a presentation at the Anthropology Congress in March 2006 and had sent a preliminary abstract for approval to Egypt. After some delay he received this response from Dr. Hawass: “as a matter of fact we can not make a kind of lecture in conference now. I am waiting to read the first report of the two parties.” As Dr. Gostner mentioned to me it is quite unclear what Dr. Hawass meant by this statement but it is apparent that a publication or presentation is not in the immediate offing. All of us who have submitted abstracts to national and international meetings know that there are deadlines for when abstracts have to be received by the organizing committee and these are usually at least six if not nine months prior to the meeting. Thus any delay jeopardizes acceptance.

We have, therefore a situation that is not readily understandable on scientific grounds. The European and the Egyptian scientists are eager to collaborate further but apparently a political decision has been reached to prevent this from coming to pass in the near future. Dr. Hawass has currently the exclusive rights to the scans and for reasons only known to him he apparently refuses to allow further studies. I believe this attitude to be ill advised and would like him to reconsider his stance.

            Dr Hawass has said in a recent speech that Tutankhamen “belongs to the world,” which is true. Although everyone agrees that the artifacts found in the tomb as well as the mummy belong to Egypt this should not be extended to scientific data derived from them. The scientific community is international and true scientists have only one goal, which is to extract the maximum information from a given set of data. This is why we have international societies for our various specialties and international meetings where we can discuss in public as well as in private the data we are most interested in.

            Since I am writing for the general public let me now explain why this international collaboration is so vital. Let us be honest with each other; even if Dr. Hawass were to give the Egyptian members of the team authority to publish a paper on their own it would run into resistance from peer reviewers, if it were to be submitted to a reputable international journal. They would immediately ask why the European members of the team were not included and to what extent they agreed with the conclusions that were expressed.

There is a further point. When one has 17,000 pictures to review it is difficult if not impossible to do justice to the data within a few days and that is all the time the members of the European team had at their disposal. Furthermore, even in everyday clinical practice we require a referral slip for a given examination. This may be for a CT scan, an MRI or as in my case EEG/MEG which tells us what area we should pay closest attention to. Digital technology has the tremendous advantage that the data are stored as megabytes or gigabytes and these can be examined at leisure from various points of view. Whenever I am not writing for general publication I do just that with electrical and/or magnetic brain activity which was in part collected several years ago. New observations are made with improved data analysis programs and published. They can then point the way for better data assessment in the future. But this takes time which overburdened clinicians usually don’t have. On the other hand those of us who have reached retirement age do have the time, know how and interest and are happy to pursue these investigations for everybody’s benefit.

            This brings me back to Dr. Gostner and the iceman because it is an excellent example why international collaboration is so vital. Oetzi, as he is affectionately called because he was found in the Oetztaler Alps, was discovered in 1991 and has been extensively investigated first by an Austrian and subsequently an Italian team. Since there are no border guards on a glacier it was initially assumed that the body was still on the Austrian side and it was taken to Innsbruck, but when it was finally determined that that part of the glacier was already on the Italian side of the border he was removed to Bolzano where he now resides in a special museum. Although the Austrians did perform a CT scan no definitive cause of death could be established. Since some of the ribs were “distorted” as if they might have been fractured it was hypothesized that the man might have been attacked, for some reason or another, escaped to higher altitudes and then froze to death. A replica of his face, similar to that of Tutankhamen, was made and the matter rested.

            But Dr. Peter Vanezis a forensic pathologist of Bolzano did not. He was not happy with what had been called the “disaster theory” and found that the body had not always lain in the position it was found. The ice had apparently melted to some extent at some time and the body moved to a slightly different location. When the water froze again the chest was partially crushed which accounted for the deformed ribs. Thus, the disaster theory had to be revisited and the cause of death was again undetermined. With this question hanging in the air Dr. Eduard Ergarter Vigl, the curator of the mummy in Bolzano, decided in June of 2001 it was time for another X-ray. This was done and the films were given to Dr. Gostner, head of Radiology at Bolzano General Hospital, for evaluation. As soon as Dr. Gostner saw the chest X-ray he noted a foreign body near the left shoulder. On close examination it was determined to have been an arrow head and, therefore, a likely cause of death.

