02x08 - Truth of the Matter

[bunniefuu]

[music playing]

NARRATOR A man sh**t his wife to death on a hunting trip

and swears it's a freak accident.

I think it's her first time with her husband hunting

and he ends up with a g*nsh*t wound to the abdomen.

It sounds a little bit weird to me.

NARRATOR To Uncover the truth, Dr. G will have to literally

piece the clues together.

I'm taking super glue and bringing the edges

of that wound together.

NARRATOR Then a man trying to collect a debt

gets the surprise of his life.

Two others started b*ating him with a x.

NARRATOR But two weeks later on the road to recovery,

he inexplicably dies.

It doesn't matter if it's two weeks or two years earlier.

Forensically, that is a homicide.

NARRATOR And are men are inherently more susceptible

to accidents than women?

It's a cliche but I've had them,

where they're up sitting on a branch

that they're actually sawed off.

NARRATOR Accidents and the sometimes

careless men who have them.

I can't wait for this episode.

NARRATOR Altered lives, baffling medical mysteries,

shocking revelations.

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

[music playing]

It's hunting season in morgues across the state of Texas,

a time of year that brings its share of firearm

accidents, some of them fatal.

Accidents happen.

They're loaded weapons.

Be very careful.

NARRATOR Such is the case of Carol Moleskie,

a -year-old woman sh*t in the abdomen while stocking

wild turkey the day before.

Dr. G begins the case by examining the Sheriff's report.

It consists mainly of testimony from the sole eyewitness

to the k*lling, Carol's husband, Bob.

His heart-- looking at his heart.

NARRATOR According to Bob, he and his wife

had recently reunited after a separation

and decided to spend the day together doing some hunting.

This was the first time she'd ever been hunting,

and she was just going along with him to be with him.

NARRATOR They hiked several miles into the wilderness, bob

with his high powered r*fle slung

over his shoulder and Carol following close behind.

He claims that, as he sees a turkey,

he's got the one g*n that he's going to start f*ring.

NARRATOR Then, according to Bob, a freak accident occurs.

She's behind him, and he's crouched down.

All he knows is that it's slipping off his shoulder,

he's trying to grab it, and it goes off.

[g*nsh*t]

NARRATOR Carol is hit in the midsection.

The wound begins to hemorrhage uncontrollably.

Frantic, Bob cuts his way through the forest

to a nearby road and flags down a passing truck.

The driver rushes Carol to the hospital, but it's too late.

She dies on the operating table from massive blood loss.

They'll be here in an hour and a half.

NARRATOR Now, the Sheriff and medical examiner

are left with one question.

Is Bob Moleskie telling the truth?

You always have to have a healthy index of suspicion

to be a good medical examiner.

A medical examiner takes nothing on face value.

You have to be the paranoid one.

NARRATOR And there's good reason to be skeptical.

Fatal hunting accidents are extremely rare.

In , there were over a million licensed hunters

in Texas but only four deaths due to accidental sh**t.

Most hunters are very responsible.

NARRATOR In addition, Bob's high powered deer r*fle

appears to be the wrong w*apon for turkey sh**ting.

When you're using a r*fle, the only hit sh*ts

you can make on a turkey is a head sh*t because anything else

would destroy all the meat.

And most people just use a shotgun.

NARRATOR Adding to the suspicion

is the fact that Bob had told police that he and his wife

had been in marriage counseling.

Could he have set something up?

Could he have made it look weird?

The central question in this is, is this man's story

holding any water?

I have to confirm or deny that that makes any sense.

[music playing]

NARRATOR As a first step, more technicians X-ray the body.

One of the transparencies clearly

shows the r*fle b*llet embedded in the woman's left buttock.

Now Dr. G steps in.

Her immediate goal will be to look for any signs of foul play

on the outside of the victim.

Externally, I look for any signs.

Maybe she struggled with him.

Maybe she had a fight with him, any other signs of bruising.
[ … ]

NARRATOR Carol is heavyset and has an overhanging belly.

Below it, on the thigh, she spots the first evidence

that could suggest Carol fought for her life

before she was sh*t.

