05x10 - False Impressions

[bunniefuu]

[ominous hum]

[sirens wailing]

NARRATOR In a South Texas swamp,

police make a grisly discovery.

STEVE MILD There were two black plastic bags.

The arms and legs in one bag, the torso and head

in the other bag.

NARRATOR And they need Dr. G's help

to piece together the clues.

Whoever put him in these bags is, you know, the perpetrator.

NARRATOR But will the autopsy findings

lead them to the suspected k*ller,

or just another dead end?

DR. G If you can't connect him to the crime,

if you can't put the pieces together that say, this

is a homicide, he may go free.

NARRATOR Then, a pedestrian is run over by a slow-moving van.

DR. G The guy's not breathing.

The guy's not responding.

The fellow that's driving that fan feels horrible.

NARRATOR But Dr. G can't figure out how a seemingly minor

mishap could have turned fatal.

DR. G So what really happened?

I don't know.

The driver doesn't know.

And certainly, the police don't know.

[theme music]

NARRATOR Altered lives.

Baffling medical mysteries.

Shocking revelations.

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

Every year in the United States, over , people

are reported missing.

The vast majority are found alive

and returned safely to their families.

But sadly, some are found too late

Dr. Jan Garavaglia has worked on a number of these tragic cases,

but one of the most disturbing occurred several years

ago, when she was a medical examiner in Bear County, Texas.

[helicopter whirring]

It's early winter in South Texas,

and law enforcement officials are scouring

the countryside for the body of a -year-old man named

Peter Gibbs.

He disappeared without a trace one week earlier

under suspicious circumstances.

STEVE MILD We had people on foot.

We had people on ATVs.

We had people on horseback.

At one point, we had three helicopters out there.

We were getting real frustrated because we

still did not have a body.

NARRATOR As the days tick by, Peter's family

worries that his body may never be found.

But eventually, investigators narrow their focus

to a shallow swamp near Angleton, Texas.

And it's not long before they find

what they've been looking for.

STEVE MILD We went out to that location,

and there were two black plastic bags.

The arms and legs in one bag.

The torso and head in the other bag.

DR. G They had called up and asked

me to do the case of a body that was found in South Texas.

And this body was in parts.

NARRATOR Two plastic bags of human remains

arrive in the morgue, just as they were found.

Investigators suspect that this is the body of Peter Gibbs, who

disappeared earlier that week.

As a first step, Dr. G reads through what police

know so far about the case.

DR. G The information we have from the investigation

is not very complete at the beginning of the autopsy.

We know he's got a wife.

We know he's a painter.

NARRATOR According to investigators,

Peter was last seen by his wife Sarah one week earlier,

when he set out to collect a debt from an acquaintance named

Andrew Garcia.

STEVE MILD He had not been seen or heard from since.

He normally contacted family members two or three times

a day, just as normal routine.

And that just threw up a bunch of red flags to them.

DR. G His wife was very worried when he didn't come home,

and almost immediately, she suspected something was wrong

and reported him missing.

NARRATOR Within a few hours, investigators

visit Garcia's home and question him

about Peter's disappearance.

But right away, his odd behavior raises their suspicions.

STEVE MILD We asked him if he had seen the victim.

And he denied knowing anything about where

he was, denied even seeing him.

He had a girlfriend.

STEVE MILD He was vague in his answers.

Inconsistent.

He was contradicting himself.

At this point, we had a pretty good idea that we probably

had a homicide on our hands.

But we still didn't have a body.
[ … ]

NARRATOR Investigators search Garcia's home

from top to bottom.

STEVE MILD We went room by room, searched high and low,

turned everything over, looked at it inside out, upside down,

and backwards.

NARRATOR They find no body and no evidence of foul play.

But they do find something else.

STEVE MILD We did find some firearms.

And we did take what we thought was narcotic residue.

[sirens wailing]

NARRATOR Police immediately arrest

Andrew Garcia for illegal w*apon and drug possession.

And while he sits in jail, investigators continue

looking for Peter's body.

Their search culminates almost a week later in the swamp

near Garcia's home.

[sirens wailing]

Investigators question Garcia about the body,

but he maintains his innocence.

However, they soon discover that he's

told a completely different story to his cellmate.

STEVE MILD He's told his cellmate, well, I k*lled a guy,

and then I hid his body.

