02x02 - The Mourning After

[bunniefuu]

[music playing]

NARRATOR A woman agrees to go on a vacation

with her ex-husband, though she hasn't seen him in years.

How many chances are you gonna get to go on a cruise?

NARRATOR But on the morning they are to set sail,

she finds him dead in the bath tub.

It's a very strange situation.

You know, a man, , shouldn't just drown in a bathtub.

Something has to happen to you.

NARRATOR Then, a father lets his only son sleep

off a late night of partying.

Son?

NARRATOR Only to make a horrifying discovery.

His son isn't sleeping.

I could see that he was, uh, dead

before I ever crossed the room.

NARRATOR And no one knows how it happened.

ANITA SEAMANS I remember standing looking down

on-- on this young man thinking that this man shouldn't

be dead.

NARRATOR Altered lives.

Baffling medical mysteries.

Shocking revelations.

These are the everyday cases of Dr. G, Medical Examiner.

[music playing]

Hi.

CLERK Hi, how are you all?

NARRATOR At first glance, Vesta and Rusty

seem like any happy couple.

They've just flown into Orlando, Florida.

And in the morning, they plan to embark

on a -day Caribbean cruise.

But first impressions can be deceiving.

This is the first time they've seen

each other since their divorce years ago.

VESTA He was a drinker.

And it worked its way into the relationship,

and it was not good.

I just asked him to leave, and he did.

NARRATOR But a few months earlier,

Rusty called out of the blue.

He'd come into an inheritance and wanted to treat

Vesta to a Caribbean cruise.

It was a strange offer, but one that the unemployed Vesta

couldn't refuse.

VESTA How many chances are you're

gonna get to go on a cruise?

And I know him, so it was a nice safe bet.

NARRATOR Vesta had just one very clear condition for Rusty.

VESTA I told him that I would love to go with him,

but that I didn't want him to be drunk the whole time.

And he said he could, you know, live like that.

So I thought it was gonna be pretty fun.

NARRATOR So years after the end of her marriage,

Vesta finds herself catching up with her ex-husband

over dinner, eagerly awaiting the promised cruise.

So far, Rusty seems to be keeping his promise,

nursing a single beer.

But something about him is not quite right.

VESTA He looked haggard.

That's a good word for that.

He looked sick.

NARRATOR Rusty confirms that in fact he has been extremely ill.

He tells Vesta that he had been hospitalized with a stroke

the previous year, and that later he was

diagnosed with prostate cancer.

VESTA He told me that he'd had a stroke and just

all sorts of horrible things.

And I had the distinct impression

that he was not gonna be around very much longer.

NARRATOR When the couple returns to their room,

Vesta can't help noticing that Rusty is trembling badly.

VESTA He shook all night long.

It was probably right up there on the list

of one of the oddest things I've ever been around.

I had my hand on his back, rubbing his back,

and it was just--

it was shaking too much.

NARRATOR The next morning, Rusty

is up at the crack of dawn, complaining

about how cold he is.

I'm cold.

NARRATOR His shivering is worse.

So he decides to take a bath to warm up.

In the meantime, Vesta gets ready for

her long anticipated cruise.

VESTA I had, like, probably a month, you know,

to sit there and contemplate this trip.

So I packed everything I own, basically.

NARRATOR Then she realizes that Rusty is taking

a long time in the bathroom.

VESTA I was going to tell him, you know, hurry up.

I have to get ready too.

[knocking]

NARRATOR She knocks on the door and enters to a chilling scene.

Rusty has collapsed unconscious in the tub.

Frantically, she tries to revive him, but there's no response.

VESTA Having to hit him in the face was very strange.

He didn't wake up and yell at me, don't hit me.

You know, so I knew that he wasn't gonna wake up.
[ … ]

NARRATOR She holds his head above water, drains the tub,

and then calls --.

Sir?

Sir?

NARRATOR Paramedics and police arrived to a baffling scene.

There's a dead man in the bathtub,

and his ex-wife can't explain how he got that way.

VESTA I guess I was afraid of them, 'cause I--

you know, who knows what police are gonna do in a situation?

They don't know that I haven't hurt him.

And that was scary, you know?

NARRATOR Rusty is officially pronounced dead at AM,

just minutes before Vesta was to embark on her dream cruise.

At a loss to explain his death, police turn over the perplexing

case of Rusty Updike to Orlando's

chief medical examiner, Dr. Jan Garavaglia,

better known as Dr. G.