There's a little abrasion on the lower aspect of the abdomen

and a mirror image abrasion on the front of the upper thigh.

So basically, the blood vessels are breaking in the skin,

and that's causing the bruising.

Arden, are your hands clean?

Could you take a quick photo?

I got your camera right here.

NARRATOR Could this be evidence of a second injury?

Yeah, tilt her a little.

NARRATOR Had Carol been beaten first, then sh*t?

Maybe over here.

NARRATOR Next, Dr. G gets her first close look

at the g*nsh*t wound itself.

But immediately there's a problem.

While trying in vain to save Carol's life during emergency

surgery, doctors made large incisions in her midsection

and greatly altered the b*llet wound.

So when you first look at her, her belly is, like, all open.

They didn't even sew it back up.

She d*ed during surgery.

And you don't even see the wound.

Yeah, we have to work through what the hospital's done.

NARRATOR For Dr. G to get any information from the wound,

she must carefully reconstruct it.

DR. G Once you bring it together and meticulously

brought the wound edges together,

you can see a nice and / inch diameter

defect from the g*nsh*t.

NARRATOR The area around the wound

is peppered with small marks known as powder tattooing.

The powder tattooing is the gunpowder

that's not quite burnt.

It's actually the gunpowder hitting your skin, causing

little abrasions to the skin.

So that tells me the end of that barrel was fairly close to her.

NARRATOR Her finding is consistent with Bob's claim

that his wife was close behind him.

But it doesn't rule out another ominous scenario.

Now, it also could go along where she's just walking around

and he turns around and sh**t her.

So what's that trajectory?

NARRATOR For the medical examiner,

mapping the trajectory or path of a b*llet

is the next best thing to finding an eyewitness.

In this case, it may show whether Bob

Moleskie is telling the truth or concealing a crime.

According to Bob, the r*fle hit the ground causing

it to accidentally discharge.

If this is true, the autopsy should

reveal that the b*llet entered very low on Carol's body.

OK.

NARRATOR To determine trajectory,

Dr. G draws a straight line between the entrance wound

to where the b*llet lodged inside Carol's left buttock.

What she finds at first is disturbing.

It looks like the g*nsh*t wound'S much higher.

It looked almost as if the b*llet

was going on a downward path.

Because I knew where the b*llet ended up.

I could see that on her buttocks,

and I could see the X-ray where the b*llet ended up.

NARRATOR If the b*llet entered from this high an angle then

traveled downward to Carol's abdomen

and into her left buttock, it would

mean that the r*fle could have only been

fired from a standing position.

And it would suggest one thing, Bob is lying.

Outside the morgue, the police arrived independently

at a similar conclusion.

Bob Moleskie has insisted that his r*fle

went off accidentally.

But when deputies try to duplicate the misfire,

they fail.

We tested a g*n and we bumped it and we could not

set off the trigger that way.

After I told him that we had already tested it for that

and we could not set trigger off,

he said, oh my god, you think I pulled the trigger.

[music playing]

NARRATOR Coming up next, Dr. G finally

unravels the surprising cause of Carol's mysterious bruising.

As the abdomen expanded, it slapped against the thigh.

NARRATOR When Dr. G Medical Examiner continues.

[music playing]

The body of g*nsh*t victim Carol Moleskie

is at the Bexar County Morgue awaiting internal exam.

The day before, she was k*lled during a hunting trip

with her husband Bob.

He claims that his g*n fell to the ground

and misfired, sending a b*llet into her gut.

But so far, Dr. G's external exam

and the police investigation suggests that he

may have k*lled his wife.

Does it makes sense for an accident,

or is it clearly that he just couldn't stand her nagging,

or for some whatever reason, lures her
[ … ]

out there on her only hunting trip

to k*ll her out in the woods?

NARRATOR Now, determining the guilt or innocence

of the husband will come down to one thing,

discovering the exact trajectory of the b*llet.

[music playing]

The external exam previously suggested that the b*llet

traveled downward.

To determine if this is true, Dr. G will

need to open up Carol's body.