[dramatic b*at]

NARRATOR Eager for a chance at a reduced sentence,

Garcia's cellmate turns the jailhouse confession

over to police investigators.

Unfortunately for prosecutors, this is not enough to secure

a m*rder conviction.

A confession to a cellmate may not

be considered reliable in court, because his cellmate

has criminal problems himself.

NARRATOR Without an official confession and only

scant circumstantial evidence, both investigators

and Peter's family fear that justice may never be served.

Obviously, they were distraught,

as any family member would be, with the loss of a loved one.

The family did believe that the suspect

had committed the crime.

The family is hoping that Dr. G will be able to prove that,

yes, their family member was m*rder*d by this person,

and could get a conviction.

[tense music]

DR. G So the autopsy will help to see

what's real with that perpetrator's story

and what we can prove isn't real.

If you can't connect him to the crime,

if you can't put the pieces together

that say this is a homicide, you know, he may go free.

[ominous hum]

NARRATOR At the Bear County morgue in San Antonio, Texas,

Dr. G is carefully piecing together dismembered remains

from two large garbage bags.

Investigators believe this is the body of Peter Gibbs.

DR. G So the body comes to me in two bags.

And I have to carefully document how this is found,

because whoever put him in these bags is the perpetrator.

So it's really important we have to save as much evidence

as we can.

So on the first bag, it's a big plastic trash bag.

It's partially torn.

And it's all gathered at the top with twine.

The second bag is also tied with twine,

but around this bag is a weight.

-pound weight, kind of rusted, held together with wires.

We don't know what we're going to find in these bags.

Hopefully, the whole body will be there and that that'll

give us some information.

You don't know until we look.

NARRATOR As she places the body parts on the gurney,

it's clear right away that the victim's legs

were severed at the thigh, and his arms

just below the shoulder.

This is a really nicely dismembered body.

I must say, many of the ones I've had were a lot more messy.

A lot of s*ab wound.

They try to do it with a Kn*fe, and they find out

that it's so difficult. And then they end up with a saw,

so you get Kn*fe marks, you get saw marks.

This one, really nice, clean marks.

NARRATOR And it isn't long before Dr. G makes

another unexpected discovery.

It's been about six days since they say this m*rder happened.

And six days in Texas could be rough.

Now, I have something going for me.

The body is surprisingly preserved.

It's been cold, and he's in water.

So that could delay any kind of decomposition.

NARRATOR For Dr. G, this means that physical evidence may

be better preserved than she expected,

including the victim's fingerprints.

DR. G Although they think it's this one person,

we still have to scientifically identify them.

We did have a set of the victim's fingerprints

on file, so we sent those fingerprints to the morgue

to be identified.

NARRATOR And it doesn't take long

to confirm that this is indeed the body

of -year-old Peter Gibbs.

DR. G First thing you want to look at
[ … ]

is, what am I seeing on this body?

The points of amputation were very clean.

The muscle was cut very sharply.

The bone was cut very sharply.

There's some tool marks on the bone.

Pretty clean cuts.

It looks like they probably used a butchering device,

like we'd see with animals.

NARRATOR Dr. G immediately notifies

investigators of this finding.

The autopsy will help them with things they

know they have to look for.

And so anything I can tell them may help them.

NARRATOR But after a thorough search of Garcia's home,

detectives come up empty-handed.

When my investigator and the detective

looked around the house, there was no evidence.

NARRATOR Back at the morgue, Dr. G

continues to painstakingly reconstruct the final moments

of Peter Gibbs's life, looking for anything that might

help the m*rder investigation.

DR. G Clearly, this man has his arms and legs amputated.

But when you look at those wounds, there's no blood.

NARRATOR This lack of blood tells Dr. G that Peter was dead

before he was dismembered, because his heart did

not pump blood to the wounds.

So this clearly looks postmortem.

NARRATOR Dr. G also sees that the front of Peter's body

is covered with abrasions.

They too appear to have been inflicted postmortem.

DR. G If you cut yourself, or if you abrade yourself,

it's going to bleed, and then it kind of crusts on there.

So this is-- all the skin is abraded off,

but there's no oozing, there's no crusting, nothing.

NARRATOR And these findings tell

Dr. G something important about the chain of events.

Peter's dead body was dragged first, then dismembered.

DR. G And how do I know that?

Well, first of all, we've got these big drag

marks on the front.

He also has drag marks on the anterior front of the thigh.

And it goes down the thigh onto the amputated area.

