03x09 - Dangerous Speeds

[bunniefuu]

NARRATOR A young man has a fatal seizure

and the hospital believes dr*gs are to blame.

The hospital is saying, hey, he's got the amphetamines.

NARRATOR His mom says otherwise.

It was like no, you know, no.

NARRATOR Then, insights from Dr. G on how car crashes k*ll.

Just using the lap belt isn't going to cut it,

and we can get terrible injuries that way.

NARRATOR And later, a small town tale

of jealousy and resentment becomes an investigation

into a possible m*rder.

Did somebody push him?

Did somebody bop him on the back of the head?

Or did he happen to just fall down the stairs?

NARRATOR Altered lives, baffling medical mysteries,

shocking revelations.

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

As a mother of two boys, Dr. G knows that every moment

with her family is precious.

And one particular case from her days

as an ME in San Antonio, Texas, stands

out as a powerful reminder.

An untimely death is always devastating to the survivors,

but there is an added poignancy when the cause of death

appears to have been avoidable.

Edward McDuffie, a -year-old cab driver

and skateboard enthusiast living in southwest San Antonio,

was known as a charismatic mentor to local teens.

He taught young people.

He sort of skated and he was real involved in the community

about getting skate parks that are safe,

you know, instead of having the kids skate on the streets.

NARRATOR One night after watching TV,

he complains of chest pains.

An hour later, he walks into a San Antonio hospital.

While alone and waiting for treatment in a triage room,

he suffers a violent seizure and collapses on the floor.

After being rushed to the OR, doctors

discover that Edward has sustained

a myocardial infarction, commonly known

as a heart att*ck.

Because Edward is so young and seemingly healthy,

the hospital and his family are baffled by the sudden att*ck.

A few hours later, his mother rushes to his side.

When I went in, he was already in the emergency room,

in a bed, and on a respirator.

It took a long time to get his rhythm,

and that he would probably have brain damage.

I prayed that the brain damage part was not true.

NARRATOR Friends and family then received another shock.

Hospital tests on Edward's urine reveal

traces of an illicit and dangerous stimulant--

amphetamine.

I thought, that's totally wrong.

I said, no.

NARRATOR Edward McDuffie never regains consciousness.

After a week in a coma, he passes away.

The hospital's final diagnosis--

a heart att*ck likely caused by amphetamine use.

On the death certificate, the cause of death,

it was going to be heart att*ck and seizures

due to amphetamine abuse.

It was like no.

You know, no.

I know that he didn't do that kind of stuff.

NARRATOR McDuffie's body is delivered

to the medical examiner's office, where determining who

is right, the doctors or the man's grieving mother,

will be up to Dr. G.

OK.

I'll-- did you get your blood yet?

Well, the bottom line is, I really

don't know what's going on, and I'm not sure they

knew what was going on.

NARRATOR Dr. G is all too familiar

with drug-related deaths.

In fact, a staggeringly high percentage of all the bodies

that enter the Bear County morgue

test positive for dr*gs and alcohol.

Alcohol abuse kills , Americans annually,

and illicit drug use causes the deaths of , more.

But are illicit dr*gs the cause of Edward

McDuffie's fatal heart att*ck?

The hospital says yes.

Edward's family says no.

Only Dr. G's scalpel and her examiner's eye

can reveal the truth behind this man's sudden death.

This is a -year-old man that didn't collapse.

He goes to the ER, and they resuscitate him,

and they say he has an MI, a myocardial infarction.

At some point, though, at some point, he starts seizing.

But they're all blaming this all on amphetamines,

because they tested his urine while he was there

and he was on amphetamines.

NARRATOR Amphetamine, commonly called

speed, and its sister drug methamphetamine,

are highly addictive stimulants that traumatize

the central nervous system.

It is the number one cause of drug-related emergency room

visits in the United States.
[ … ]

With the stigma of a drug-related death

hanging over her son's memory, Edward's mother hopes

her son's name can be cleared.

He already d*ed, but why put a stain on his character?

My elderly aunt's thinking, he was such a nice boy.

We didn't know he was a drug addict.