After making the usual Y incision

and removing most of the internal organs,

Dr. G makes a surprising discovery.

There is massive damage to Carol's lower pelvic region.

The projectile destroys a lot of the pelvic vessels.

There's a huge tear to the iliac vein.

NARRATOR Iliac veins are major vessels

responsible for returning blood from the lower half of the body

to the heart.

It's clear that the laceration to this critical blood vessel

is what caused Carol to bleed to death.

Total unsurvivable injury.

The path of the projectile went through that abdomen,

breaking the pelvic bone, shattering the inferior ramus,

this lower portion of the pelvis, going up,

and then it goes into the buttocks.

NARRATOR But when Dr. G factors in this new finding

with her previous calculations, something doesn't add up.

A high velocity b*llet, which typically travels

in a straight line, could not enter the abdomen,

travel downwards to the pubic bone,

then turn upwards to lodge in the left buttock.

To solve the riddle, Dr. G turns away from the b*llet wound

and returns to Carol's second injury,

her strange thigh bruises.

She has not only this g*nsh*t wound

but a tremendous amount of hemorrhage

in the skin on the front of the upper thigh.

NARRATOR It is now clear to Dr. G

that the contusions were not caused

by a b*ating from the husband.

They are a direct result of the g*nsh*t.

But how could a b*llet cause severe bruising

to the outside of the body, so far from the actual wound?

She's got a very large abdomen, what would I

call a pendulous abdomen.

As the b*llet was passing through,

that b*llet will have a lot of kinetic energy

that it will disperse into the body,

and you have a real temporary cavity where the tissues

actually expand out.

Arden, you know, it was the kiss of death.

NARRATOR This virtual expl*si*n in Carol's abdomen

provides an important clue.

As your belly is expanding with that kinetic energy,

the two surfaces come together, probably, you know,

through clothing.

But you have an abrasion on the thigh

and abrasion of the abdomen, so they kind of slap together.

Because as it expanded out, it slapped

enough to cause an abrasion.

NARRATOR The bruising proves that Carol's thighs had

to be touching her abdomen when she was sh*t,

a finding that provides Dr. G with the cases

most significant revelation.

She had to have been bent over for her pendulous abdomen

to get over her pubic symphysis, all indicated that she

was crouched down, bent over.

NARRATOR This means that Carol had

to be in a crouching position when

the b*llet entered her body.

But does this help explain the b*llet's strange trajectory?

The only way you can get that into a straight line

is if she is bent over with that pendulous abdomen

hanging over her lower pelvic region.

NARRATOR With the body in a bent over position

and the abdomen hanging over and below the pelvis,

the entrance wound, the b*llet's internal path,

and its resting place lined up perfectly.

And what that tells me, it's an upward sh*t from very low.

Now, she's crouched over, we've got evidence of that,

and it's an upward sh*t.

That's a very hard sh*t to just turn around and sh**t somebody.

But it does make sense for the g*n to be hitting the ground.

As it hits, the g*n goes off.

The g*n is very low, and it goes into her abdomen

and goes upward.

So that does make sense.

NARRATOR Circumstantial evidence

initially seemed to implicate Bob in his wife's death.

But suddenly, it appears the b*llet's trajectory

supports his claim that the w*apon discharged

after it hit the ground.

[g*nsh*t]

In the course of the autopsy, the case has done a .

Dr. G's findings now favor the husband's story.

This is one where you just have to take what you can find

from the autopsy and piece it together what they can

find from their investigation.

NARRATOR But the police still have their doubts.
[ … ]

After testing the r*fle several times,

they could not get it to discharge in the manner

that Bob described.

To verify their findings, they bring in an expert gunsmith

for a thorough going over.

This time, the outcome is different.

We were able to determine on his r*fle,

if he took it up and took the safety off, it worked properly.

If you took it and held it this way, and turned it that much,

and took the safety off, the g*n would fire.

So if he was taking it off his shoulder like this,

and he did accidentally trip that safety,

that g*n was fired.

That would also line up the sh*t that went into the wife.