So they cut right through the drag mark.

So clearly, they cut him up after they dragged him.

NARRATOR When Dr. G inspects his face more closely,

she finds something else.

There's also an incised wound, which is kind of interesting.

It's like a cut, like somebody took a Kn*fe

and cut underneath his chin.

Possibly, they were trying to initially cut his--

maybe decapitate him and just decided it wasn't worth it.

NARRATOR At this point in the autopsy,

Dr. G only knows how Peter Gibbs's body was disposed of.

Now, the pressure is mounting for Dr. G

to find any evidence that could connect Garcia to the m*rder.

And as soon as she turns Peter's body over,

she finds something that just might.

When you flip him over, you see what

might be the cause of death.

And that's two g*nsh*t wounds to the back of the head.

[g*nshots]

Oh, yeah.

We want to see if he was alive when he

received those g*nsh*t wounds.

And did the g*nsh*t wounds k*ll him?

NARRATOR As a first step, Dr. G and her morgue technician

perform head X-rays on the body of Peter Gibbs.

DR. G When you have a g*nsh*t wound,

X-rays are always taken first.

We want to see if there's a projectile

that needs to be recovered.

NARRATOR These revealed two b*ll*ts

still lodged in Peter's brain.

We were hoping that she would be able to recover the b*ll*ts

themselves so that we could then compare those to the firearms

owned by the suspect.

NARRATOR This might be the linchpin needed to finally

connect Garcia to the crime.

You need to recover the b*llet,

because the b*llet may have striations on it that may link

that b*llet to a specific g*n.

Well, certainly, if the b*ll*ts recovered

from the victim at the time of autopsy match

a firearm that's been retrieved from the possession

of the suspect, that's good evidence for the state.

[tense music]

Good, good, good.

NARRATOR But before she can remove the b*ll*ts,

she must first examine the wounds.

So what I'm doing is I--

so I got to shave off the edges of the wound to really--

so I can see it much more clearly.

So we're going to dab it again.

Well, the first impression is that there are small defects.

They only measure about an eighth by an eighth inch.

Look like a small caliber projectile, like a ..

NARRATOR But she won't know for sure

until she reflects the scalp for a look inside the wound.

After I'm looking at the wound externally,

we cut the scalp from ear to ear in the back, reflect that,
[ … ]

and we see a lot of scalp hemorrhage,

or bruising from the g*nsh*t wound.

Clearly, his heart was pumping when

he got those g*nsh*t wounds.

[heart thumping]

[saw whirring]

NARRATOR Next, Dr. G opens the calvarium,

exposing Peter's brain.

The b*ll*ts to the back of the head

that caused massive trauma to his brain are what k*lled him.

The brain was actually getting to decompose a little faster

than the rest of the body.

That's because of all the trauma there.

But you could clearly still follow the paths.

The one on the left went back to front

and slightly left to right.

The other one went back to front and slightly right to left.

NARRATOR Now, she can finally remove the b*ll*ts

lodged in his brain.

DR. G Well, you always retrieve the b*ll*ts with your finger.

You never want to use anything metal, because remember,

there's those striations on the outside of the b*llet.

Those striations are made by the lands

and grooves on the inside of the barrel

that helps give the projectile-- a b*llet its spin.

The small striations from those lands and grooves

are unique for that g*n.

After b*ll*ts are fired, there's little imperfections

on the inside of a g*n, and those little imperfections

cause those markings on the b*llet, which are unique.

And so you never want to touch the outside of that b*llet

with metal because you want the examiner to be able to look

at those striations as best he can,

and you don't want any interfering scratches on there.

NARRATOR Although the b*ll*ts are removed,

the autopsy is far from over.

DR. G But I still need to do an internal examination.

Is there any other internal trauma

that I didn't see externally?

But there's also another really important

reason to do the internal examination,

is I need to get toxicology.

I need to get blood from him.

Okie-dokie, I think that's it.

Let's go for it.

So we're going to do our Y-shaped incision.

We're going to look in his chest cavities,

abdominal cavity, and look for any other trauma.

I'm going to look for hemorrhage underneath the skin

to see if he'd been beaten.

All right.

There's no hemorrhaging subcutaneous tissue.

It doesn't look like he's been beaten.

NARRATOR Dr. G's next step is to collect

fluid samples for toxicology.