            For the Austrians this was major embarrassment. They had previously had the body for several years, had performed a CT scan and had missed detecting that metal fragment. Professor Horst Seidler from the University of Vienna stated in a BBC interview: “that has been the shock of my life.” Why had they overlooked the arrowhead in the CT scan? Well, sometimes you can have too much information and the proverbial needle in the haystack doesn’t jump out. When Dr. Wolfgang Recheis loaded up the scans again on his work station in Innsbruck now knowing where to look the object not only showed up clear as daylight but with further study and newer data analysis tools the arrowhead could be completely reconstructed. This is a perfect example for international cooperation how to get at the bottom of a scientific problem. Oetzi had been shot in the left shoulder, escaped from his pursuers to higher ground, pulled out the arrow, which was found in the general vicinity, died of his wounds and the body froze.

            Let us now return to our Pharaoh and what should be done. The most obvious immediate action should be to make the CT scans available to the European team so that a preliminary scientific report on the data can be presented. There are so much data on hand that the scans should subsequently be made available to qualified specialists around the world upon their request. Different scientists have different areas of interest and a series of papers, including a monograph, could be published. This can readily be done and requires only the “go ahead” from Dr. Hawass. 

            But a CT scan can also give only a partial picture and more information might have been obtained had a DNA sample been taken which opens another chapter of this Saga. In response to Ms William’s report Ann Marie Ackermann of Boenningheim, Germany wrote a Letter to the Editor of National Geographic: “Although your article on King Tut was fascinating, it contained an omission. Were any DNA samples taken and, if not, why not?” The answer from the magazine was: “It is the policy of Egypt’s Supreme Council of Antiquities not to do DNA testing on mummies. Some experts believe such tests are not yet accurate enough for ancient remains and would only open the door for speculation.

Although this is true it is not the whole answer. Drs. Griggs and Woodward had, as mentioned above, obtained samples even from pharaohs during the 1990s but for reasons beyond their control never did get the go ahead to obtain samples from Tutankhamen. Furthermore, when I reviewed Internet data for this article I found to my surprise that Carolyn Hawley had reported from Cairo for BBC News on November 11, 2000: “Tutankhamun to undergo DNA tests.” The article stated in part

“A Japanese team, working with local experts, will conduct DNA tests on Tutankhamun’s mummy, which has lain undisturbed in its tomb in Luxor [sic] since it was last X-rayed in 1969 [sic].

The results will be compared with tests on the mummy of the man thought to be his grandfather, Amenhotep III, now in the Egyptian museum.

But mummy expert, Nasry Iskander, cautions that DNA analysis on ancient remains is still a hit-and-miss affair and that Tutankhamun’s mummy may be in too poor a shape to yield conclusive answers.”

CNN.com reported on December 5, 2000 that a team of Japanese experts was expected to arrive in Egypt “this week” to obtain DNA samples. We don’t know at this time what happened but apparently Dr. Iskander was overruled and the Japanese never got their samples.