First of all, the only thing we had initially about this

patient is that he's years old,

and he's very excited to go on a cruise with his ex-wife.

It's a very strange situation.

I think we needed a lot of information.

So you know, a man, , shouldn't just

drown in a bathtub.

Something has to happen to you.

NARRATOR Given the circumstances,

Dr. G will examine Rusty's body for signs of foul play.

But she also suspects that one of his reported illnesses

could be the culprit.

DR. G I thought it was maybe another stroke that caused

him to collapse in the bathtub.

VESTA I got a call from Dr. G. And she was asking me questions

about what I had told the police about him having

a stroke and things like that.

DR. G Here she is, you know, her dead ex in the bathtub.

So even though we have a history that he's

got some terrible diseases, we still--

I mean, this needs to be autopsied.

We have a thin man, looks a stated age of mid s.

NARRATOR Dr. G begins by closely

examining Rusty's body for any signs

that might indicate an as*ault.

There's a tiny little abrasion on his side

that my investigator said that he got when he was trying

to get him out of the bathtub.

NARRATOR There was no sign of struggle,

and she finds no trauma to the face or neck that

would point to suffocation.

DR. G Nothing external whatsoever.

Not a bit of trauma.

NARRATOR It's a good sign for Vesta.

But while there are no outward indications

of what k*lled Rusty, the internal exam

should provide some answers.

Dr. G makes the classic Y incision across the torso,

cutting from shoulder to sternum.

Considering that he was found in the tub,

she first looks for signs of drowning.

If he had drowned, his lungs would be filled with fluid.

His lungs show no evidence whatsoever of any drowning.

No fluid when I cut the lung.

So there is nothing to suggest a drowning.

It looks like he probably had something happen to him prior

to putting his head under.

NARRATOR Halfway through the autopsy, Dr. G

has found no signs of v*olence and confirms

that Rusty didn't drown.

I don't have a reason to think she k*lled him.

It's hard to put somebody under water in a bathtub.

They knew that I hadn't done anything to hurt him.

So that was good.

I was pretty interested, really, and eager to find

out what he had died from.

NARRATOR But while Vesta can now breathe a sigh of relief,

for Dr. G, the hard part is just beginning.

Coming up, Rusty Updike's autopsy

appears to have Dr. G stumped.

It's just kind of odd.

We don't really know what's going on with him.

NARRATOR When Dr. G Medical Examiner continues.

[music playing]

As they do during all autopsies, morgue technicians extract

blood, urine, and eye fluid samples

from the corpse of Rusty Updike, a -year-old man

found dead in a hotel bathtub earlier that morning.

We're gonna definitely send off that blood for toxicology.

NARRATOR After eliminating foul play as a suspect in Rusty's

strange death, Dr. G must now focus her investigation

on natural causes.

I started the autopsy thinking I

was gonna find just a whole host of natural diseases

in this fellow, who seemed to be quite sick.

We got the information that he was in the hospital for three

weeks with a cerebral vascular accident, a bleed in his brain

or a stroke in his brain.

NARRATOR Before trying to determine which,

if any, of these potentially fatal ailments k*lled Rusty,

Dr. G learns more about his most serious

long-term illness, alcoholism.

VESTA Rusty at first was very charming, you know?
[ … ]

He was fun to be around.

NARRATOR Vesta met Rusty Updike when he was a young firefighter

in his early s.

The couple decided to tie the knot after the arrival

of a baby girl, Natis.

But according to family members, not everything

was picture perfect at home.

Growing up he was actually a pretty

good dad, when he wasn't drunk.

I wish that he wouldn't drink all the time,

but I knew that he wasn't gonna change.

NARRATOR After six years, Rusty's alcoholism made

the union unbearable for Vesta.

He had lost his job.

We were gonna lose the house.

You know, it was--

it was just all too much.

And I just asked him to leave, and he did.

NARRATOR She would not see him again until the fateful trip

to Orlando.

The organ which typically tells the dark story of an alcoholic

is the liver.

But when Dr. G takes a closer look,

what she finds surprises her.

Liver for a chronic alcoholic doesn't look too bad.

Looks like he might have some fatty changes,

but certainly not cirrhotic.

NARRATOR She can rule out any liver disease

related to his alcohol abuse.

But more potential K*llers are lurking

in his reported medical history, beginning

with the prostate gland.