Despite the fact that the body has been dismembered

and submerged in water for six days,

there is still liquid blood remaining in the heart.

DR. G His heart still had blood in it from the aorta.

We were able to collect that blood for toxicology.

NARRATOR With toxicology samples drawn,

Dr. G begins removing the organs and dissecting each one

carefully, looking for any additional evidence that may

help her reconstruct the crime.

DR. G I remove the organs one by one,

but I really don't see anything remarkable.

There's no real evidence of natural disease,

and there's no evidence of any other trauma to the neck,

the chest, or the abdomen.

No surprises.

No natural disease.

And really, nothing interesting found.

After all the examination on the body, I package the evidence.

I send the b*ll*ts off to a firearms examiner.

And I send the blood and the urine

off to our toxicology lab.

NARRATOR With this, Dr. G ends her autopsy.

She must now wait at least three weeks for the toxicology report"], index ,…}

in order to conclusively rule on Peter's death.

But before the tox results arrive,

detectives received the anxiously-awaited ballistics

report, and it delivers a stunning blow.

STEVE MILD The b*ll*ts that were found

were analyzed against the weapons

that we had found at the country home.

Unfortunately, they didn't match up to any of the weapons

that were in our possession.

NARRATOR After a full autopsy and a three-week investigation,

the prosecution still has no concrete evidence

to link Garcia to the death of Peter Gibbs.

STEPHEN LUPTON There is concern about the possibility

that the evidence might not be convincing to a jury,

and that the jury might not find the suspect guilty.

[ominous hum]

NARRATOR Despite a full autopsy,

Dr. G has not uncovered any hard evidence

to link Andrew Garcia to the m*rder and dismemberment

of Peter Gibbs.

And now, Peter's family fears the man who k*lled

their loved one may go free.
[ … ]

STEVE MILD The family is hoping that a case

can be made strong enough to be able to get a conviction.

NARRATOR But just when Dr. G is ready to close the book

on the autopsy, she receives the toxicology back from the lab,

and the report reveals a finding so shocking,

it threatens to turn the entire case on its head.

DR. G You never know what you're going to find.

You don't know if it's going to be important or not important.

So I was truly surprised when I got this tox back.

[tense music]

NARRATOR The first thing Dr. G discovers is a small amount

of cocaine in Peter's blood.

It wasn't enough to k*ll him, but it's clear that he

used it just before his death.

DR. G The cocaine was all very recently ingested,

which means he d*ed very quickly after he ingested that cocaine."], index ,…}

But there was something even more surprising.

He had a fatal level of strychnine in his blood.

NARRATOR Strychnine is a poison typically used to k*ll rodents."], index ,…}

It is highly toxic, and can lead to an extremely

slow and painful death.

DR. G It's a stimulant.

It causes your muscle to be so overstimulated

that it paralyzes them.

It paralyzes your respiratory centers,

because they're so stimulated that you can't even breathe.

Finding strychnine in his system was a complete

out-of-the-blue finding.

I don't think anybody suspected it.

And it certainly-- you couldn't see

anything with the internal exam that you would suspect it.

Poisons in general are just gone out of favor,

but when I do see it, I tend to see arsenic,

and I've seen cyanide.

I have to say, is the first case of strychnine I'd ever had.

NARRATOR Dr. G immediately phones

the prosecutor Stephen Lupton to deliver the stunning news.

STEPHEN LUPTON After the toxicology came back

showing there was strychnine in the system of the victim,

then law enforcement went out to the scene of the crime

and did a search.

And they found strychnine, which is used for predator control.

It's a poison present at that location.

NARRATOR With the discovery of strychnine at Garcia's home

and in Peter Gibbs's blood, the prosecution is now certain

that the strength of this evidence

will help secure conviction against Garcia.

STEVE MILD It's something that he's going to have an extremely

hard time explaining away.

And it just bolsters our case that much more.

NARRATOR And with all the information in hand,

Dr. G can finally describe step-by-step

how she believes this gruesome and unusual crime unfolded.

[light music]

It's around AM on a sunny Saturday morning,

and Peter Gibbs arrives at Andrew Garcia's home

to collect a long-overdue debt.

However, Garcia has no intention of paying him.

DR. G They gave him some cocaine,

probably laced with strychnine.

Strychnine takes about , minutes to act.

And it causes your muscles to contract.

It almost looks like you're going into a seizure,

but you're still awake.