NARRATOR This new finding gives Dr. G the amm*nit*on she

needs for an official ruling.

Based on the trajectory of the b*llet, based on the story

that he told that matches the trajectory of the b*llet,

and based on the fact that the g*n was tested

and found to repeatedly fire when it's upside down

and hits the ground, everything fits together.

This is an accidental death.

NARRATOR The case has been full of revelations and reversals,

but Dr. G now knows exactly what happened to Carol Moleskie

on her first and last hunting trip.

[music playing]

It's a Texas rite of spring, a long trek through the brush

in search of wild turkey.

A sudden rush of excitement as Bob and his wife Carol

spot their prey.

As he crouches down to sh**t that turkey,

the g*n's falling off his shoulder.

NARRATOR The defective r*fle hits

the ground, tripping the safety and triggering

the f*ring mechanism.

Carroll is hit in the abdomen, leaving a gunpowder tattoo

around the entrance wound.

That tells me the end of that barrel was fairly close to her.

NARRATOR Because she is crouched down

and with her belly hanging over her pubic bone,

the b*llet enters through the abdomen

and travels upward into her pelvic region.

As it tears through her body, the b*llet

releases its kinetic energy.

The stomach violently expands, leaving a mirror

image abrasion on her thigh.

Which made me think that her--

she was bent over.

NARRATOR The b*llet strikes her pubic bone,

then continues upward and destroys the iliac vein.

Doctors are unable to stop the bleeding,

and Carol dies on the operating table.

The autopsy findings have made Bob

and Carol's recent marital problems irrelevant.

There is no longer any question that this was

a tragic accidental sh**ting.

There were no charges filed.

The case was closed as an accidental sh**ting.

[music playing]

NARRATOR In , the state of Texas

saw only hunting accidents, with just

a fraction of them fatal.

I'm not sure you should be carrying

a loaded g*n already cocked on your shoulder

with your wife behind you.

Now, that's a whole 'nother ballgame.

But, you know, safety, safety, safety.

[music playing]

NARRATOR Coming up next, are men inherently more susceptible

to accidents than women?

I thought about this for a long time.

Why we just don't see women down here with those kind of accs.

NARRATOR The debate is on when Dr.

G Medical Examiner continues.

[music playing]

Pelvic fractures, subdural, parietal--

NARRATOR Dr. G sees them every day in the morgue.

His face is horrendous, very bad.

NARRATOR Victims of accidents, deaths caused

by unintended consequences.

Oh yeah.

He's got a-- kind of a step down from the skull fracture.

NARRATOR But nationwide death statistics in the US

reveal a disturbing yet little known fact.

Most victims of accidental fatalities are men.

Large amount of damage here.

His face is so distorted from the accident,

we need a better identification.

NARRATOR This is the phenomena of Men and Accidents.

In the United States, accidental deaths k*ll

over , males every year.

Astoundingly, for males between the ages of and ,

accidents are the number one cause of death.

We got three stories, hm.

I think that accidents are a public health issue,

and I think and you can almost say it's a crisis.

The biggest k*ller of men between and

is preventable.

Doesn't really say what happened.

NARRATOR But for Dr. G, it isn't just the numbers
[ … ]

that she finds troubling.

It's the kind of accidents men tend to fall victim to.

Before I start, I should say I really do like men.

They're some of my best friends.

I mean, Steve is probably my best friend.

He's a guy.

I don't have a problem with him.

But I have been doing this for years, and I personally--

I personally see a pattern that I think even my male colleagues

would agree, that we see really stupid things

done by men in this office.

I'm talking about just things that men don't think of.

And I don't think they think through.

NARRATOR A case in point, Dr. G once investigated

the accidental death of a man who

was attempting to fix the undercarriage of his truck

without using a jack.

Instead of doing a jack, he drives

his car up on a spare tire.

And it rolls off.

And unfortunately, it rolls off onto him.

I've thought about this for a long time,

why we just don't see women down here with those kind of accs.

I have nothing against men.

There's something about them.

Maybe it's, you know, the chance taking,

and maybe that's why I like men so much.

Maybe women are a bit more conservative.

