04x09 - Dangerous Games

[bunniefuu]

[music playing]

NARRATOR A case that strikes close to home for Dr. G.

You know, I have a son this age.

I think, oh my gosh, you know, that's so sad.

NARRATOR Did the boy die by his own hand?

The father found him on the floor,

and they find his karate belt around his neck.

NARRATOR Or was it a tragic accident?

I don't care what nobody says.

David Cody didn't commit su1c1de.

I'm not here to necessarily make the family feel good.

I'm still here to make the right answer.

NARRATOR And then a visiting scientist from Russia

mysteriously collapses in the middle of his lunch break.

We had a lot of news reports about a Russian being poisoned.

And certainly, possibly, this is another poisoned Russia.

NARRATOR And when both the Russian embassy and the FBI

get involved, Dr. G wonders if the dead man in her morgue

was more than just a scientist.

Well, I think there's another mystery here.

[music playing]

NARRATOR Altered lives, baffling medical mysteries,

shocking revelations.

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

[music playing]

At the District morgue in Orlando, Florida,

the graveyard shift has just begun

when a call comes in from the Children's Hospital downtown.

Medical Examiners.

Carol.

NARRATOR A nurse reports the death of a -year-old boy

named David Cody Hudson.

Right now?

From Leesburg?

OK.

Who's his next of kin?

His father?

NARRATOR Investigator Carol Crosby is

dispatched to pick up the body.

I'll be on my way.

Thanks, bye.

I'm on my way to the hospital to pick up a -year-old who is

suspected of hanging himself.

[music playing]

JAN GARAVAGLIA It's a beautiful day today,

but I don't think I'm gonna enjoy it.

I know I have a young boy that looks like he hung himself.

That's always hard.

He's very young.

I have a son this age.

And I think, oh my gosh, you know, that's so sad.

Looks like he might've committed su1c1de.

You know, it's just tragic.

Your life-- you're just beginning.

Hey, Carol.

How are you?

NARRATOR As soon as she arrives at the morgue,

Doctor G's first priority is to weed

through the investigator's report compiled by Carol Crosby

the night before.

JAN GARAVAGLIA When the body first arrives,

I'm told that we have a -year-old boy

that the police are investigating

as a probable su1c1de.

The father found him on the floor,

and they find his karate belt around his neck,

and the police think maybe he hung himself

with the karate belt over the ceiling fan,

which I actually see a lot of suicides that way

with the ceiling fan.

They were able to start CPR.

the father's a paramedic.

And they were able to get him to a hospital,

he just didn't have any brain function.

NARRATOR According to hospital records,

David Cody never regained consciousness.

Within hours, he was pronounced brain dead

and removed from life support.

[music playing]

My granddaughter, Alyssa, called, and she says--

she was crying, and she says, grandpa, David Cody's

k*lled himself.

And I said, Alyssa, don't be calling me and telling me

nothing like that.

I said, that ain't funny.

And she says, no, it's true.

He was years old.

Had his-- should've had his whole life ahead of him.

I mean, I'll never see him grow up to be a man, get married,

you know?

David Cody.

You're five today, right?

Six.

DAVID HUDSON Six?

NARRATOR For the Hudson family, the loss is staggering.

The very idea that David Cody might have hanged himself

is a concept that's nearly impossible to accept.

su1c1de was never--

the kid was saving up for a bicycle.

He had other things going on.
[ … ]

I mean, I--

I don't think--

David Cody didn't think of su1c1de.

If he did, he never displayed any of that sort of thing

to me.

I mean, he wasn't a depressed kid, you know?

I don't care what nobody says.

David Cody didn't commit su1c1de.

[music playing]

JAN GARAVAGLIA Of all the cases I do,

family members have a hard time accepting that it's a su1c1de.

I mean, that's gonna be our worst nightmare.

But once again, I'm not here to necessarily

make the family feel good.

I'm still here to make the right answer.

And ultimately, I think they want to know the truth

just like everyone else does.

[music playing]

NARRATOR Dr. G begins the difficult external examination

of -year-old David Cody Hudson.

JAN GARAVAGLIA This is sad, don't you think?