NARRATOR Peter soon experiences a violent wave

of muscle contractions.

But the effect is not what Garcia anticipated.

DR. G Poison's probably not working fast enough,

or it's not working the way he expected.

Maybe he didn't expect the muscle contractions.

So he takes his g*n and sh**t him in the back of the head,

not once, but twice.

Those b*ll*ts cause massive destruction to his brain,

and within minutes, his heart stops b*ating.

NARRATOR Peter is dead, but now Garcia needs

to get rid of the evidence.

DR. G He drags him to another location, where

he then processes him by cutting off his legs,

cutting off his arms, putting those in bags,

and then throws them into the water.

[light music]

NARRATOR When investigators confront

Garcia with Dr. G's autopsy findings,

he knows the game is over.

STEVE MILD The evidence that Dr.

G found was extremely crucial.

It basically slammed the door on any possibilities of him being

able to work his way out of and get either a lighter sentence

or even get off of the charge.

DR. G Certainly finding strychnine in the body helped

show that this was an intentional act, probably

premeditated.

Once they confronted him with the evidence, he took a plea.

NARRATOR Garcia pleads guilty to the m*rder of Peter Gibbs,

but never confirms the details of the crime.

STEPHEN LUPTON There's no requirement in our state, when

a defendant pleads guilty, that he debriefs

or tells the full story.

So we never know what his story may be with regard

to strychnine or anything else.
[ … ]

NARRATOR The conviction brings some much-needed solace

to Peter's family.

STEPHEN LUPTON The defendant plead

guilty to a charge of m*rder and received

a -year sentence in the Texas Department of Corrections.

NARRATOR For Dr. G, this is one of the most

satisfying aspects of her job.

DR. G It always feels good to know that you add

a little piece of the puzzle to help a criminal be

held accountable for his crime.

But you know what, it happens on a regular basis in the morgue.

That's why the job is so much fun.

NARRATOR In Dr. G's next case, the mystery

is no less confounding and the stakes no less important.

We're going to see, is there any pieces of the puzzle

that I can put together?

Because the poor driver of the van wants to know what

happened.

How come he didn't see him?

[ominous hum]

NARRATOR It's a busy morning at Orlando's District morgue,

but Dr. G always makes time for her kids.

[phone ringing]

DR. G I think this is Eric.

Wait a minute.

Hello?

Hey, how did you do?

OK.

So you're going to hang there?

OK.

All right.

I'll be there at , then.

Bye, honey.

Thanks for calling.

NARRATOR Her kids call frequently,

but visits are rare.

They haven't come see me at work

since Alex was four years old and he accidentally walked in.

And that's when he said he saw the calvarium off,

and he told everybody I cut people's

heads off for a living.

And the other one is really kind of, ooh.

He's a little spooky about the whole death thing.

NARRATOR But for Dr. G, understanding death is what

makes her job so fascinating.

Dr. G carefully reads through the investigator's report

of -year-old Raymond Morris.

And right away, it's clear that the case

will be a difficult one.

DR. G Oh, boy.

We got a report from the hospital

that somebody d*ed in their ICU from being hit by a van.

NARRATOR So far, all that's known about Raymond's death

has been provided by the driver, Martin Stanhope.

[train horn blowing]

According to Martin, the trouble began just

before dawn, as he was setting out on his newspaper delivery

route.

[engine starts]

DR. G He says he starts to back out, and he hears something.

He stops immediately, and he walks out,

and he notices there's a man down right next to his tire.

MARTIN You OK?

DR. G The guy's not breathing.

The guy's not responding.

And he's worried he ran over him.

Paramedics are called.

Paramedics make the decision that it looks

like they ran over his head.

NARRATOR Raymond is swiftly transported to the hospital,

but by the time he arrives at the ER, he's barely alive.

DR. G They do a CAT scan, and they

think they see some blood around the brain stem from the injury."], index ,…}

NARRATOR But as doctors work to pinpoint

the source of the bleeding, Raymond's condition

quickly deteriorates, and within hours, he dies in the ICU.

[inaudible]

NARRATOR Now, Dr. G's priority will

be to determine exactly how the accident caused his death.

DR. G It's unclear what kind of trauma he has, so we'll see.

We'll hopefully get the facts of what's really going on with him"], index ,…}

and figure out what happened.

NARRATOR Unfortunately, Dr. G has little in the way

of background to go on.