But we're just not going to see them down

here with the stupid accidents.

NARRATOR Statistics indicate that men

are more than twice as likely to die in an accident than women.

But less clear is, why?

One possibility--

[music playing]

Throwing back a few drinks with the guys

may seem harmless enough, but the statistics

linking men and alcohol reveal a disturbing relationship.

Alcohol takes away good judgment.

It impairs the processing of information.

NARRATOR Dr. Nancy Slicner is a forensic psychologist

who studies how social influences affect our behavior.

Especially in younger guys, what you're going to see

is that alcohol makes them feel invincible.

Alcohol, unfortunately, is a big factor

with accidental deaths.

NARRATOR Drinking was a central cause in a case Dr. G worked

on several years ago involving two men,

a cliff, and a case of beer.

There's a nice sign that says, do not camp within I

think it was feet of the edge of the cliff.

Well, these guys like the view.

Why not camp right on the edge of a cliff?

And then why not have a few beers?

Well, there is a little problem with that.

After you have a few beers, you feel like you

have to relieve yourself.

So you get out of your tent and take

a walk to relieve yourself.

And over the cliff he goes.

That's probably why they didn't want people putting their tents

up next to the cliffs.

But obviously, they didn't think about that.

They didn't think about the next step.

Oh, I do believe I have they reek of alcohol here.

NARRATOR But alcohol is not the sole culprit in thousands

of accidental deaths.

Something else that might account for the higher death

rates in males, their hormones.

The most vulnerable population is your, say,

to -year-old male population.

They have the highest testosterone levels,

and they're going to engage in the most risk-taking behaviors.

NARRATOR But for Dr. G and other experts,

testosterone, like alcohol, tells only part of the story.

I think, in some aspects, some of our accidents

are clearly testosterone driven.

Risk-taking, the driving fast, the "thinking

I don't need a helmet", I think there is a macho aspect to it.

Whatever caused this defect to his head,

it went all the way into his brain.

NARRATOR Coming up next, new research in the field of men's

health might finally answer the question of why more men

die in accidents than women.

I think a lot of it is how men are raised.

NARRATOR And later, Dr. G receives

a case of a man whose cause of death

seems written all over his body.

This is a guy who was beaten, and I've

got to answer the question, can we relate

that b*ating to his death?

NARRATOR When Dr. G Medical Examiner continues.

[music playing]

The phenomenon of male death rates and accidents

is puzzling.

But new research in men's health is

taking a closer look at why men die much

more frequently than women.

The theory, perhaps males engage in riskier behavior largely

because of widely accepted and continually
[ … ]

reinforced social norms.

But I think it goes back to early conditioning,

where your parents are forever telling the little girl,

don't do that.

You're going to get hurt.

But it's OK for boys to try it.

I have two boys, and I'm very cognizant

of the culturalization of men just being kind of macho

and the taking control.

But I do try to teach them to think about the consequences

of your actions.

Because I think, most of these accidents,

they could have been avoided if there

was a little thought process.

Thank you, Dr. Hoban.

Thank you, Steve.

I can't wait for this episode.

You can really point to some of these stories

and really laugh.

The sad part of it is is that somebody has d*ed,

and somebody's loved one has d*ed, and it is sad.

But when you take it out of the personal realm

and just look at some of the stupid actions that have

occurred, you're not laughing at the person dying,

but you're just laughing at the totality of these stupid acts

that occurr in life.

[music playing]

[music playing]

NARRATOR While men die from accidents at twice the rate

of women, shockingly, they are about three times

more likely to be victims of yet another manner of death--

homicide.

His brain stem is torn.

He d*ed very quickly.

NARRATOR Many such men enter the nation's morgues every day

as seemingly clear cut homicides.

And with confirmation from the medical examiner,

a criminal investigation may proceed.

I'm sketching all the wounds on his face.

NARRATOR Kyle Gilbert, a -year-old car mechanic

is one of these possible homicide victims.

At the time of his death, he lived with his mother.

And according to the investigator's report,

he had a long history of alcohol abuse.