You know, I was angry.

Deals with why does this man die suddenly

and unexpectedly at the age of .

NARRATOR To begin, Dr. G conducts

a thorough external exam, searching for any evidence that

might indicate drug use, such as fresh needle

tracks, tiny bruises, or skin ulcers on the arms or feet.

She finds none.

Just looking, I don't see any vascular scars on him.

He doesn't look like he's a big time drug user.

You know, his mother made the comment, "If it's in him,

it was the first time ever."

NARRATOR Dr. G must next look inside the body

where other signs of drug abuse might leave some fatal clues.

Next, Dr. G makes a startling discovery--

Oh, my gosh.

There, we got something here.

NARRATOR --when "Dr. G, Medical Examiner" continues.

Dr. G prepares to begin the internal examination

of a -year-old man whose fatal heart att*ck

has two competing explanations.

The hospital asserts it was caused

by an amphetamine overdose.

His mother says that can't be true.

Now it's up to Dr. G to discover whether Edward

McDuffie is a victim of bad health or a bad decision.

This could be a drug overdose.

This could be a stroke in his head.

It could be heart disease.

We're going to have to look at our drug tests

and kind of have to wait to put this one together.

It's not a classic amphetamine overdose,

because those people tend have really high body temperatures

and start to seize.

But the thing is, they're attributing

everything to this amphetamine, and all we've got

is a positive urine.

So I really think we need to look at his heart

and look at his brain and see.

NARRATOR After making the Y-incision,

Dr. G inspects each of Edward's organs

and takes samples of body fluids.

She is particularly interested in examining Edward's heart.

Amphetamines can elevate the blood pressure

to dangerous levels, which can lead

to a rapid, irregular heartbeat.

She cracks open the ribs to remove and weigh

Edward's heart, and what she finds

is a seriously damaged organ.

His heart's enlarged.

A normal heart for a young man like this should be--

you know, he's not that big a guy.

It should be maybe , grams,

and this heart weighs grams.

You know, a lot.

NARRATOR His heart has a massively enlarged left

ventricle, which could be a sign of chronic amphetamine

abuse or heart disease.

A lot of times, we see that with high blood pressure,

because the left side has to work harder.

He does have some natural disease here.

NARRATOR Edward McDuffie was a victim of high blood pressure,

unusual in someone his age.

She wonders if this elevated blood pressure is

due to chronic amphetamine abuse,

and if this could have led to his heart att*ck.

To find the answer, she must cut open the heart

to look for damage inside the blood

vessels that supply the organ.

This is an artery, one of the main arteries

that supplies blood and oxygen to the heart muscle.

It comes right off the aorta, it's coming down.

Now when that gets clogged, that part of the heart

can't get the blood and oxygen. Danny,

do we have a little, tiny probe?

NARRATOR Then Dr. G makes a surprising discovery.

Oh, my gosh.

There, we've got something here.

This little fella, he actually has a little clot.

You can really see the end of that blood clot here.

This is the clot that caused his heart att*ck.

He only had a pinpoint opening remaining.

And then he's got a little bit there.

He had severe narrowing to the coronary artery,

the blood vessel that supplied the blood and oxygen.

NARRATOR This discovery of atherosclerosis

suggests that the hospital was wrong.

Edward had a defect in his heart.

A narrowed artery blocked by a blood clot

caused this young man's heart att*ck.

This chronic condition had caused high blood pressure

and other minor symptoms in the past

that had simply been ignored.

That's not going to happen overnight with amphetamines,
[ … ]

so we knew that he had natural disease.

NARRATOR But what about his positive test for amphetamines

at the hospital?

To solve the riddle, Dr. G has her technicians

locate the original, week-old urine sample.

We have a sample of urine that they

saved from the day he came in.

We're going to recheck that for amphetamine.

NARRATOR And then she calls Edward's mom to find out

more about his medical history.

What she learns corresponds to the conditions

she observed in his body.

Sometimes you have to listen to the family,

because we're the ones that know our history.

We have a family history of young people having

heart att*cks and some of them even dying

from the first heart att*ck.

