Michelle Muscat MD MRCS(Ed) MSc, PG Dip, FRCPath, PhD


Director: Kunihiko Ikuhara

Producers: Hiro Haruyama/ Shinichi Ikeda

Writers: Kunihiko Ikuhara/ Takayo Ikami

Animation Studio: Brain’s Base

Original Run: July-December 2011


‘Mawaru Penguindrum’ (animated series produced by Brain’s Base; co-written and directed by Kunihiko Ikuhara) is a story with strong references in the backdrop to the notorious Tokyo subway sarin gas attacks. In the mid-90s, sarin, a colourless and odourless toxic gas, was released into the trains during rush hours. (1) Sarin nerve gas works by inhibiting acetylcholinesterase and hence resulting in cholinergic hyperstimulation. (2) The incident itself resulted in the death of 12 individuals as well as another 5500 individuals being harmed in the process. This constitutes an acute chemical emergency which requires prompt treatment through initial decontamination, support of the respiratory system and use of antidotes such as atropine and pralidoxime. (3-5)

The story of ‘Mawaru Penguindrum’ starts with the narrator discussing the concept of fate and claiming, “ever since it happened … we had no future”. The protagonists are the two brothers, Kamba and Shouma and their sickly sister Himari. Early in the story Himari is seen to collapse and is taken to the hospital in a hurried frenzy where we hear the doctors state they are giving her epinephrine and atropine together with antibiotics, and later the nurse exclaims that there is ventricular tachycardia, till soon after asystole is shown on the monitor. The story subsequently deviates from medical plausibility, with Himari’s revival and ‘survival tactics’, which the doctors in the story deem ‘a miracle’.  Later on we realize that although the three protagonists were not blood relatives, they were a surrogate family who cared for each other deeply. It was Shouma’s father who was behind the subway attacks.  The show does not directly mention the true perpetrators and events, but makes reference to a terrorist organization instead and includes the use of bombs. It focuses more on the ramification on the children’s lives in the aftermath of the event. The story contains many other figuratively used elements, deconstructs certain features of childhood, draws on the metaphorical, and has very strong thematic literary elements. More than just of entertainment value, it touches upon very deep subjects, which may initially be easily dismissed as confusing or for pure entertainment value by a more Western audience less conversant with certain notions. There is a recurring usage of the number ‘95’ as the show progresses, also subtle references to the works of the famous author Haruki Murakami, as well as the ‘fruit of fate’ and the concept of the ‘child broiler’. The tale also incorporates many fictitious elements into multiple layers of surrealism. Although initially presented with parallels of ‘penguins’ and other fantastical elements, it is a multifaceted thought-provoking story deeply rooted in symbolism.

The show is taken in this review as a platform for discussion of cholinergic hyperstimulation resulting from sarin nerve gas, as well as some biochemical and toxicological laboratory techniques used to detect sarin poisoning, even though the latter are not directly referenced in the show. Acetylcholinesterase and butyrylcholinesterase are inhibited by different sarin analogues.(5) Musing instead on a few means of biochemical and toxicological detection of sarin poisoning, gas chromatography-mass spectrometry (GC-MS) and gas chromatography-tandem mass spectrometry (GC-MS-MS) can be used to detect traces of chemical warfare and the degradation products of the nerve agent sarin (isopropyl methylphosphonofluoridate). (6, 7) Gas chromatography-chemical ionization mass spectrometry by use of isotope dilution and large volume injection can also be used to quantitate the fluoride ion. (8) Dynamic portable air samplers using the principle of solid phase micro-extraction and GC-MS have also been devised. (9, 10) Enantiomers of sarin may also be analysed by thermal cold trap injection coupled with two dimensional gas chromatography. (11) Microchip analytical devices based on continuous flow microfluidics, are point of care devices that have also been developed. (12)

This review is partially funded through the Endeavour Scholarship Scheme

Selected References

  1. Okudera H, Morita H, Iwashita T, Shibata T, Otagiri T, Kobayashi S, et al. Unexpected nerve gas exposure in the city of Matsumoto: report of rescue activity in the first sarin gas terrorism. Am J Emerg Med. 1997;15(5):527-8.
  2. Lee EC. Clinical manifestations of sarin nerve gas exposure. JAMA. 2003;290(5):659-62.
  3. Tokuda Y, Kikuchi M, Takahashi O, Stein GH. Prehospital management of sarin nerve gas terrorism in urban settings: 10 years of progress after the Tokyo subway sarin attack. Resuscitation. 2006;68(2):193-202.
  4. Volans AP. Sarin: guidelines on the management of victims of a nerve gas attack. J Accid Emerg Med. 1996;13(3):202-6.
  5. Bartling A, Worek F, Szinicz L, Thiermann H. Enzyme-kinetic investigation of different sarin analogues reacting with human acetylcholinesterase and butyrylcholinesterase. Toxicology. 2007;233(1-3):166-72.
  6. Black RM, Clarke RJ, Read RW, Reid MT. Application of gas chromatography-mass spectrometry and gas chromatography-tandem mass spectrometry to the analysis of chemical warfare samples, found to contain residues of the nerve agent sarin, sulphur mustard and their degradation products. J Chromatogr A. 1994;662(2):301-21.
  7. Barr JR, Driskell WJ, Aston LS, Martinez RA. Quantitation of metabolites of the nerve agents sarin, soman, cyclohexylsarin, VX, and Russian VX in human urine using isotope-dilution gas chromatography-tandem mass spectrometry. J Anal Toxicol. 2004;28(5):372-8.
  8. Jakubowski EM, McGuire JM, Evans RA, Edwards JL, Hulet SW, Benton BJ, et al. Quantitation of fluoride ion released sarin in red blood cell samples by gas chromatography-chemical ionization mass spectrometry using isotope dilution and large-volume injection. J Anal Toxicol. 2004;28(5):357-63.
  9. Hook GL, Jackson Lepage C, Miller SI, Smith PA. Dynamic solid phase microextraction for sampling of airborne sarin with gas chromatography-mass spectrometry for rapid field detection and quantification. J Sep Sci. 2004;27(12):1017-22.
  10. Schneider JF, Boparai AS, Reed LL. Screening for sarin in air and water by solid-phase microextraction-gas chromatography-mass spectrometry. J Chromatogr Sci. 2001;39(10):420-4.
  11. Spruit HE, Trap HC, Langenberg JP, Benschop HP. Bioanalysis of the enantiomers of (+/-)-sarin using automated thermal cold-trap injection combined with two-dimensional gas chromatography. J Anal Toxicol. 2001;25(1):57-61.
  12. Tan HY, Loke WK, Tan YT, Nguyen NT. A lab-on-a-chip for detection of nerve agent sarin in blood. Lab Chip. 2008;8(6):885-91.