We have heard very little this week about what may have caused Otto Warmbier to wind up in a coma. One thing is for certain: You can like President Trump or dislike him, but the president’s State Department got Warmbier released from North Korea and into medical care in his home state of Ohio.

What we have seen over and over again is the video of Otto making his “confession,” and we know he was sentenced to 15 years of hard labor for supposedly stealing a propaganda sign. That is about all we knew until he was returned via flight with a medical team this week.

Warmbier’s home is in Cincinnati, and he was taken immediately to Cincinnati Medical Center. Physicians there conducted a full medical exam, which also involved brain scans showing there had been damage to his brain. During the press conference, one of his doctors, Dr. Daniel Kanter, said Otto had “extensive loss of brain tissue in all brain regions.”

The North Koreans have said he took a sleeping pill and suffered the effects of botulism. How on earth would Otto Warmbier have had access to a pill to take after he was convicted and photographed being taken away by North Korean guards? Why were the after effects of botulism not found?

The doctors who examined Otto Warmbier say they did not find evidence of beatings. In fact, they said there was “no evidence” of an acute or healing fracture, including to the skull. The pattern of brain symptoms was “not the type we normally see with traumatic brain injury,” the doctors said, and evidence points to cardiopulmonary arrest. There might not have been beatings, as there are other ways to destroy someone’s brain.

We know of a daughter-in-law of a family friend who was not permitted to board a plane in Arizona. She was on her way to substance-abuse treatment. As many people do before entering treatment, she decided to have one or two “last drinks.” This clearly made her more argumentative and difficult. However, after being taken away in handcuffs, she was put in a holding cell and died. Why? The police said she might have tried to get out of the handcuffs and strangled herself. Physicians I know said perhaps it was the way she was put in the handcuffs that made it difficult for her lungs to obtain oxygen.

That may have been what happened to Otto Warmbler. He may have been held by handcuffs in a position that didn’t allow him to breathe. He may have had a bag held over his head, depriving him of oxygen. In that circumstance, he might not have had obvious injuries, but it could have caused brain tissue to die and heart problems, which would account for his condition.

Why did North Korea send back a brain scan with Otto Warmbier that was taken in April 2016 but no other information? His brain was most likely injured before that. Why did North Korea keep him alive by feeding him but not even tell China what had happened? North Korea has been a member of the United Nations since September 1991. North Korea could have spoken to the American ambassador who was appointed by President Obama. To our knowledge, North Korea chose not to.

You don’t have to be a physician to know this is a very fishy story. Why wasn’t the family notified right after Otto Warmbier went into a coma, and why wasn’t the Swiss embassy (which acts on behalf of the U.S. in North Korea) allowed to see him? The other issue that begs the question is, why did the Obama administration not put up a bigger fuss and ask China to look into this?

There are all kinds of hearings taking place in Congress. The case of North Korea and Otto Warmbier raises many questions that should be answered. This should really be the work of the United States Congress.

We still have three American citizens detained in North Korea. They too could suffer brain injuries that would not allow them to function as full human beings. We need answers, and Congress should help us find out the answers to those questions, lest others have the same fate as Otto Warmbier.

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