NARRATOR What's more, Edward had complained

to his mother of chest pains, and she'd

urged him to seek medical care.

His mother had suggested he go to the doctor,

but he kind of was ignoring his symptoms.

NARRATOR His autopsy and his history

clearly point to heart att*ck, and when the urine test results

come back, Dr. G knows she's got the final piece of evidence

in her hand.

We retested that urine, and it was negative for amphetamines.

NARRATOR Edward's mom was right all along.

How could a hospital make such a mistake?

The hospital screens sometimes cannot distinguish

between the stimulants in some cold

medicines and amphetamines.

Hospital staff may have made a hurried assumption

in an emergency.

With her autopsy and the test results,

Dr. G can now reconstruct the series of events that

led to Edward McDuffie's death.

He'd been having chest pains and had

been kind of blowing it off.

I think a lot of young men would do.

NARRATOR The pain is caused by an almost completely blocked

coronary artery that prevents blood

from reaching his heart muscle.

One night, the pain is too intense to ignore,

and he goes to the hospital.

On admission, he's given routine tests.

He came into the hospital and tested positive on a urine

screen for amphetamines.

NARRATOR Edward's chest pain is due to a blood

clot that has formed where plaque

ruptured into his artery.

The clot blocks his already narrowed

artery that is now struggling to fuel his heart muscle.

The heart muscle begins to die, and Edward

goes into cardiac arrest.

Doctors spring into action.

They brought his heart rate back, and then went

into an arrhythmia.

But at some point, he falls off a gurney

and then starts having seizures.

NARRATOR Edward's seizures occur because his brain has

been without oxygen for so long, but the hospital

believes the seizures are caused by amphetamines.

But it seemed like they really jumped to the conclusion right

from the beginning as soon as they saw the amphetamine screen

was positive in the urine that all his problems

seemed to be due to that.

NARRATOR When Edward's mother arrives,

doctors have restarted his heart,

but because his brain is irrevocably

damaged from lack of oxygen, he remains in a coma.

And then they did the EEGs and stuff.

You know, you can never lose hope,

but things happen, and that was, I believe, part of the plan.

You know, the big plan.

The big picture that God has for all of us.

NARRATOR After a week with no improvement,

Edward McDuffie dies.

Rosa is forced to accept the loss of her son,

but she cannot accept the hospital's explanation.

So she is very grateful that Dr. G's

findings have confirmed what she knew in her heart all along.

I think she's heaven sent.

I thank god that she decided to really look into it.

When Dr. G called me and said that it was not the case,

it was like--

it just makes all the difference in the world to me.

Well, in this case, the mother knew her son,

and he didn't use amphetamines.

I knew I was right.

I knew my son.

NARRATOR Next, after thousands of autopsies,

Dr. G has learned a thing or two about car wrecks.

Well, I mean, I've learned a lot,

and these are Dr. G's pearls of wisdom

that I've learned in the morgue.

NARRATOR Her insights into how accidents on the road

can k*ll when "Dr. G, Medical Examiner" continues.

Saturday, AM.

A young driver heads home from a night of drinking.
[ … ]

His blood alcohol level is at ., twice

the legal limit in Florida.

The road markings are hard to follow.

He's drifting between lanes, miles over the speed limit,

and off to sleep.

[tires squealing]

Every minutes somewhere in the United States,

a car accident kills.

For the victim's loved ones, each crash

is a catastrophic personal tragedy.

But there are some who must tackle

those tragedies from a professional point of view.

One, two, three.

Saturday morning and we've got three auto accidents.

That's typical.

Every day we come down here and we're looking at death.

NARRATOR At the Orange Osceola County Medical Examiner's

Office in Florida, about one in every five cases

is from a car crash.

We're going to have to look at his spinal cord.

I have to kind of piece all the parts of the puzzle together

to come up with what happened.

NARRATOR Bad weather, high speeds, failing brakes,

alcohol, heart att*cks, seizures, a su1c1de wish,

a m*rder attempt.

Every wreck has a story.

We want to know if it is truly the car

accident that k*lled them.

NARRATOR And the final discoveries of both Dr.