Investigators learn that Raymond was a former machinist who had

recently fallen on hard times.

But that's pretty much all they know,

and so far, they've been unable to track

down a single next of kin.

DR. G We can't find any family.

The hospital couldn't find any family.

Our detectives couldn't find any families.

My investigators can't find any families.

It's unusual.

We try to exhaust all the resources we have,

but we do get a handful every year.

Why do we do the autopsy even though we

can't find any next of kin?

Maybe nobody cares.

Believe it or not, society cares.
[ … ]

The police want to know what happened.

I want to know what happened.

NARRATOR Still, Dr. G hopes to provide

much-needed answers to Martin Stanhope,

the driver of the van.

Martin is overwhelmed by the thought

that he may have k*lled Raymond, and feels

responsible for his death.

DR. G Police felt that he truly was

surprised about hitting him.

So I don't think they're going to charge him with anything,

but he has a lot of guilt about this,

and he would like to know what happened.

He's baffled by what happened.

How come he didn't see him?

NARRATOR For Dr. G as well, the death of Raymond Morris

raises many questions.

DR. G It's unclear how trauma k*lled this fellow.

Was he already on the ground when he hit?

Why is his head the one that's injured?

What really happened?

I don't know.

The driver doesn't know.

And certainly, the police don't know.

So we're going to see, is there any pieces

of the puzzle that I can put together to help

figure out what really went on?

Well, when I first saw his body, he certainly has evidence

of being in the hospital.

He's a little bit disheveled.

He's got a lot of tubes.

A tube out of his mouth, endotracheal tube that

was hooked to a ventilator.

His hands are edematous.

They've got needle sticks from IVs,

and attempts to IV and draw blood.

NARRATOR And something else stands out about his hands.

He's got staining of the fingertips from smoking.

NARRATOR Dr. G's first step is to chart the external trauma

on Raymond's head.

And sure enough, she finds evidence of injury right away.

DR. G On the right side of his face,

he's got like a one fourth by one fourth inch

abrasion above his eyebrow.

He's got a nice abrasion and contusion

on his cheekbone prominence that goes across to his ear.

He's also got a small contusion on the right shoulder.

[dramatic music]

NARRATOR But then Dr. G spots what could be another injury--

one that doctors might not have recognized.

DR. G His belly's a little bit distended,

a little bit firm to palpation.

NARRATOR This might be a sign of internal bleeding,

which would mean the van might have

struck Raymond's torso as well.

But to find out, Dr. G will need to open the body

and determine its cause.

The question is, will her finding allay Martin's fears

or confirm his worst nightmare?

So what we'll do is we'll look and see what kind of injuries

we have, and maybe we can help piece

together what really went on.

[ominous hum]

NARRATOR Dr. G is ready to autopsy the body of Raymond

Morris, who doctors believe was k*lled when Martin Stanhope ran

him over with his van.

The fellow that's driving that van feels horrible.

He's very guilty.

He didn't see him.

But it's unclear exactly what happened,

so we're going to have to open him up

to really see what the injuries are.

NARRATOR Dr. G begins the examination with a Y incision.

She is on the hunt for any sign of fatal trauma.

DR. G If it ran over his chest and not his head,

then I would expect some rib fractures.

I would expect some contusion or bruising to the skin

and to the musculature.

If it ran over his abdomen, I would expect maybe a torn liver

or lacerated spleen.

Oh, nice full bladder.

Mm-mm-mm.

OK.

NARRATOR With the organs exposed,

Dr. G carefully inspects them for any indication of damage.

But what she sees is puzzling.

DR. G At some point in the records,

they felt that he had some type of abdominal injury.

So I open him up, and I incise that area,

but there's no broken ribs that I can find.

There's no blood there.

There's no trauma there.

They said he had some internal injuries,

but it's certainly very underwhelming by looking at it.

NARRATOR But Dr. G can now see what

caused the abdominal swelling that she observed

during this external exam--

fluid.

DR. G His abdomen has a lot of edema fluid.

That's because he's laid in the hospital for a day and a half,
[ … ]

pretty much dead.

And they're still giving him fluids.

They gave him a lot of fluids to try to get his blood pressure

up when he first got there.

And this fluid has kind of just leaked out.

It's in his abdominal cavity.

It's in his abdominal tissue.

Ugh.

I don't like going to the bone.

There we go.

