The good news is that Otto Warmbier, a 22-year-old student, is free from a North Korean prison where he spent the last 17 months. The bad news is that he has lost a considerable amount of brain tissue and will likely never recover. The Atlantic poses the obvious question, what happened to him?

Warmbier falls afoul of North Korean law

Warmbier, who was in North Korea as part of a guided tour out of China, was at the airport ready to leave when he was arrested for attempting to steal a propaganda sign as a souvenir. After a show trial and a forced confession, the young man was sentenced to 15 years hard labor and vanished into the North Korean prison system.

While the Obama administration seemed not disposed to make any serious effort to free Warmbier, the situation changed once Donald Trump was elected president. After a Swedish diplomatic delegation visited the young man and found that he was in a coma, the State Department insisted that he be released immediately. The North Koreans apparently embarrassed at what had happened to their prisoner, acceded to the demand. Warmbier is now in a hospital in Cincinnati.

What happened to Otto Warmbier?

Otto Warmbier has lost a considerable amount of brain tissue and exhibits what doctors call “spontaneous eye-opening and blinking.” He shows no sign of awareness. Warmbier does not show any signs of trauma from the result of beatings one would expect from being in a North Korean prison.

The destruction of brain tissue was likely caused by prolonged respiratory arrest. The North Koreans claim that Warmbier suffered from botulism and took a sleeping pill. Much of that explanation does not add up.

Substandard medical care

Everything points to substandard medical care on the part of the North Koreans. While Warmbier shows no sign of having had botulism, signs would likely not be presented about a year and a half later.

In any case, the disease is highly treatable. As botulism can lead to paralysis to muscles in the body, in combination with a sleeping pill, it is entirely possible that it led to a cardiopulmonary arrest that resulted in the destruction of Warmbier’s brain tissue. But such an incident is also treatable, using cardiac resuscitation and ventilatory support.

How North Korea destroyed a young man

It seems clear that the North Koreans arrested Warmbier on a trumped up charge and sentenced him to a draconian stretch in a labor camp as a way to make him a pawn in its relations with the United States. Then, something went wrong, and the young man suffered more through neglect and incompetence than through active torture. Such behavior demonstrates the barbarity of the North Korean regime.