G and police investigators can influence

insurance claims, criminal charges,

and even future auto designs.

A car crash may mean the end to a life, but for Dr. G,

it is just the beginning of a new investigation.

Every car accident is a scientific journey,

one that begins not in the morgue, but out in the field.

I

I was told we got a pedestrian,

walked across, out of the parking

lot, crossed over the roadway, struck by the station wagon.

NARRATOR Florida highway patrolmen

investigate over , fatal crash scenes per year.

One of the first things they must do with such a scene

is sort through the wreckage.

You have to switch into the investigative mode,

and your objective at that point is to try to help the deceased

and be the mouthpiece for them.

NARRATOR The highway patrol's homicide unit

is expertly trained to map a scene,

taking critical photographs and measurements.

The purpose of gathering all the information

in the investigation is to confirm or deny certain things

that may have or have not caused the crash, things like speed,

somebody accelerated through red light.

We can use that to make the charges

for who caused the crash.

The skid marks, the damage to the vehicles,

and the gouges in the road, all that together

will tell us what happened.

NARRATOR But to be accurate, the investigators

have got to move fast.

A rainy night, for example, may wash

away portions of a skid mark.

At times, the crash site is spread over hundreds of feet.

Even the bodies may no longer be in the car.

Sometimes, when everybody is k*lled in a crash

and ejected also, we have no idea who was driving.

We'll seize the entire vehicle and have it taken to the crime

lab, and they can use the occupants of the vehicle's

clothing to try to match that back

to the driver's seat, the seat belt, the dash, whatever

they impacted.

Even their blood, to put them in the seats.

NARRATOR Each piece of evidence helps

to get at the truth behind the cause of every accident.

But nothing leaves the scene until an investigator

from Dr. G's office gets a firsthand look.

They can't clear the wreck until my investigators get

there, and our responsibility is to go ahead and put

the perspective of the environment surrounding

the body, so that the doctor knows what's

going to be affecting the body.

What kind of vehicle was it?

Was it an SUV?

Was it a pickup truck?

It puts the doctor at the scene.

NARRATOR All that information arrives with the deceased

at the morgue.

This is a -year-old struck by a pickup truck.

NARRATOR Then it's up to the medical examiner

to determine the true cause and manner of death.

When we hear about someone dying in a car crash,

it's easy to assume he or she d*ed from the injuries.

But in the morgue, many autopsies of car crash victims

have a multi-layered mystery to be solved.

And a lot of people think, why bother?

Why bother doing them?

NARRATOR For example, many auto fatalities are actually

the result of natural causes.

Why did his heart stop?
[ … ]

We don't know yet.

Did he have a natural disease?

Did he have a stroke?

Did he have a heart att*ck?

All of these things, we can help answer.

NARRATOR A medical examiner must also

look for other influences on the driver's body.

We always draw toxicology.

Oh, nice big bladder.

He's been drinking at the party.

At least % of people who die in traffic accidents

have alcohol in their system.

NARRATOR The other % include a few surprises.

I had a fellow that, poor thing, a bee

flew in the cab of his truck and he ended up in an accident.

I like the stories, putting the pieces together,

making a difference.

NARRATOR In the process, Dr. G comes face-to-face

with the reality of what a car accident

can do to a person's body.

The most common fatal wounds--

Just blunt trauma to the head, all sorts of type

of head injuries.

NARRATOR Followed by multiple internal trauma.

When an aorta is totally cut in half,

when your diaphragms are totally ripped in half and all

your abdominal organs are in your chest.

Looks like a bad horror picture.

That's an understatement.

NARRATOR An accident victim's death speaks volumes

to Dr. G. Their injuries can also

tell her how to avoid ending up in the morgue herself.

I mean, I've learned a lot.

These are, you know, Dr. G's pearls of wisdom

that I've learned in the morgue, and I

just use them for my own--

how I live my life.

I guess I'll share them with you.

NARRATOR Dr. G's first pearl of wisdom?

I don't speed.

I see a lot of the accidents are caused by excessive speed,

where the--

your chance of dying goes up every miles faster you go,

exponentially.