NARRATOR Next, Dr. G opens Raymond's

rib cage, and one by one, begins to examine his internal organs."], index ,…}

DR. G Of course, I start with his heart.

And his heart was of normal shape, normal size,

but his coronaries were not good.

His are all very crunchy.

He had severe narrowing to his coronary arteries.

And when I mean severe, I mean % narrowing

to the coronary artery that supplies

the front of the heart.

% narrowing to the coronary artery

that supplies to the back of the heart,

and almost as severe on the circumflex,

the side of the heart.

He clearly has heart disease, clearly not something that we

know about, or anybody--

I think-- knew about.

It was not in any of his medical records that we found,

and it was certainly unknown to the emergency staff

and to the doctors that took care of him

for a day and a half.

NARRATOR At the very least, Raymond's diseased heart

would have made recovery from the accident very difficult.

But Dr. G also wonders if the shock of being run over

could have actually induced a fatal arrhythmia, or even

a heart att*ck.

If you have a bad heart and you're hit by a car,

there's a good chance that you're not going to survive

just because you have a weakened heart,

and the stress of the accident, and the pain, and everything

that causes your blood pressure to go down

will certainly affect your heart even worse.

His heart is a ticking time b*mb.

He could have had an arrhythmia with that heart at any time,

even in the best of circumstances.

NARRATOR But even to the trained

eye of the medical examiner, an arrhythmia leaves no evidence.

So to confirm this as the official cause of death,

Dr. G must first rule out everything else.

DR. G His heart was enough to k*ll him alone,

but it's unclear what's going on,

and I have to look at each organ to just see, what

else are we going to find here?

The next thing to look at would be the lungs.

Now, he had an X-ray in the hospital.

One doctor's reading this X-ray as normal, one

reading it with severe disease.

What is it?

When I look at his lungs, it's severe disease.

NARRATOR Dr. G can clearly see that the air

passages of Raymond's lungs are pocketed with pus.

It's a sign that he suffered from pneumonia, an infection

of the lung tissue.

This illness, a common complication for patients

on ventilators, may have been contracted during Raymond's

time on life support.

But to be sure, Dr. G will need to examine the lung

tissue at the cellular level.

His lungs were in bad shape, and I needed to look

at those under the microscope.

NARRATOR But first, she must examine the remaining

organs for any signs of trauma.

Unfortunately, the findings are once again slim.

DR. G Well, his stomach is remarkable only

that he had a feeding tube in.

Sometimes when you get a feeding tube through your nose

down your esophagus and your stomach,

it can cause some irritation and some superficial mucosa

ulcerations, and that's what he did.

Just some irritation from the feeding

tube, but really not much else.

He has no trauma to the liver.

His spleen's intact.

It's not torn.

There's no hemorrhage in the back part of his abdomen,

in the retroperitoneal area.

His kidneys look fine.

There is no trauma in his abdomen,

and there is no trauma to the chest.

And the rest of him is really not that remarkable.

NARRATOR Which means only one thing--

the only trauma Raymond sustained in the accident

was an injury to the head.

The question is, did it k*ll him?

DR. G We reflect the scalp, and I'm particularly

interested in the right area, where that abrasion in cheek

were.

And I really don't see any contusions.

Something's got to be going on arond there.

He doesn't have any skull fractures.
[ … ]

And I'm thinking, well, he's got closed head injuries,

so it's more on the inside in the brain.

This is a big van running over your head.

I would expect maybe some hemorrhage overlying the brain,

or contusions to the brain, or bruising to the brain itself.

NARRATOR Dr. G's more technician, Brian Machulski,

uses an oscillating saw to open Raymond Morris's skull.

And right away, Dr. G finds no sign of the blood the hospital

CAT scan supposedly detected.

Instead, she finds that Raymond's

brain is massively swollen.

DR. G His brain is squeezing through the only opening

it has, which is the base of the skull.

It's like squeezing the tube of a toothpaste.

It's only going to go out the one hole.

NARRATOR It's clear that the brain swelling is so severe,

there's no way Raymond could have survived it.

And yet there's still something extremely puzzling

about Raymond's injuries.

In short, he doesn't have any.

DR. G His brain is definitely swollen,

but surprisingly, there's nothing else in the cranium.

It's no trauma.

It's all due to lack of oxygen.

NARRATOR Dr. G's surprising conclusion?

Raymond's death is not a result of being

run over by Martin's van.