Initially, when you see him, he's a cute kid.

You know, he looks like a little all-American kid.

He's my son's age.

But he's got all the hospital paraphernalia, the tube down

his throat, the tube going out his nose,

and your heart goes out to him.

Your heart goes out to the family.

NARRATOR As she documents the condition of the body,

Dr. G is looking for forensic evidence

that will confirm whether or not David Cody committed su1c1de.

But she's also looking for any signs that might

hint at his emotional state.

According to the police and the boy's father,

David Cody had been grounded the weekend of his death.

He's on weekend restriction because he

tried to skip school on Friday.

He was actually picked up by the Leesburg Police Department

and escorted to school.

I asked him, I says, David Cody, how come you

keep getting in trouble, boy?

And he says, I don't know.

I guess I just need attention, grandpa.

He says it seems like the only time I get attention

is when I'm in trouble.

These are some of the things that you look for when you're

looking at a potential su1c1de.

You know, are there any recent behavioral changes?

Is there anything that's weighing on the person's mind,

you know, that would make them think that life

is no longer worth living.

With children, there are sometimes indications,

and they do usually look to adults

to be able to help them out, so that they often may provide

some drawing or some note.

They're not necessarily very elaborate,

but they often have also told people

that they are interested in hurting themselves,

and told people that they're in a fair amount of pain.

I do know that there is some question of some minor trouble.

I know he's skipping school.

We're gonna have to put the pieces together.

Again, we let the facts kind of lead us to what

happened and see what's going on.

NARRATOR There's also the possibility

that if David Cody did commit su1c1de,

it might have been a single spontaneous act.

JAN GARAVAGLIA A lot of times, suicides

are very impulsive acts, especially with young people.

They get very angry at somebody, and especially somebody

who they love, and they act out impulsively.

And they don't even sometimes even

think about the long-term consequences.

They're mad.

They don't want-- they don't want this anymore,

and they act impulsively.

NARRATOR Dr. G scrutinizes David Cody's body inch by inch.

JAN GARAVAGLIA Part of the role as a forensic pathologist

is to confirm or deny the accounts of the witness.

Does he have evidence of previous su1c1de marks

on his wrists?

Is he maybe a self-mutilater?

Any signs of kind of psychological problems?

Anything that would give us a clue of what's

what's happening.

NARRATOR But she finds no scars that would suggest that David

Cody attempted su1c1de in the past

or suffered from emotional problems.

Only injuries typical of a -year-old child.

You know, there's some little scars on the knees,

just like a kid, you know?

You have scars on your knees.

Most boys do.

[music playing]

NARRATOR Yet she does find evidence

to suggest the young boy did indeed hang himself.

There is a large bruise on the back of his head,

perhaps sustained when his body fell from the ceiling fan.

And there are many broken blood vessels

around David Cody's eyes called petechiae,
[ … ]

sometimes seen in hangings.

JAN GARAVAGLIA He's got little burst blood vessels on his face

and in florid petechiae in the inner aspects

of his lower eyelids.

So it's looking like it is, you know,

some type of strangulation or hanging

that has been resuscitated.

We'll often see the really florid

petechiae, a lot of them.

Uh, once they have had some kind of strangulation

and they've survive and they try to do CPR, that seems

to make him worse because you're then bringing blood

flow to those areas that have already been, um, starved

of oxygen and have increased pressures.

And that just makes the blood pressure--

that makes the little petechiae worse the little blood--

broken blood vessels.

So then, after you do the general examination,

I note these things.

I will go then concentrate on the neck.

What I see, usually on hangings, is a ligature mark

and then you have a suspension from that hanging.

So it goes around your neck, but part of it's

attached from the knot.

And it has to be attached from the area of suspension.

So the point of suspension will have an inverted V.

And that's a real classic.

NARRATOR But when Dr. G inspects David Cody's neck,

that's not what she sees.

Instead of an inverted V, Dr. G finds

marks that are horizontal.

And this raises troubling questions.

Is it possible that the -year-old was strangled

by someone else's hand?

JAN GARAVAGLIA His was very interesting.