NARRATOR Dr. G also has a unique take on the improper use

of a familiar safety device--

the seat belt.

You've got to use them the way they're constructed.

Putting half the seat belt behind you,

not using the harness belt and just using the lap belt,

isn't going to cut it, and we can

get terrible injuries that way.

NARRATOR A person's body is at the mercy of inertia

when a fast-moving car crashes.

With no harness belt, the body will hit the wheel or dashboard

and suddenly stop, while the organs keep

moving at miles per hour.

What's happening is you're decelerating very quickly,

and your chest stops but your internal organs

continue, and then it tears the anchor part of your aorta.

You stop quickly, but your internal organs

haven't quite kept up.

NARRATOR The harness seat belt helps

to keep the body and organs in sync and off the dashboard.

We just recently had one where they

didn't use the belt correctly, and it didn't help them.

NARRATOR Often, car accident victims

are also simply in the wrong place at the wrong time.

I never, ever stop my car on the side of a freeway.

They stop their car on the freeway

to discuss the accident, it's a fender bender,

and then somebody comes along and rear ends the cars,

and somebody gets k*lled.

I've had an officer get k*lled that way, at least two.

I've had people who have just stopped to fix

a tire get k*lled that way.

So I actually had a time where my engine light went on,

and I can remember, you know, stop the car, stop the car.

You shouldn't be driving with the engine light on.

I think it was my husband's little voice.

And I just didn't feel comfortable stopping the car

on the side of the road until I could get an off ramp,

because I was not--

that engine light wasn't going to k*ll me at that point,

but stopping my car on the side of the road, I wasn't so sure.

NARRATOR Car accidents, violent crashes--

Everybody at the scene is affected by it.

NARRATOR --unexpected injuries--

What do you think about this break?

I need to see his file.

Wait a minute, wait a minute, wait a minute.

I needed to look at that, and I didn't look at it good.

I was giving philosophy.

NARRATOR --shedding new light on life.

And it is very sad, but I have some questions to answer,

and I don't--

I have to get past the sad part pretty fast.

I need to go change and start work.

NARRATOR Coming up next, a suspicious death

in a small town leads Dr. G down a path of possible homicide.
[ … ]

Did somebody push him?

Did somebody bop him on the back of the head?

Or did he happen to just fall down the stairs?

NARRATOR When "Dr. G, Medical Examiner" continues.

Dr. G's next case involves jealousy,

intrigue, and suspicions of m*rder in small town America.

OK.

Well, today we've got an interesting case.

It comes from a rural area, and this man is dead at the bottom

of the stairs.

He was working in kind of an old, historic hotel.

NARRATOR The case comes from a county

nearly miles from the morgue,

and the decedent's name is Alexis Jones, a man who

had been trying to put the pieces of his life

back together after a painful divorce.

In communities too small to afford

a medical examiner's office, coroners

investigate unexplained deaths.

So I'm the first one that is called out

to determine the cause of death or determine

whether or not there is an autopsy that's needed.

So I'm at her mercy to getting the information.

NARRATOR According to the investigation report,

it all started when a hotel employee

noticed something ominous outside of the manager's living

quarters.

Immediately, he called Shirley Williams, the local coroner.

He actually noticed a pool of blood up underneath a door.

The person at the scene said there was blood.

NARRATOR Williams arrives at the hotel

to start her investigation.

As the caller had reported, she finds blood seeping out

from under the door leading to the hotel manager's apartment,

and when she opens the door she finds his dead body

at the bottom of the staircase.

He was lying down, and there was garbage around.

It looked like he was probably either taking garbage out

or had fallen into some garbage.

He is at the bottom of the stairs.

Did he just trip and fall?

NARRATOR Dr. G notes that Williams performed

a preliminary exam of the body at the scene,

and carefully reads through her findings.

There was a lot of head trauma.

I mean, which would not have been very unusual for someone

that had fallen, you know, the distance that he had fallen,

or, someone that had taken a tumble down the staircase.

NARRATOR At first glance, it appears that the manager

innocently slipped, fell down the stairs,

and banged his head on something sharp,

causing the massive bleeding.