We got the information that he might have prostate cancer

and that it may be quite severe.

NARRATOR Dr. G reaches below the bladder

and removes the prostate gland, where according to Vesta

there should be signs of pathology.

But when she dissects the walnut sized gland,

she is once again taken aback.

DR. G I look at his prostate, and his prostate

looks just fine.

There is no evidence of prostate cancer at all.

It looked just great.

NARRATOR It's puzzling.

For someone who was as sick as Rusty claimed to be,

she can find no evidence of it.

Only one organ remains that might

reveal what caused this man to die

in a hotel bathroom, the brain.

Surely the answer's in the head

because he's had this big stroke.

He had to spend three weeks in the hospital.

And that'll give me the answer.

I was just looking to see if I could see any evidence

of an old stroke externally.

Could be just a small--

like a hypertensive stroke on the inside.

NARRATOR She thoroughly sections his brain

and closely examines the vessels for any signs of bleeding

or clots, but he encounters yet another inexplicable dead end.

And open the head, and there is nothing wrong with it.

Nothing wrong with his brain whatsoever.

Medulla.

They all look fine.

I don't really see anything.

NARRATOR In fact, there is no telltale scarring in his brain

tissue that indicates Rusty ever had a stroke,

and no tumors or malignant tissue in his prostate

that would point to any cancer.

Keep getting this history that he's-- you know,

had a stroke and had this prostate problem that

he should get himself, uh--

his papers in order, but yeah, we're not really seeing much.

NARRATOR It now appears that the medical information

provided to Dr. G is inaccurate.

It's just kinda odd.

We don't really know what's going on with him.

I'm definitely gonna talk to his doctor.

NARRATOR It's rare, but it happens.

Dr. G is stumped.

The toxicological samples may shed further light.

This is OK.

NARRATOR But first, she'll have to cut through this web

of misinformation to get to the bottom

of Rusty's mysterious death.

Coming up, one phone call takes the investigation

into a whole new direction.

I got a totally different picture of this man.

NARRATOR And later, a young man's mysterious death.

I don't know why he's dead.

There's no real apparent reason for it.

NARRATOR Leads Dr. G to a microscopic k*ller that

can strike without warning.

DR. G You don't know what life has for you.

And it's one of those things.

You can't do anything about it.

NARRATOR When "Dr. G Medical Examiner" continues.

[music playing]

Dr. G orders her investigators to track down

Rusty Updike's medical records from his hometown,
[ … ]

Memphis, Tennessee.

We need to go do little more investigation here.

NARRATOR The autopsy is over, and she finds herself

in unfamiliar territory.

I don't have a clue what's going on with this man.

None of this history was confirmed at autopsy.

NARRATOR While waiting for the hospital records,

Dr. G has another idea.

Vesta has given police Rusty's home phone number in Memphis.

I knew that he lived at a motel because of the way

I had to dial the phone.

And he was living with a friend of his at the time.

I wanted to talk to that roommate myself

and see what he knew and what was really going on.

NARRATOR Dr. G makes the call and quickly learns

that Rusty's life after he left his family had been far

tougher than anyone realized.

I got a totally different picture of this man.

This is a man that lives in a kind of homeless shelter motel.

Um, which I didn't know.

All that time I was talking to him on the phone,

I didn't know that.

NARRATOR And the roommate reveals more.

Apparently, in the weeks before his trip to Orlando,

Rusty's inheritance had paid for his serious drinking binge.

He's a big time alcoholic--

very big time alcoholic-- and is rarely

without alcohol in his system.

NARRATOR Finally, the elusive hospital records arrive.

They confirm that Rusty had indeed been hospitalized

for three weeks, as he had told his ex-wife,

but not for the reasons he had claimed.

DR. G He was not in the hospital for a stroke.

He did not have prostate cancer.

He was in the hospital for effects of chronic alcoholism.

NARRATOR According to his records, while in the hospital,

Rusty suffered a serious case of delirium tremens, or the DTs.

DR. G He started going into alcohol withdrawal seizures

and had to be medicated for that.

NARRATOR Because alcohol is a depressant,

it decreases the activity of an alcoholic's brain cells,

or neurons, causing the symptoms associated

with heavy drinking-- slurred speech, coordination

loss, and numbness.

After prolonged exposure to alcohol,

the neurons of an alcoholic like Rusty's speed up to compensate

for the depressive effects.