What k*lled him is lack of oxygen to the brain,

a condition called anoxic encephalopathy.

When the brain doesn't get enough oxygen,

it's being injured.

Those cells can die.

The blood vessels are injured, and they

can start leaking and swelling.

[inaudible]

So now we got to dig a little deeper.

What was the reason for his brain not to get enough oxygen?

Then we're going to have our answer.

[ominous hum]

[light music]

NARRATOR Dr. G has just completed

the autopsy of Raymond Morris.

She now knows what k*lled him--

fatal brain swelling.

But she doesn't know what caused it.

DR. G I have lack of oxygen. But that's a mechanism.

That's not my cause.

NARRATOR For Dr. G, there's only one place left

to look for an explanation--

the microscopic slides of Raymond's heart and lung

tissue.

DR. G So ultimately, at the end of that autopsy,

I needed to look at those micros,

because we don't have any trauma.

He's got a bad heart.

Is anything acute going on in his heart?

Is there anything acute or chronic going on in his lungs?

NARRATOR A few days later, the samples come in.

And all it takes is a single glance for Dr. G

to conclude exactly what happened to Raymond Morris

that fateful morning in the parking lot.

I think we've hit upon what the ultimate cause of death is.

[ominous hum]

[train horn blowing]

NARRATOR It's about AM, and even though Raymond Morris

has been feeling sick for days, he spent the entire evening out

at his local bar.

But he's growing extremely fatigued, and for good reason.

Raymond is suffering from a severe lung infection.

DR. G He certainly has an acute pneumonia, a pneumonia

that he'd just gotten.

But also a chronic older pneumonia.

So his pneumonia was quite extensive.

NARRATOR The tissue sample of Raymond's lungs

is the smoking g*n, and shows that his infection

was much worse than Dr. G could see at autopsy.

It appears older and more extensive than what

would have occurred as a result of a respirator.

And now she knows why his brain was deprived of oxygen.

Raymond's lungs were so damaged that he

literally couldn't breathe.

You think of a sponge, and you have the little air spaces.

And that's where the air should go

to exchange the oxygen for the carbon dioxide

in the surrounding blood vessels.

But if those air pockets fill up with pus,

it's hard to get air exchanged into your body.

NARRATOR As Raymond leaves the bar just before dawn,

his lungs are failing.

Oxygen is still entering the organs,

but it can't be exchanged in the air pockets

because they're clogged with pus and scar tissue.

It isn't long before Raymond grows short of breath,

but there's no one around to help him.

Until he spots Martin Stanhope's van.

DR. G Once he sees that delivery van,

he probably starts walking over to try

to tell him he's in distress.

NARRATOR But by this point, Raymond's lungs

are barely functioning.
[ … ]

He can hardly breathe, much less call for help.

And now his diseased heart begins to falter as well.

DR. G That lack of oxygen is causing

his heart to get irritable.

That's the final coup de grace.

Goes into an arrhythmia.

It's not pumping blood.

Collapses, hitting the van most likely going down.

That's the hit that the guy feels.

NARRATOR That's when Martin Stanhope jumps out of the van

and finds the -year-old man sprawled out on the ground.

At this point, Raymond's heart isn't b*ating,

and his brain begins to swell, pushing beyond the confines

of his skull.

He's rushed to the hospital, but by then, it's far too

late for anyone to save him.

And so what turned out to be trauma

with unsurvivable injuries after autopsy, as usual,

we find the truth.

Turns out to be natural disease.

He d*ed ultimately from the lack of oxygen in the brain.

But what caused that, what caused that is his bad lung

disease, both acute and chronic pneumonia, and his bad heart

disease, which probably caused him to have an arrhythmia.

NARRATOR With no next of kin, Dr. G's first phone call

is to Martin Stanhope to assure him that he was in no way

responsible for Raymond's death.

DR. G At least the driver knows that he

didn't k*ll this fellow.

[music playing]

(SINGING) I can hear your voice.

You sound so alone--

NARRATOR Sadly, however, Dr. G believes

this is one autopsy she shouldn't have had to perform.

He himself could have gone to a clinic,

could have gone to the hospital before it

was too late, before he collapsed, and got

treated for that pneumonia.

Ultimately, like I usually see in this morgue,

it's the choices you make that ultimately cause

you to die before your time.

(SINGING) I've got problems on my own.

This is the end.

Hope I will see you again.

[whooshing]

MAN Atlas.