But his older medical history said

he does have cirrhosis of the liver, where your liver

scars down and damaged.

It looks like-- now, this is just--

looks like this is probably due to alcoholism.

NARRATOR But it's not his past medical history

which catches her attention.

As she continues to read the report,

she learns that, days earlier,

Kyle paid a visit to a client who was

late paying his repair bill.

He went over there to get some money that was owed him.

NARRATOR But instead of cash, Kyle

receives an unexpected payment.

Somebody calls his name, he turns,

and he starts getting beaten by a x.

NARRATOR Kyle eventually makes it home where his mother

is shocked by the injuries.

She wants to call an ambulance, but he

prefers to nurse his own wounds with a stiff drink.

So what happens is he's home.

Now, he didn't get any treatment for this b*ating.

NARRATOR Kyle's wounds heal slowly,

but he seems to be on the road to recovery,

until two weeks later.

He is home, sitting on his bed, talking with his mother,

and he just collapses and stops breathing.

NARRATOR It's a mother's worst nightmare.

She immediately calls .

He did make it to the hospital,

and they said he had some kind of internal hemorrhaging.

NARRATOR But less than two hours

after collapsing, Kyle is pronounced

dead in the emergency room.

He had some blood coming from his mouth, the throat.

It appeared to the family that this

was just very consistent with the b*ating that he'd received.

NARRATOR Despite the two week gap,

police and the medical examiner's office

see a clear connection between the b*ating and Kyle's death.

And Dr. G decides to order a complete autopsy.

The information received from an autopsy is always critical

when somebody later dies, especially after a b*ating

or receiving some sort of injuries.

If he was beaten with a x, and that set up

a chain of events that eventually caused him to die,

it doesn't matter if it's two weeks or two years earlier.

Doesn't matter if it's years earlier.

Forensically, that is a homicide.

NARRATOR For police, autopsies of potential homicide victims

have a special urgency because they can lead to arrest

and successful prosecutions.

But for Dr. G, they come with a unique burden.

If her findings are inconclusive,

the guilty could go free.

[music playing]
[ … ]

I would expect a lot of blood in there.

NARRATOR Coming up next, Dr. G is shocked by what she doesn't

find inside Kyle's body.

We don't see any free blood in his abdominal cavity.

We don't see any free blood in this pleural cavity.

NARRATOR When Dr. G Medical Examiner continues.

[music playing]

Morgue technicians weigh and X-ray the body of Kyle Gilbert.

Two weeks after a ruthless b*ating,

he suddenly collapses and dies, showing

signs of internal bleeding.

The assumption everyone has, including the police

and my investigator, is that the time frame is so quick that he

probably d*ed from the b*ating.

NARRATOR If Dr. G finds forensic evidence

that the b*ating is responsible for Kyle's death,

police will make arrests.

If she can't, his K*llers could go free.

[music playing]

You've got to find--

NARRATOR Meanwhile, with the investigation

of a possible m*rder brewing, police gather in the morgue,

awaiting answers from the autopsy.

All we're getting is what the EMS told the hospital.

[inaudible] a cardboard [inaudible]..

NARRATOR When Dr. G begins the external exam,

she notices that Kyle's skin is jaundiced.

--yellow.

His body skin tone is a little yellow.

NARRATOR But what really attracts

her attention is the incredible bruising on his body.

Oh yeah, we see a lot of bruising on him.

NARRATOR Kyle's body is covered in more

than a dozen bruises, still painfully

visible after two weeks.

We see bruising on this right hip region.

A little bit of abrasion and a bruising contusion on his knee.

And then he's got a lot of bruises on his back, also.

He's got them on the lower sacrum, the mid back, posterior

shoulder, and also some blows to his arm's, possibly

trying to defend himself.

NARRATOR Dr. G finds one wound particularly alarming.

It's just above the costal margin,

the bottom of the rib cage, and measures seven by three inches.

A haunting imprint of a x.

He has a nice big bruise right around here

in the epigastric region.

So you wonder how bad the blow is.

Did he injur his aorta?

Did he injure his liver?

Did he injure his duodenum or small bowel?