So then why did Williams request that Dr. G autopsy the body?

I don't know.

I don't know what's going on here.

NARRATOR But as Dr. G reads on, the reasons become clear.

Upon further inspection of the body, Williams notices

several wounds, wounds she feels could

be inconsistent with an accidental fall

down the stairs.

There was blood on his face, there's

some swelling of his eye, and that made her suspicious.

NARRATOR Suspicious that an assailant

may be responsible for this man's death.

Or was there an altercation?

Or was it an accident?

Or was there something just a little bit more to this?

That's very unusual, to fall down the stairs and die.

We don't see that very often.

It's not common.

In this case, you rightly determine

that she needed autopsy.

I think it's intriguing, though, that he lives there, is

the general manager, and there is

definitely quarreling going on.

Nobody seems to like the guy.

NARRATOR Suddenly, an apparent run-of-the-mill

accident has turned into a small town "m*rder, She Wrote."

And now Dr. G must try to find evidence

to solve the mystery of what or who

k*lled this -year-old man.

Did somebody push him?

Did somebody bop him on the back of the head?

Or did he happen to just fall down the stairs?

This will be interesting, to see if we can figure

out what happened to him.

I can see the big ol' scar going down the center of his chest.

NARRATOR As Dr. G begins the external exam,

she immediately finds evidence of previous surgeries.

We undress him, and I see a big scar on his chest,

going straight down his chest, from the base of his neck

all the way down.

That usually indicates that he's had heart surgery, typically

bypass surgery.

He's got a matching scar down his leg.

So it's consistent with that he's had a bypass surgery.

NARRATOR Clearly Jones suffered from heart

problems in the past.

Dr. G wonders if his weak heart could have failed again,

contributing to his death.
[ … ]

She'll need to wait for the internal autopsy

to explore that theory further, but as she continues

her external exam, Dr. G finds several other wounds on Jones's

body that points to foul play.

He certainly could have been struggling with somebody.

He's got the smeared blood on his face.

Could have been-- the eye could have been from a blow.

And he certainly has the contusion abrasion

on the back of his hand.

I mean, it could have been a struggle.

NARRATOR There was also a deep cut on the side of his head,

possibly the result of another blow.

So he hit his head or somebody hit his head,

and it's about and / inches in length.

NARRATOR But evidence of v*olence does not stop there.

I also found some little petechiae, or broken blood

vessels, in his conjunctiva.

Classically, we would see that with strangulation.

NARRATOR But Dr. G will have to wait for the internal exam

to explore this theory further.

With all of Jones's external injuries suggesting foul play,

she prepares the body for the Y-incision.

Coming up next, shocking internal findings

throw the m*rder investigation for a loop--

And he could have d*ed at any moment.

NARRATOR --when "Dr. G, Medical Examiner" continues.

There's a lot of activity going on in our morgue today.

NARRATOR Dr. G and her morgue techs

prepare the body of hotel manager Alexis

Jones for the internal exam.

Earlier that morning, Jones's body

was discovered at the historic country hotel where he worked,

and based on wounds on his body, Dr. G wonders if he may have

been the victim of foul play.

He certainly could have been struggling with somebody.

NARRATOR Then midway through the autopsy,

coroner Shirley Williams calls Dr. G from the hotel.

She's just uncovered a possible motive for m*rder.

According to interviews that Williams conducted

with local residents, Jones was not the most

popular man in his community.

He'd moved to town just six months earlier,

and a mere two months later, he received a huge promotion.

They had just made him manager,

and the other people didn't like it.

He wasn't well-liked and he'd been having so quarreling

with some other employees.

NARRATOR But did they hate him enough to k*ll him?

You know, could someone have gotten in there

and whacked him over the head, and then

pushed him down the staircase to make

things look like an accident?

I don't know if they're taking justice in their own hands

or not.

I mean, he was not the man for the job, at least

in their eyes.

NARRATOR Dr. G has unsubstantiated external

evidence and a possible motive that could point to m*rder,

but before she can rule this case a homicide,

she must find tangible forensic evidence inside Jones's body.