He has the marks in a band-like pattern,

but it's horizontal all the way around the neck.

The other thing that's interesting on his neck

is that there's another mark there.

It looks like from another ligature.

[intense music]

That's not consistent with a suspension hanging,

which is a little disturbing.

[dark music]

[music playing]

NARRATOR Dr. G has just completed

the external examination of -year-old David Cody

Hudson, who police believe committed su1c1de

by hanging himself.

But observations in the external exam aren't adding up.

JAN GARAVAGLIA Once I do that external exam

and I see that the neck ligature is horizontal

and he's got another ligature mark on his neck

and then he's got a you know, nice abrasion on the back,

it's just not sounding like a su1c1de hanging.

NARRATOR But if David Cody didn't hang himself,

what happened?

DAVID HUDSON Blow, boy.

Blow.

Hurry on.

Get them all out.

NARRATOR Waiting for answers is his devastated family.

DAVID HUDSON Every time I close my eyes,

I'm reliving the whole event all over again.

My six-year-old daughter talks about him quite a bit,

brings him up on several occasions, you know.

Might just say, my brother d*ed, or I miss my brother.

I wish he was here.

Uh, her roughest days are--

are when it rains.

You know, she thinks David Cody is crying you know,

because it's raining.

JIM HUDSON And David Cody was my buddy.

(SINGING) Twinkle twinkle.

[chuckles] [laughs]

I mean, uh, I was there when the kid walked.

I was there and waiting he got his teeth.

He was just like my own kid.

This boy is dangerous.

Let me tell you.

David Cody.

[laughs] You're going to hit yourself

in the head in a minute.

[inaudible]

[chuckles]

[dark music]

NARRATOR Dr. G opens the body with a Y incision.

She will first search for any signs of foul play.

I really don't suspect that.

But there is nothing to indicate that.

But stranger things have happened.

Uh, you know, and I'm the final person that's really going

to be looking at that body.

I have to rule everything out.

When we look internally, we're just

looking for some subtle signs of trauma.

We're looking of a rib fractures.

I'll be looking for head trauma.

You know, and just, of course, just the general

looking his organs, making sure there's
[ … ]

no-- nothing else going on.

NARRATOR As expected, she finds evidence of a body

kept alive on life support.

David Cody's heart is pale due to low blood pressure,

and his lungs show early signs of pneumonia--

a common infection went on life support.

OK, Sandy.

SANDY All righty.

You have any side you want.

I'm [inaudible] little fluid.

SANDY I'm going to leave.

I'm going over there.

OK.

He's got a little bit of fluid [inaudible]..

NARRATOR However, there is no evidence

of any internal trauma or disease,

either in the abdominal or chest cavities.

To completely rule out foul play,

she then dissects the neck.

If David were strangled, she would expect

to find signs of trauma there.

JAN GARAVAGLIA The money's in the neck, without a doubt.

The neck and the head.

So when I do his neck dissection,

it's a very tedious dissection.

I take each strap muscle, and I remove it and look

for any evidence of hemorrhage even

there on the front of the muscle,

at the back of the muscle.

And I look at the hyoid bone, which is

where your tongue is attached.

I looked at the thyroid cartilage, the back of it.

NARRATOR However, as she dissects the neck,

Dr. G finds no trauma whatsoever.

The neck dissection was completely normal.

All of the findings were on the external aspect of the neck.

NARRATOR The lack of any internal neck trauma

rules out the possibility that he was strangled

by someone else's hand.

And given the horizontal ligature marks

Dr. G found during the external exam,

she does not believe David Cody hanged himself either.

JAN GARAVAGLIA I don't believe that he was suspended at all.

I do not believe their theory that he's

suspended at any point.

So if they try to tell me that he's hanging, I can say no.

Here it is.

NARRATOR But if David Cody did not hang himself

and no one choked him to death, how did the -year-old boy

die?

There's only one place left to look--

David Cody's brain.

[cranial saw]

JAN GARAVAGLIA So I do the head dissection.

And it-- because I really want to evaluate that abrasion,

contusion on the back of the scalp.

How-- how bad is that?