But if alcohol is suddenly removed from the bloodstream,

these neurons are caught in overdrive, triggering

all sorts of problems.

You start having physical symptoms without the alcohol.

NARRATOR One common symptom of alcohol withdrawal

is autonomic dysfunction.

The nervous system simply loses its ability to control

the body's temperature.

Severe trembling can also set in as the brain

cells overstimulate muscles.

Other symptoms are even more serious.

You can have even hallucinations

and psychosis and seizures.

NARRATOR In such seizures, the brain cells

lapse into uncontrolled, continuous firing,

overloading entire areas of the brain.

When not medically supervised, sudden withdrawal

for a serious alcoholic like Rusty

can be fatal up to % of the time.

The fact that Rusty was hospitalized

with alcohol withdrawal syndrome might explain

why he had lied to Vesta.

It's hard to say, I spent three weeks in the hospital

because of alcohol.

It's a little easier to say, I spent three weeks

in the hospital because I had a cerebral vascular

accident and a stroke.

NARRATOR But these revelations about Rusty's hospitalization

still don't provide an answer to his death.

She already knows he wasn't m*rder*d

and that his various reported illnesses weren't responsible.

But now there's another possibility.

Perhaps Rusty had another bout of alcohol withdrawal syndrome.

The results from his toxicology samples

should provide a definitive answer.

When the report comes back, it shows

that virtually no ethanol was found in Rusty's blood, urine,

or eye fluid samples.

And that could mean real trouble for a serious alcoholic

like Rusty.

With this final piece of the puzzle,

Dr. G now has an answer to the mystery

of what k*lled Rusty Updike.

Rusty Updike is a homeless alcoholic when

he receives an inheritance.

He uses it to go on a massive drinking binge

with his roommate in Memphis.

The two of them, I imagine, went through $,

in a really short period of time.

NARRATOR With the money left over,

he invites his ex-wife Vesta on a luxurious cruise.

Though she hasn't seen him in years,

she agrees to go, under one condition--
[ … ]

that he not get drunk like he did when they were married.

Rusty agrees, and keeps his promise.

DR. G They had dinner together.

And he just had one beer.

One beer's nothing for this man.

He's usually drinking and more a day.

NARRATOR Over dinner, Rusty tells Vesta

that he recently had a stroke and was also

diagnosed with prostate cancer.

DR. G All of his stories about all of his illnesses

were just made up.

And all of his illnesses boil down to chronic alcohol abuse

and having withdraw seizures from chronic alcohol abuse.

NARRATOR Having had only one beer the whole day,

Rusty begins to experience alcohol withdrawal,

causing severe tremors.

His nervous system, accustomed to compensating

for the depressive effect of huge quantities of alcohol,

goes into overdrive.

The tremulous can occur within starting six hours after--

after your alcohol level goes down.

NARRATOR Rusty's body begins to experience

autonomic dysfunction, losing the ability to regulate

its own temperature.

The result-- he's freezing.

DR. G He's cold.

He just feels horrible.

And so that's why he ends up wanting to take a bath.

NARRATOR While in the bathtub trying to warm up,

his alcohol withdrawal takes a fatal turn.

ACTOR PLAYING VESTA Rusty.

Rusty.

He dies in the bathtub, most likely

from either a seizure or cardiac arrhythmia associated

with his alcohol withdrawal.

NARRATOR Rusty Updike kept his promise to Vesta.

He stayed sober for their vacation.

He's trying to act as best for her.

And unfortunately, that's what does him in.

NARRATOR But Vesta believes there's more to it.

She thinks he knew exactly what would happen if he stopped

drinking for their trip.

I'm positive that he knew he was gonna die.

That's just an odd thing to say, but I know that it's true.

I think he was feeling very alone in the world.

And I think he just wanted somebody to maybe see him,

you know?

It's hard to go through life and not be seen.

That hurts.

NARRATOR Dr. G can't help seeing

the irony in Rusty's case.

DR. G If he'd been drinking and had his usual amount of beers

that he normally would take and the amount of alcohol

he usually had in his system, he probably wouldn't had died.

He was charming.

You know, he was mostly a good person

that had a drinking problem.

NARRATOR Coming up, a father attempts to wake his only son

and makes a horrifying discovery.

I could see that he was, uh, dead

before I ever crossed the room.

DR. G A young kid.

.