What's going on?

NARRATOR But other external clues on Kyle's body

also point to heavy internal bleeding.

He's bleeding out of his nose.

He's bleeding out of his mouth.

NARRATOR From the external exam,

all signs still point to m*rder.

But to unravel the mystery of the internal bleeding,

Dr. G will have to delve inside Kyle's body.

She makes the classic Y incision.

Once she removes the chest plate,

Dr. G carefully inspects the flesh beneath the most vicious

bruise on Kyle's abdomen.

And it's a deep bruise.

As soon as I do the Y incision, I

see that he's got a lot of hemorrhage in the muscle

from the b*ating.

NARRATOR As feared, this single devastating blow

had caused damage deep into the abdominal wall.

If Dr. G finds pooling of blood inside the abdominal cavity,

she could have her smoking g*n.

It's a lot of trauma.

We'd expect a lot of blood in there.

And what are we seeing?

A lot of just--

NARRATOR But here, she gets her first big surprise

at the autopsy.

I don't even see hardly any blood.

We don't see any free blood in his abdominal cavity.

We don't see any free blood in his pleural cavity.

NARRATOR With the exception of the deep bruising,

Dr. G can't find any internal damage from the xs at all.

Then it would be easy.

If I found something definitive like a rib that broken the--

pierced the lung.

No evidence of any type of as*ault type trauma.

NARRATOR A case that seemed like homicide

only minutes earlier has suddenly become less clear cut.

Without concrete forensic evidence,

police can't arrest the men who b*at Kyle.

We were waiting for the results of the autopsy

to determine how we were going to proceed

with the investigation.

Ultimately, I can't connect any dot

until I figure out why he d*ed.

[music playing]

NARRATOR Coming up next, does Kyle Gilbert's body

contain an expl*sive secret?

There was a time b*mb waiting to happen.
[ … ]

NARRATOR When Dr. G Medical Examiner continues.

[music playing]

With the help of morgue technicians,

Dr. G prepares to weigh and examine

Kyle Gilbert's internal organs.

I still have to take my organs out in my usual fashion.

I don't jump anything.

NARRATOR Only minutes ago, the case of the man beaten by xs

seemed to be an open and shut homicide.

But so far, Dr. G has been unable to find

the internal evidence to prove it.

Some of the obvious reasons for him to die from a b*ating

are kind of being ruled out here.

NARRATOR If Kyle did not die from the intense b*ating,

then what k*lled him?

And what caused him to cough up blood?

Dr. G must look internally for other reasons which might

have contributed to his demise.

[music playing]

Having read Kyle's medical history,

Dr. G already knows that he suffered

from cirrhosis of the liver.

The liver, look at that.

It's not looking good.

NARRATOR Upon closer inspection,

she can see that the damage to his liver

is worse than his record suggested.

Normally, a liver has a beautiful, smooth capsule,

and is brown, and has a very sharp edge.

His liver was gnarly.

It was yellow.

NARRATOR Cirrhosis is a liver disease most often

associated with hepatitis B or C,

or in Kyle's case, alcoholism.

But liver problems don't typically lead

to sudden death like Kyle's.

His history of just talking one minute lucidly

and then just going down, like, that's not

consistent with liver failure.

NARRATOR Liver cirrhosis typically develops

over the course of a decade.

As liver cells die and are replaced by fibrous scar

tissue, the organ begins to lose its ability to process blood.

Toxins accumulate in the unfiltered blood,

resulting in symptoms that range from nausea,

to weight loss, to coma.

Without treatment, the scar tissue

overtakes the liver, turning it into a mass of fibrous nodules.

His liver was all lumpy, bumpy.

He had probably what we call end-stage cirrhosis.

NARRATOR But for Dr. G, the advanced cirrhosis still

doesn't quite explain Kyle's death.

Dr. G sees nothing out of the ordinary.

Then she opens his stomach where she

makes a startling discovery.

Oh, wow.

He's got a liter of blood.

Inside the stomach, where food should be,

has a liter of blood.

If you get that much blood, I suspect

that he tore something major.