Is that really-- could that have kind of added,

uh, you know, insult to injury in this poor kid

and maybe causing a skull fracture or some brain trauma.

NARRATOR Dr. G removes the skull cap

and reveals David Cody's brain.

Immediately, she spots a critical problem.

The boy's brain is grossly swollen, so much so

that the organ has herniated downward into the spinal cord.

JAN GARAVAGLIA And it's swollen and it compresses out

of the only space it knows, which

is the bottom of the skull you know,

where your spine comes out with the whole brain's kind of push

in through that because it's just under so much

pressure from the swelling.

NARRATOR The massive swelling is without a doubt

the cause of David Cody's death.

JAN GARAVAGLIA Once that herniates, it's--

it's incompatible with life.

It's very difficult then to go on.

NARRATOR But oddly, Dr. G discovers that the swelling

in the brain was not caused by trauma from a fall,

but rather from lack of oxygen.

JAN GARAVAGLIA So the injury from the fall is you know,

a minor.

I mean, it's just a superficial injury.

[music playing]

NARRATOR The autopsy of -year-old David Cody Hudson

is complete, and yet the circumstances of his death

are still baffling.

Though he was found with a karate belt around his neck

and his brain was deprived of oxygen,

Dr. G does not believe he hanged himself or was choked.

So what possibly could have led to the untimely death

of this -year-old boy?

DAVID HUDSON All kinds of things

are going through your head at that time.

You know, you don't know.

I mean, he was behind the door.

The only thing we know right now

is things aren't making sense.

[dark music]

[suspenseful music]

NARRATOR By AM, Dr. G has completed
[ … ]

the full autopsy of -year-old David Cody Hudson.

She is determined that he d*ed from lack of oxygen

but is confident that he did not hang himself

and was not choked by anyone else.

But she's worried that the forensic findings,

in particular, the two horizontal ligature

marks on David Cody's neck might be

an indication of another disturbing possibility.

JAN GARAVAGLIA I'm not liking what I see.

I'm seeing a ligature that is completely horizontal.

I see another mark on his neck that looks

like a previous ligature mark.

And I have a really young kid.

The pieces are getting put together,

and it's fitting in another kind of subset

that we occasionally see down here.

Thankfully, not too often, but we do see it.

I'm really worried that he may be doing this as a game.

NARRATOR The game that Dr. G fears might be responsible

for the death of -year-old David Cody Hudson

is known by many names, including suffocation

roulette, space monkey, and perhaps most

commonly, the choking game.

Believe it or not, some of the kids--

and it's typically seen in this kind of really

young adolescent boys--

choke themselves as a game.

What the choking game is is kids using some method

to be able to deprive themselves of oxygen. Um,

usually, it's done with groups because it's easier to do

that or work in pairs of kids.

And they-- they basically cut off

their airwaves in some fashion.

And they deprive their brain of oxygen. And as a result,

they get involved with a brief period

of unconsciousness, a brief period of altered

state of consciousness.

And kids like it.

They-- they find as something that's interesting, and they--

they-- they seek that out in some fashion.

NARRATOR But in order to determine if David Cody d*ed

from strangling himself while playing the choking game,

Dr. G needs more than just a hunch.

JAN GARAVAGLIA How can I prove this?

How do you figure out what this is?

They-- you know what?

The autopsy didn't tell me the whole story.

We need some good police investigation.

I need to talk to the investigator that

is going to investigate this.

So as soon as I'm done with the autopsy,

I marched upstairs to my office and give the guy a buzz.

NARRATOR The investigator is Detective Richard

Giles, a -year veteran of the Leesburg,

Florida Police Department.

Dr. G and I, when we spoke the first time,

we actually discussed the choking game.

Um, and she had--

I had heard of it, but she had more information

on it at the time that I did and kind of described it as like,

"Wow.

You know what?

This kind of seems like it's about the same thing,

but it's something that we still got to check into."

Because I had to find something to corroborate it.

I can't just say this is what happened without being

able to corroborate, you know, my findings

in the investigation.

JAN GARAVAGLIA I, you know, I tell him, you've got

to talk to the-- there some--

you've got to talk to his friends or somebody

that knows something about it.