And he's dead in bed.

No evidence of external trauma.

NARRATOR When "Dr. G Medical Examiner" continues.

The sudden death of a healthy young man

is always troubling, all the more so when the circumstances

of the death baffle everyone involved Dr. G found herself

participating in just such a case during her tenure

as medical examiner in San Antonio, Texas.

It is the eve of Super Bowl Sunday,

and -year-old Max Maxson is enjoying a well-deserved night

out on the town.

He's popular, a reliable employee

at the excavation company where he works with his father Harry.

HARRY Yeah, we had--

we had a very good relationship.

He was a good guy.

He had a good relationship with just--

just about everybody that I knew.

It was just incredible how many friends he had,

male and female.

NARRATOR A few years earlier, Max moved back

in with his father, and the two began

to enjoy the bachelor life.

HARRY Yeah, we had a lot of fun.

A lot of times, we'd just get-- get in his Jeep,

and we'd ride up River Road go up

to Canyon Dam on the weekends, just be riding along.

We had a lot of fun.

NARRATOR But tonight, Harry is not with his son.

Max is out at a nightclub on San Antonio's famed River

Walk with some friends.

[chatter]

HARRY He had a whole slew of friends.

He'd go somewhere with one one time,

and another one another time.

They'd go to the nightclub and go dancing.

He enjoyed doing that a lot.
[ … ]

NARRATOR At around AM, Max calls it a night.

He drives home, gets into bed, and turns on the TV.

Four hours later, just after dawn, his father Harry

begins his day.

Like any concerned parent, the first thing he does

is check on his son.

I woke up about and--

and went and looked out the window.

His Jeep was in the driveway, so I knew he'd made it home OK.

NARRATOR But rather than wake him,

Harry figures it's better to let Max sleep off his late night.

HARRY He always slept till or o'clock

from when he'd come in late.

So you know, I've been real quiet not to--

not to wake him up.

NARRATOR But by that afternoon,

Max has still not stirred.

His father finally decides to check on him.

HARRY It was dark and his room.

He was laying there on the bed.

Looked like he was OK.

I closed the door and went to the bathroom.

While I was in the bathroom, I thought that, you know,

something didn't look quite right.

So I went-- I went and hollered at him a couple of times,

and I didn't get any sound.

And I banged on the door pretty loud two or three times.

And finally, I opened the door and turn the light on, and--

I could see that he was, uh, dead

before I ever crossed the room.

I called the police, and then I called his mother.

He said, I've got bad news.

And, uh, he said, Max is dead.

So I called EMS, and I told them, I said, there's no--

no need to hurry.

He's-- he's been dead a long time.

I walked back to the front door.

I looked out the front door and I said,

this cannot be happening.

EMS and police arrive on scene and confirm

Harry Maxson's assessment.

One of the paramedics had come up to me

and advised me that this was a DOA, a Death on Arrival.

ANITA SEAMANS I remember standing looking down on--

on this young man, thinking, this man shouldn't be dead.

I don't know why he's dead.

There's no real apparent reason for it.

So it was a bit puzzling.

NARRATOR Puzzling but for one possible lead

discovered next to Max's bed, a Ziploc bag containing and /

tablets and a bottle of liquor.

Mixing narcotics with alcohol can be a fatal combination

because they can shut down a person's

central nervous system.

ANITA SEAMANS When we see pills and alcohol in close proximity

to one another in a scene such as this and the person

is deceased, we have to stop and consider,

OK, did this person purposely or accidentally

overdose on something?

An autopsy was definitely needed in this case.

Definitely.

NARRATOR On Super Bowl Sunday, the medical examiner

who gets that call is Dr. G.

DR. G Well, my investigator goes out to the scene.

He's my eyes and ears.

And he tells me what he--

what he finds.

He's a -year-old kid, good kid, but he's dead in bed.

And he'd been partying the night before.

The other little red flag is he's got

some pills next to his body.

Hmm.

A little a container of alcohol there too.

So maybe he really is partying and it's a drug overdose, which

are so frequently in my morgue.

So you know, it looks it might be one

of those routine drug deaths.

NARRATOR But the presumption that Max

abused dr*gs of any kind is one his father strongly

disagrees with.

He didn't want nothing to do with dr*gs.

NARRATOR Coming up next, Dr. G performs the autopsy

on Max Maxson and discovers that the cause of his death

is anything but routine.