Dr. G opens the body of Alexis Jones

with the standard Y-incision, cutting through scar tissue

on his chest, a result of previous bypass surgery

to his heart.

As a first step, she removes his heart.

for the heart.

When we look at the heart, first of all,

we actually see that a little bypass.

We see that blood vessel that has been sewn from the aorta

to the coronary artery.

It looks fine.

NARRATOR Dr. G notices that the bypass surgery looks perfect.

However, she doesn't dismiss Jones's heart

yet, and rightly so.

When she cuts into another artery

that supplies blood to the organ,

she makes a grim discovery.

One of his coronary arteries was completely narrowed,

completely occluded.

He's had a previous heart att*ck.

The whole back of his heart was dead and scarred down.

NARRATOR Despite the success of Jones's bypass surgery,

his heart remains hopelessly diseased.

If you continue to smoke and you continue to eat bad

and you continue to keep your cholesterol up,

the bypass grafts can get narrowed

and thickened just like your regular coronary arteries.

He could have d*ed at any moment from that diseased heart.

NARRATOR It now seems possible that no one assaulted Jones,

and that he simply had a heart att*ck at the top of the steps

and came tumbling down, hitting his head on something

sharp along the way.

So at this point, I don't know.

NARRATOR But Dr. G does know how to find out.

If he suffered a heart att*ck at the top of the steps,

Jones' internal wounds from the fall would not bleed.

This is because wounds only actively bleed

if the heart is pumping blood.

But if Dr. G finds a large collection of blood

around the wounds, his heart must have been b*ating when he
[ … ]

fell, thus ruling out a fatal heart

att*ck at the top of the steps.

Looking for signs of internal bleeding,

Doctor G's techs now open Jones's cranium.

As she removes the brain, she makes two critical findings.

This is interesting.

I reflect the scalp, and then I notice

there is a lot of contusion or blood collecting in the scalp

itself.

NARRATOR Based on this, Dr. G now knows

that Jones was bleeding internally

when he fell down the steps.

This reveals a very important clue about his heart.

I can say that that heart was at least still b*ating

when he got the head trauma.

NARRATOR And that means he did not die from a heart att*ck.

But Dr. G's next finding is even more revealing.

As she looks inside Jones's skull,

right away she sees the injury that did k*ll him--

a bruise on the left hand side of his brain.

A definite bruise.

He d*ed from the severe head injuries that he received.

NARRATOR Yet Dr. G notices that the bruise on his brain

is not directly beneath the cut on Jones's scalp, an injury

that she documented in the external exam.

I know it's an odd thing.

The scalp on the right side has one laceration about a

and / inches in length.

Lo and behold, the contusion is on the opposite side

where there's no trauma over the scalp.

NARRATOR This type of injury is referred to as a contrecoup,

literally meaning "opposite the blow."

It occurs when a body is in motion

and the head strikes a hard surface.

The abrupt impact causes the brain to shift

from side to side in the skull.

The brain comes back and hits the inside of the skull

in the opposite direction.

Yes, this is interesting.

NARRATOR Often, a bruise will develop

opposite the side of impact as a result of the shifting brain.

As opposed to a blow and you're stationary,

the contusion is right underneath the blow.

NARRATOR The presence of a contrecoup and Jones's brain

indicates that he was moving when he sustained the injury,

and provides Dr. G with the evidence she

needs to determine how he d*ed.

So at this point I can definitively

say that the trauma, which is why he d*ed,

is from a fall and not a blow to the head.

NARRATOR Coming up next, one central question remains--

Now, the million dollar question is, was he pushed?

OK.

NARRATOR --when "Dr. G, Medical Examiner" continues.

Dr. G now knows that Alexis Jones d*ed

from severe cranial injuries after falling down the stairs,

but because she still hasn't determined

if his fall was an accident, the case remains far from closed.

If Dr. G can come up with another plausible explanation

for Jones's fall, she can rule out homicide once and for all.

And there's one place left to check.

Toxicology always can give us insight of what's going on.

NARRATOR But in this case, the toxicology report

only raises further questions.