And the detective did what I asked him to.

I mean, someone would've blown it off, but he found a friend.

He found some of his friends that knew that he

played that choking game.

RICHARD GILES They basically said that yes,

that David Cody was participating in this game as

well as some of them.

Some of the ones that I spoke with also participated in it.

Sometimes, it was done in pairs.

Sometimes, it was done alone.

NARRATOR What's more Detective Giles learns from David Cody's

father that on the morning of the accident,

there were odd marks on David Cody's neck.

JAN GARAVAGLIA Earlier in that day,

they noticed a red mark on his neck.

And he tells them that he got his neck caught in the covers

that night.

And-- and that's-- you know, that's a tip off.

DAVID HUDSON Hey, I'm ready!

Do it.

Bow!

Strike one!

NARRATOR This confirmation is the last piece of the puzzle.

And for Dr. G, the manner of David Cody Hudson's death

is finally apparent.

JAN GARAVAGLIA I think it all adds up pretty clearly

that this is not a su1c1de, that this is an accidental death.

[eerie music]
[ … ]

NARRATOR The day of the accident, David Cody

is grounded to his room for truancy.

Based on the two horizontal marks discovered at autopsy

and testimony from David Cody's friends,

Dr. G believes that the young boy

likely played the choking game early

that morning, without incident.

He's got another red area that's horizontal and linear,

looking like a second ligature mark in a whole different area.

NARRATOR But it's the second time playing

the game that turns tragic.

Alone in his room, David Cody wraps a karate belt

tightly around his neck.

I've heard of kids, you know, putting their hands

around one another necks.

I've heard of also kids helping each other out

by putting ropes or some kind of tie around their neck.

And then there's also some kids where they just basically put

a lot of pressure on each other's chests,

either by hugging one another very tightly

or sitting on one another to be able kind to compress the chest

and again, make it impossible to get some oxygen into the body

and into the brain.

NARRATOR Instantly, he begins to feel lightheaded.

And then suddenly, within only seconds,

he blacks out and falls to the floor.

JAN GARAVAGLIA It happens very quickly.

You can pass out.

From just occluding your carotids in, you know,

several seconds, , , or seconds,

you can occlude those and pass out.

Now, that doesn't mean you'll die.

If you released it really quick, you'd come back.

But anything much more than that, you'll

start having seizures really relatively quickly when

those carotids are occluded.

NARRATOR But David Cody's game goes awry.

Unconscious on the floor, he cannot unwrap the karate

belt strangling his neck.

JAN GARAVAGLIA Unfortunately, he

passes out before he releases.

NARRATOR Without blood flow, immediately,

neurons in David Cody's brain begin to die.

The dad immediately removes the karate belt

around his neck.

They were able to start CPR, but the damage is already done.

NARRATOR Despite immediate lifesaving measures,

David Cody's brain is dying and begins to swell.

The brain'll swell.

And because it's injured from the lack of oxygen

to the brain, to the neurons to the other cells in the brain.

And so as it swells, there's not a lot of places for it to go.

[cardiac monitor beeps]

In the hospital, they are desperate to try to keep that

swelling down, but unfortunately, it

swells to the point where it herniates out

of the only orifice that's left.

And that's the one at the base of the skull where your spinal

cord goes through, but that's also where your brain stem is,

your respiratory centers, your cardiac centers that would

cause your heart to b*at, until once that herniates, it's-- it

affects your brain stem.

And it's very difficult then to go on.

And he dies.

[emotional music]

DAVID HUDSON Sergeant Carlos came by here,

gave me the actual police report.

Told me, uh, what Dr. G was going

to put on the autopsy report.

I was kind of surprised and not surprised.

I was surprised in the fact that there was a game.

But I wasn't shocked that David Cody had tried it.

You know, I mean, he was an outgoing kid.

You know, if his friends are doing it, he's going to do it.

But I just wish I'd known about it or of its existence.

You know, If I'd known, if only I would have known.

I was totally shocked.

I was shocked and mad.

I mean, I was ready to call the President of the United States

and tell him we need to do something

about this crazy stuff that's going on,

kids are doing in their school.