Such a shock, like a lightning bolt.

NARRATOR When "Dr. G Medical Examiner" continues.

Max Maxson's body is prepped for autopsy while Dr. G reviews

the few facts of the case.

DR. G A young kid.

.

And he's just dead in bed.

No evidence of external trauma.

NARRATOR Max had been out with friends at a nightclub

and was discovered by his father dead in bed the next day.

HARRY He was wearing his shorts.

His knees were propped up, and he just looked like he'd, you

know, fallen asleep.

NARRATOR To Dr. G, the case looks

like a fatal drug overdose, a contention that sits

uneasily with Max's father.
[ … ]

For now, what k*lled Max Maxson is still an open question.

Hopefully, it won't be for long.

As Dr. G conducts the external exam,

she comes to the same conclusion as the investigators

on the scene.

Outwardly at least, there appears to be nothing

wrong with the young man.

There was nothing to note.

He looked healthy.

foot , and he weighed about pounds.

NARRATOR In fact, the only notable abnormality

on Max's body is the nightclub ink stamp

on the back of his right wrist.

The innocuous mark is for Dr. G one more

check on the list of indications for a possible drug overdose.

Statistics show that every year in the United States,

over , people are rushed to the emergency room

from overdosing on dr*gs at nightclubs.

Of those, many will result in fatalities.

And even though Max's father does not believe his son used

illicit substances, Dr. G encounters this type

of scenario all too often.

Yes, I hear that a lot from parents

that the kid doesn't use dr*gs or, you know,

not a big partyer.

And you know, I take that into consideration,

but I've also had many a case where they're not big partyers,

but it only takes one time with some of these dr*gs.

NARRATOR Nevertheless, beyond the circumstantial evidence

recovered at the scene, the external exam

reveals no additional indications of drug abuse,

such as needle marks.

There was really no signs of drug

use on the outside of his body.

But you oftentimes don't see that.

NARRATOR After completing the body chart,

Dr. G begins the internal exam.

OK.

Scalpel.

NARRATOR Opening Max's torso with a Y incision.

But her findings here are also all negative.

There is no indication he suffered any trauma.

There are no pills or dr*gs in his stomach.

His heart shows no signs of trouble.

Yeah, that's healthy.

NARRATOR In fact, everything appears perfectly healthy.

No trauma, and nothing that was remarkable

internally on his body.

NARRATOR Nothing remarkable except for his lungs.

They are filled with fluid.

Look at that.

You can see the fluid just pouring out of the lungs.

Heavy lungs when I open them up.

You know, kind of wet, heavy lungs.

NARRATOR Although the mechanism that causes a person's lungs

to fill with fluid is not fully understood,

the finding itself is a significant clue.

It means that whatever k*lled Max did not k*ll him instantly.

He died slowly, perhaps over the course of several hours.

Fluid starts building up in the lungs with--

with the overdoses.

They tend to be in a coma for a while and then die.

And we usually see very, very heavy lungs.

NARRATOR To check for the presence of dr*gs,

Dr. G draws fluids for toxicology tests.

However, the results can take up to six weeks.

So you know, really thinking this is probably gonna

be a drug death at that point.

But it's not over till it's over,

and it's never over till you open that cranial cavity.

We're cutting the dura, the base of the brain.

NARRATOR But as she does, Dr. G discovers

another anomaly, something completely unanticipated.

I look at the base of the brain,

and there's a very large concentration

of subarachnoid blood overlying the base of the brain.

NARRATOR Subarachnoid bleeding means that displaced blood has

collected under the thin, translucent arachnoid membrane

that covers the brain.

In other words, Max was hemorrhaging.

Later, when Dr. G completes the autopsy,

she discovers the surprising cause of Max's brain bleed.

Well, I'll be darned.

NARRATOR When "Dr. G Medical Examiner" continues.

To Dr. G, the death of Max Maxson

appeared to be a straightforward drug-induced death--

a late night at a nightclub, pills and alcohol

by the bedside, and at autopsy, heavy, fluid-filled lungs.

But then she examines his brain.

Very large.

There's a very large concentration

of blood overlying the base of the brain.

NARRATOR Now Dr. G must figure it out.

Why was Max's brain hemorrhaging?

Dr. G takes Max's brain to the dissecting table

for a closer look.

She carefully cleans his brain and then

begins to dissect it, searching through

the delicate and tiny blood vessels

for the source of the hemorrhage.
[ … ]

And then she sees it.