If you take a Coke liter-- you know, you've all

seen the Coke liter--

that's filled up with blood, and that's distended his stomach.

NARRATOR The average adult needs about five liters

of blood to live.

And Kyle lost at least a full liter of blood

to internal bleeding.

Still, the question remains.

What is the source and cause of the bleeding?

And could it have somehow stemmed

from his earlier b*ating?

After completing her examination of the stomach,

Dr. G quickly searches the gastrointestinal tract.

The intestines contain more blood but no indication

of its source.

She then moves upwards to where the esophagus

enters the stomach.

His is gone.

Now, this could be interesting because--

NARRATOR There, she finally finds what she's looking for,

an enlarged worn blood vessel that has recently burst.

I think I know where the blood's coming from.

He's got a big--

you can actually see where the esophagus

was a little bit eroded.

So all this blood is going right out that tear.

Basically, he ruptured one of his varices.

NARRATOR As it turns out, Kyle had

developed a form of varicose veins on his esophagus.

Varicose veins are abnormally dilated

and twisted blood vessels.

The walls of esophageal varicose veins

are very thin and prone to rupturing.

When people have varices in the legs,

have you ever seen what they look like?

They kind of go like-- they're wiggly.

NARRATOR There was only one type of organ

that could cause varicose veins to form

on the wall of the esophagus, a liver with cirrhosis.
[ … ]

Blood is having such a difficult time

getting through that liver that it tries to find another path.

NARRATOR To compensate for this slow moving weak circulation

in the liver, veins around the esophagus

take on the extra blood flow.

They expand beyond their normal capacity,

turning into varices with dangerously thin walls.

This is a home run for a medical examiner.

You think you got a real clear cut cause of death.

NARRATOR Only one question remains.

Did the b*ating contribute to the rupture

of the blood vessels, or was the timing sheer coincidence?

Now, can I connect that dot to the b*ating?

And I can't.

I can't connect that dot.

I can't think of any way where the b*ating

exacerbated anything to cause him to get varices.

NARRATOR Dr. G can now retrace the chain

of events that led to Kyle Gilbert's untimely death.

Initiating event in this case is drinking.

Chronic alcoholism.

The liver has taken a b*ating from the alcohol.

There's liver necrosis going on from that alcohol.

Then it tries to regenerate, and then the scar tissue farms.

NARRATOR Blocked by the cirrhosis,

Kyle's blood backs up and forms varices around his esophagus.

The enlarged veins struggle to contain the rising pressure.

Unaware of his condition, Kyle carries on as usual until one

day a client visit goes awry.

You need to pay [inaudible]

They greet him with a x, and they b*at him.

NARRATOR The att*ck leaves Kyle heavily bruised.

But meanwhile, Kyle's blood pressure in the thin walls

of his varices begins to rise.

It was a time b*mb waiting to happen.

NARRATOR Finally, two weeks after the b*ating

and in front of his mother, the time b*mb goes off.

Now it ruptures.

The blood is coming out of that esophageal varice.

NARRATOR More than a liter of Kyle's blood

flows down and chills his stomach.

He then gets to a point where he

can't maintain his blood pressure because he's

bleeding out too much.

He's lost too much blood.

NARRATOR Kyle's heart rate increases

in a futile attempt to deliver more blood through the body.

Ultimately, he goes into shock.

So this guy [inaudible] then goes down very quickly.

NARRATOR By the time EMS reached him, it's too late,

and Kyle dies from internal bleeding.

[music playing]

With Kyle's chain reaction fully traced,

Dr. G has only one thing left to do.

SGT. JOE MYERS I finally received

a call from the ME's office.

Hello?

After her-- the results of her autopsy showed that--

that the cause of death wasn't related

to a criminal offense, of course,

it's not going to be m*rder.

It can't be m*rder.

NARRATOR Dr. G closes the case, confident that Kyle's body

has given them the full story.

You like it when you have a clear cut diagnosis.

The pieces fit together.

The pieces fit together great.

And I'm the one that put them together.

And that's very satisfying

MALE SPEAKER Atlas.