They're doing it on school buses.

They're doing it everywhere, and kids are having fun at it.

Well, there's a fun thing to everything,

but there's also a bad side.

The bad side is kids die from it.

Oh and this is just such a tragedy.

It'd be a tragedy either way, whether you committed su1c1de

or whether it's accidental.

But I think this-- this accidental is

even more of a tragedy because you can almost

see your own kid doing it.

I mean, it's just such a senseless death.

NARRATOR Since David Cody's death,

his family has made it their mission

to inform the public of the game and its deadly consequences.

JIM HUDSON I've got my next sign on one of my cars

and on my truck.

And it's got David Cody's picture on there,
[ … ]

and it's telling kids don't play this game or you will die.

You're going to die period.

You're going to die.

[emotional music]

NARRATOR David Cody's death was ultimately

ruled a tragic accident.

But Doctor G's next case, the mysterious death

of a Russian scientist, looks to be anything but accidental.

All of a sudden, we have the intrigue

of could he have been poisoned?

Could he not?

Why is he dying suddenly?

[dark music]

[lively music]

JAN GARAVAGLIA Beside to be really Disney,

tonight is unfortunately, John [inaudible] whose last day.

We hate to see him go.

WOMAN Wow.

Did you see it?

Did you two do this?

We couldn't let you go without us saying a formal goodbye.

So you can put that on your--

WOMAN Office wall.

Don't.

You know I'm not much for words.

But it's been fun.

JAN GARAVAGLIA He's a pleasure to work with,

and we're just lucky to have him for years.

NARRATOR But Dr. G knows all too well that not everyone

has a chance to say goodbye.

Her next case is Dimitri Petrov, a visiting scientist

from Russia who d*ed suddenly yesterday

afternoon, a world away from all of his friends and family.

[suspenseful music]

JAN GARAVAGLIA Today, we have a -year-old man from Russia,

who is here working temporarily as a scientist

in one of the labs.

NARRATOR According to the investigator's report,

Dimitri was a biochemist from Moscow who had just

begun a six-month sabbatical at a local Florida

research facility.

Yesterday, Dimitri was having lunch

with a few of his co-workers when suddenly, he collapsed.

He's in the process of eating, and he just slumps over.

NARRATOR One of his colleagues immediately calls .

And within minutes, Orange County Fire and Rescue arrive

and rushed Dimitri to the ER.

EMS technicians attempt to revive him several times,

but their efforts are in vain.

They get him to the hospital pretty much pronounced him.

So he d*ed fairly quickly while he's eating.

NARRATOR Dimitri's colleagues have no idea what happened

and neither do the ER doctors.

To make matters worse, the only people

who can provide helpful information

about Dimitri, his family or his doctor,

are a long way away in Russia.

JAN GARAVAGLIA You know, the problem

with autopsying foreigners or people who you know,

don't have a home here is that it's very hard

to get information on them.

Sometimes, there's a language barrier.

Sometimes, we don't have access to their medical history.

You know, here in the United States,

I can just call their doctor up and say

what kind of medical history does this person have.

What kind of medication are they taking?

And I can get that information relatively easy.

Uh, it's very difficult to get it for a foreign national.

And so we just know less usually going in.

NARRATOR The fact that Dimitri is Russian

also means that Dr. G will have to follow

international protocol.

We do have to notify the embassy that he d*ed.

There is a diplomatic agreement with certain countries

that we will notify other embassies

of their foreign nationals, the deaths.

NARRATOR But the investigation into Dimitri's death

lies squarely on Dr. G's shoulders.

Fortunately, she discovers one detail in his file

that suggests a possible culprit.

Dimitri had recently flown to Orlando from Moscow

on a -hour flight.

He certainly traveled a long way to get here from Russia.

Maybe he was on the plane for a long time

and has that dreaded traveler's disease of forming clots.

And your lower legs are break free, go to your lungs,

and you die suddenly.

NARRATOR These clots, called pulmonary emboli,

k*lled by cutting off blood flow in the lungs.

They often develop during extended periods of inactivity

like long distance travel and can strike days or even

weeks later with no warning.