An eight-millimeter long bulge in one of his cerebral blood

vessels has torn open.

Well, I'll be darned.

NARRATOR Max died from a ruptured cerebral aneurysm.

We can see a distension.

We can see an aneurysm here.

NARRATOR The type of aneurysm that Dr. G discovers is known

as a saccular or berry aneurysm, because of its shape,

like a berry.

They often develop at the branch points of cerebral arteries.

I've seen many a berry aneurysm,

and that's what they look like.

NARRATOR Cerebral aneurysms form when a blood vessel

is weakened and begins to balloon

or dilate under the pressure of blood pulsing

through the vessel.

Over time, the enlarging vessel can leak or even burst,

resulting in a catastrophic brain hemorrhage, which

in the United States causes death or severe disability

in nearly % of its victims.

Weighing heavily on Dr. G, however,

is that ruptured cerebral aneurysms are sometimes

associated with drug use.

Oftentimes, these are associated

with elevated blood pressures.

And oftentimes, on a young person,

they're using some type of stimulant,

like a methamphetamine or cocaine,

something that would really cause their blood

pressure to elevate.

NARRATOR Only the toxicology test performed on fluids drawn

from Max's body will tell Dr. G for certain

if dr*gs played a role in his death.

But the results are not in yet.

While she waits, Max's case remains open

and his cause of death undecided.

Finally, two weeks later, the toxicology report is completed,

and it's determined that Max Maxson

had no dr*gs in his system.

DR. G His blood was clean.

He had no dr*gs on board.

NARRATOR And further investigation

determines that the pills found at his bedside

were nothing more than a common antibiotic.

He had an infection, and he was taking some pills,

but that had nothing to do with the aneurysm.

NARRATOR But if dr*gs played no part in Max's death,

what then could have caused an otherwise

healthy young man to die of a ruptured cerebral aneurysm?

Dr. G concludes that Max's berry aneurysm was likely the result

of a congenital weakening within his delicate cerebral blood

vessels.

It's considered to be congenital,

meaning had it since birth.

You may not see it at birth because it

takes time for that weakening of the wall to balloon out.

NARRATOR In other words, Max's aneurysm was a time b*mb

that took years to detonate.

It just was, unfortunately, a very unusual, uh,

natural death.

NARRATOR With all the facts in place,

Dr. G can now piece together the events of Max

Maxson's last night alive.

That night, Max is out at a club in San Antonio.

According to toxicological findings,

he does not take any dr*gs.

And yet lurking at the base of his brain is his k*ller.

As he enjoys time with his friends,

the congenital berry aneurysm deep within his brain likely

begins to leak nearly imperceptibly.

He probably was having some minor bleeding.

And this was a fairly big aneurysm.

It was-- it was about eight millimeters.

Oftentimes, I only see them two, three millimeters.

NARRATOR Sometime around o'clock AM, Max drives home,

gets into bed, and turns on the TV.

DR. G Well, he probably has a headache,

and that headache was probably due to some minor leakage.

And then, at some point, it ruptures.

NARRATOR Blood no longer trickles.

It bursts through the weakened vessel.

The pumping blood seeps into the open spaces

of Max's cranial cavity and under the protective arachnoid

membrane that covers the brain.

If he wasn't asleep already, within minutes, he

is most certainly unconscious.

DR. G He probably goes unconscious very quickly.

NARRATOR Soon, Max slips into a coma.

Because he is comatose, fluid begins to fill his lungs,

making it difficult for his heart to beat.

In Max's brain, the pressure of the accumulating blood

eventually short circuits his brain

stem, the part of the brain responsible for signaling

the heart's rhythm.

The heart ceases to beat, and Max dies.

From what I hear, he had a very easy passing.

HARRY They told me later that--

that they thought that he had probably died eight or nine

hours before I found him.
[ … ]

So he had-- he had been dead for quite a while.

Sometimes I--

I feel like I can hear him, and he'll say, don't cry for me.

I'm better off than anybody.

I'm in a better place.

And I believe that.

I think an aneurysm, when you don't know you have it and you

die from it, it's just such a shock, like a lightning bolt.

I mean, you just don't expect it.

It's one of those things that, uh--

you know, life has chances.

Life has-- you don't know what life has for you.

And it's one of those things, you can't do anything about it.

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MAN Atlas.