When I get the tox back, he ends up

having a very elevated blood alcohol of a .,

very highly intoxicated.

NARRATOR Then Dr. G's attention is quickly diverted

to a far stranger finding.

Jones's blood also contains a large quantity

of a chemical called quinine.

It's typically associated with treating malaria,

a potentially fatal mosquito-borne disease

found in the tropics.

And I was like, why would he have quinine?

Quinine is a chemical that you can use to treat

malaria or maybe leg cramps.

There's not a lot of call for quinine anymore.

And, you know, I didn't quite understand why he'd have that.

NARRATOR Was Joan suffering from malaria?

If so, Dr. G should have picked up on one

of the many physical signs--

small skin hemorrhages, swelling of the brain,

an enlarged spleen, and anemia.

But Jones exhibits none of these,

and because malaria is rarely seen in the United States,

Dr. G doubts that he was infected with this disease.

So what explains the high levels of quinine in Jones's blood?

There is a quinine poisoning, and quinine poisoning

is early quite severe.

There is a whole syndrome of having too much quinine.

You actually get dizzy and nauseated,

and you can actually lose your eyesight.

NARRATOR Struggling for answers,

Dr. G turns to coroner Shirley Williams to see if she observed

anything at the scene that could shed

light on this strange finding.

As it turns out, Williams remembers seeing something

during her examination of Jones's apartment

that could provide an explanation.
[ … ]

I did notice that there was a bottle of dry gin

and also a bottle of tonic there, and they were open.

NARRATOR While quinine is used for treating leg cramps

and malaria in third world countries,

it is best known stateside as an ingredient of tonic water.

He was really drinking, and his blood alcohol was high,

and his quinine level was high, so he liked his gin and tonic.

NARRATOR With a lack of evidence

supporting foul play at the hands of Jones's fellow hotel

workers, and no forensic evidence

that he had a fatal heart att*ck prior to falling down

the stairs, Dr. G can now replay what

likely happened to Alexis Jones on the night of his death.

Perhaps celebrating his promotion to manager, or maybe

stressed about another day of bitter quarreling

among his colleagues, Jones indulges heavily

in his favorite cocktail--

gin and tonic.

We know that he was drinking his gin and tonic

prior to going downstairs.

We know he's highly intoxicated.

NARRATOR Now suffering from impaired balance

and blurred vision, Jones inexplicably

makes a fatal decision--

to take his trash out.

The effects of the alcohol in his system

cause him to stumble on the steps.

He falls down the stairs, hits his head very badly.

NARRATOR As Jones falls, he lacerates the right side

of his skull on the steps.

The impact causes his brain to bounce

back and forth, slamming against the opposite side of his skull."], index ,…}

As a result of the trauma, his brain

begins to bleed and to swell.

After just a few minutes, oxygen can no longer reach

his damaged brain and he dies.

He d*ed from the severe head injuries that he received.

NARRATOR Dr. G assures Shirley Williams

that she found no evidence that Jones was m*rder*d.

They ruled it as an accident, so we went ahead

and just closed our files.

NARRATOR But while the case is officially

closed at the morgue, an unsettling incident

a year later causes Shirley's town to relive

the tragedy all over again.

Wasn't too long after that, then the next hotel

manager shows up dead.

NARRATOR This death was eventually ruled a su1c1de,

but Shirley Williams remains astonished by the coincidence.

I mean, what are the odds in such a small community

that two people in the same position would show up dead?

NARRATOR Without a confession or a witness,

Dr. G stands by her ruling and the case

remains filed as "accidental."

I'll never prove that he wasn't pushed.

We don't-- well, you know, unless we have a witness.

Now, if someone, you know, years from now

comes and says I pushed him down the stairs

and I pushed him on purpose, there's nothing I could say.

NARRATOR It's just one more tragic accident,

one more life cut short, that Dr.

G sees every day in the morgue.

Being in the morgue, you realize

you have a finite amount of time here on earth.

When you face that every day, you realize that hourglass

is constantly moving.

You don't turn it over in midstream.

And you've gotta go and try to find happiness in life.

Atlas.