Dimitri d*ed only six days after landing in Orlando,

well within the danger zone.

He's, uh, eating in the cafeteria, and he dies.

So that's a possibility.

NARRATOR A possibility, but nothing more.

The only way Dr. G can unlock the truth

behind Dimitri's mysterious death
[ … ]

is with her scalpel and hard evidence.

JAN GARAVAGLIA We'll see where the facts takes us.

See what answers autopsy is.

[dark music]

Well, I-- you know, he looks pretty good.

He looks at a state at age of .

Let me hold it.

I'll hold it for you.

Oh, that's OK.

Just go ahead.

Looks like he keeps himself in good shape.

NARRATOR But then as Dr. G is Dimitri's legs,

she notices a disturbing clue that

reinforces her initial theory.

JAN GARAVAGLIA Little bit of edema, a swelling of his lower

extremities, which you know, may be due to a pulmonary embolism."], index ,…}

Maybe he's got a clot in his lower leg.

Did you take a picture of this [inaudible]??

[camera clicks]

NARRATOR But before she has a chance to explore this angle

any further, her assistant informs her

that she's just received a phone call from the Russian embassy.

They are very interested in why he d*ed.

NARRATOR And it seems another group

is interested in Dimitri's death as well.

We even get a call from the FBI, wondering why he d*ed.

NARRATOR What is it about Dimitri Petrov that

has suddenly piqued the interest of the Russian embassy

and the FBI?

[intense music]

The mysterious inquiries raised Dr. G's suspicions.

Could there be more to Dimitri's death than meets the eye?

Could Dimitri have been m*rder*d?

About this time, we had a lot of news reports

about a Russian being poisoned.

And that certainly stirred the imagination that possibly this

is another poisoned Russian.

[dark music]

[music playing]

OK, thanks.

NARRATOR The Russian embassy and the FBI

both want to know what happened to the man lying

in Dr. G's morgue.

-year-old Dimitri Petrov, a visiting

biochemist from Moscow, who d*ed suddenly during lunch.

It sounded a little mysterious to me.

This Russian scientist, temporarily working

here and then found dead.

NARRATOR Not long before Dimitri arrived in the US,

the news was abuzz with the story of a Russian spy who

had been k*lled by unwittingly ingesting thallium

poison hidden in his food.

Could Dimitri have met the same fate?

I really don't know much about the guy.

I don't know why he's here.

We don't know if he has any natural disease.

We don't know if he has any natural enemies.

I just thought it was a little odd

that this Russian scientist all of a sudden

ends up dead in my morgue.

NARRATOR Dr. G now wonders if the Russian and US

government suspect foul play.

Certainly, with all the news reports that we'd

had at this time with, you know, Russians being poisoned,

I would put that on my list.

NARRATOR She finds no external signs

of an acute poisoning such as a rash,

but that hardly rules it out.

JAN GARAVAGLIA If somebody is poisoned,

I don't always see any signs of external signs of poisoning.

NARRATOR Instead, she must rely on other means

to determine if Dimitri was assassinated.

Well we do always do toxicology

on a lot of our cases.

And in this case, I certainly would take a lot of toxicology

more so than maybe I would normally.

NARRATOR Unfortunately, identifying

a poisoning will be tricky.

Some symptoms of toxic substances

can mimic fatal medical conditions.

Now, on the front lines of an international investigation,

Dr. G must search for evidence deep within Dimitri's body.

I mean, all of a sudden, we have

the intrigue of could he have been poisoned, could he not.

NARRATOR Dr. G begins by making a Y incision

from Dimitri's shoulders to his sternum

and down to his pubic bone.

To look for signs of poisoning, she keeps

one sense on special alert--

her nose.

I would smell when I open up the body, any abnormal smells.

It seems like he d*ed relatively quickly.

So I'd worry about cyanide, kind of an almond,

bitter almond smell to it.

NARRATOR She reflects the skin in fact,

exposing the abdominal cavity.

And immediately, she discovers something horrific.

As soon as I open this guy up, I said, oh my.

NARRATOR What shocks her is not what she smells,

but what she sees.
[ … ]

He had tumor spread all over his abdominal cavity.