            This is a very unfortunate situation. It is true that lineage may be difficult to ascertain and that there are considerable technical problems. The difficulties in regard to lineage are compounded in the case of royal mummies because, apart from Tutankhamen, all have been removed from their tombs in antiquity and one is working on bodies whose precise identity may be in doubt. This also applies to the mummy of Amenhotep III. But lineage, important as it may be, is not the only reason why an adequate DNA sample should have been obtained as mentioned in my correspondence with Dr. Selim. The cause of the pharaoh’s death is unknown and the skeletonized dismembered remains may not yield full answers in regard to the cause of death but the viscera might provide additional information. They were found by Carter in canopic jars in the tomb and transported to Cairo at that time. They ought to reside somewhere in the Cairo museum. I am saying “ought” and “somewhere” because a physician, Dr. Bucaille, who wrote a book for the general public in which he severely criticized Carter’s handling of the mummy, stated that he could not find the canopic jars in the museum. Thus even if someone were to look into the various nooks and crannies of this vast building and were to find canopic jar contents labeled “Tutankhamun” one would never know for sure whether these labels were indeed correct. If we had DNA from the mummy, the contents of the jars might be properly identified and one might be one step further in unraveling the mystery that surrounds the young king’s unexpected death. Dr Hawass has been quoted in an interview on March 8, 2005 (MSNBC.com) as having told the Associated Press: “I have two theories – that he may have died from natural causes or that he was poisoned. We are going to look at the viscera to see if his organs show any signs, but it is virtually impossible to prove how he died.”  I agree with the last part of the last sentence but how is Dr. Hawass going to establish for certain, without DNA confirmation, that the viscera really belonged to Tutankhamen?                                             

            Thus the Saga continues. The last word has not been spoken with the Press Release and it behooves us to find a way that allows proper scientific research of at least the CT scans to proceed. But it is not only the fate of the CT scan that is at stake. If Dr. Hawass were to insist that he has the right to control all scientific publications resulting from excavations in Egypt the entire field of Egyptology is in peril. This is why I wrote this article and why I shall give it wide circulation. Inasmuch as I could not get a private reply from Dr. Hawass I am now writing to him in public.

            Dear Dr. Hawass

            During the past months I have made several attempts to contact you through private channels but my efforts were unsuccessful. Since the topic is vital for the current state of Egyptology I feel obliged to write to you in this forum. It seems that the scientists who have evaluated the CT scans of Tutankhamen are currently prevented from publishing their findings in the scientific literature. I do not know the reason, but I do know that they are seriously interested in doing so because Press Releases cannot do justice to the many questions that are still unanswered.

As a first step I would like to request that you make the entire set of scans available to all members of the scientific team. This should be done electronically so that the scientists from the different disciplines can independently investigate these scans at their leisure rather than in a hurried manner. They can then discuss their agreements and disagreements among themselves, arrive at sustainable conclusions and publish the data. Thereafter a Symposium could be arranged at an appropriate International Congress where the scientific community at large is given an opportunity to see the data and review the conclusions derived from them. You might want to give the keynote address at that Symposium. This is how science proceeds in all other areas and the CT scan data should not be an exception. At present the scans are of no benefit to anyone including you because they require specialized expertise for further evaluation.

            You have recently received from the American University in Cairo an Honorary Degree of “Doctor of Humane Letters” and I appeal to you to regard this not only as an honor but also as an obligation. You cannot shut out the international scientific community because you depend on it for your future work. By not releasing the scans you are not only hurting the scientific community at large but also and especially your Egyptian co-workers who have spent a great deal of time on evaluating the scans and have a right to see their results published. Furthermore, without the help from the U.S. and Germany the scans would never have materialized in the first place. While pride in the achievements of one’s country is thoroughly understandable it should not turn into chauvinism because this has always led to disaster.      

You have mentioned repeatedly that you have enemies and that the forces of Seth are arraigned against you. This may well be so but please feel assured that the scientific community is not your enemy but is only interested in a search for the truth, regardless where it ultimately may lead to. I would, therefore, like to urge you not to provide those with whom you have differences with more food for animosity; which secrecy surely breeds.

Those of us who love and respect the magnificent culture your ancestors have given to the world would be severely disappointed if this tradition of sharing, which has characterized them in the ancient world were to be abandoned now. I, therefore, urgently request that you reconsider your decision and follow the suggestions made above. In American parlance this is a “win-win” situation where nobody loses and everybody gains.

Sincerely yours,

Ernst Rodin MD