NARRATOR Dimitri's abdomen is riddled with dozens of tumors,

ranging in size from the width of a penny to as large

as a half dollar.

I'm amazed that he looks so good on the outside

for how much tumor he had on the inside.

I mean, they're white and they're

firm and kind of fibrous.

And they're studding his omentum, the inside

of his abdominal cavity.

They're all over.

NARRATOR Suddenly, Dr. G has uncovered a major suspect

in Dimitri's untimely death--

cancer.

DANIEL BUCCHOLZ Cancer is an abnormal growth.

And it could happen in any organ in your body.

The normal cells change into cancer cells

by a mutation in their DNA.

And then they lose the ability to have

their growth under some kind of normal control.

NARRATOR Without medical intervention,

these cancer cells can literally consume the victim's organs.

DANIEL BUCCHOLZ The patient will

ultimately die from the cancer just overwhelming his body.

NARRATOR But surprisingly, in Dimitri's case,

Dr. G isn't so sure that cancer is the k*ller.

JAN GARAVAGLIA First of all, just because they have cancer,

doesn't necessarily mean they have d*ed from it.

And he's eating there, having the time of his life

eating lunch and then just kills over.

Why is he dying suddenly?

[intense music]

NARRATOR And there's something even more inexplicable.

JAN GARAVAGLIA Why is a man with this horrible metastatic

cancer not at home in hospice?

I mean, does this story making sense?

It isn't.

[rock music]

[dark music]

NARRATOR Dr. G begins extracting the abdominal organs

of Dimitri Petrov, a Russian scientist

whose bizarre death has intrigued the Russian embassy

and the FBI.

JAN GARAVAGLIA OK, let's see.

NARRATOR Soon behind the stomach,

she makes a crucial finding--

the probable source of his extensive cancer.

The tumor appears to have started

in the head of the pancreas, and it's about to inches

actually in the pancreas and expanding and then also

encasing part of the bowel.

NARRATOR This could explain why Dimitri appeared

unaware of his condition.

JAN GARAVAGLIA Pancreatic cancer

tends to spread really quickly.

And you just don't get much symptoms from it.

And so unfortunately, most of the time, when

people find out they have pancreatic cancer,

it's already spread.

NARRATOR Dr. G also believes that the type of cancer

may reveal what struck him down so suddenly.

JAN GARAVAGLIA Going back to pulmonary emboli.

Pancreatic cancer is one of the notorious cancers of causing

your blood to clot more easily.

Clots form in the leg is just like, you know, you'd have

the problems of traveler's.

NARRATOR Dimitri's -hour flight from Russia

already put pulmonary emboli on the list of suspects.

Now, with pancreatic cancer in the mix,

she's even more convinced that it's

what ultimately k*lled him.

JAN GARAVAGLIA It would really makes

sense and very neatly packaged for me if that was the case.

So that's really what I was expecting.

NARRATOR Next, she cuts into the lungs,

searching for fatal clots.

[rock music]

But to her surprise, she strikes out.

Well, unfortunately, he doesn't

have any clots in his lungs.

Uh, so that wasn't the cause of death either.

NARRATOR Suddenly, Dr. G's investigation hits a dead end.

While the pancreatic cancer may look bad in and of itself,

it's still probably not enough to k*ll him so suddenly.

But the FBI, the Russian embassy, and presumably,

Dimitri's family, far away in Moscow

are counting on her for answers.

So I really don't, um, know exactly why he d*ed yet.

I need to finish the autopsy.

[music playing]

NARRATOR She now has two major organs left to examine--

the heart and the brain.

She begins with the heart, still in his pericardial sac.

JAN GARAVAGLIA The pericardial sac is kind of like the balloon

that the heart sits in and pumps away.

And it's usually got a little bit of fluid

and that helps lubricate it.

It moves easily over the--

over its covering.

NARRATOR Carefully, she cuts open the sac
[ … ]

and immediately finds something alarming.

Blood has filled up in his pericardial sac.

And I measure and it's CCs of blood.

NARRATOR Dimitri's heart is trapped in a pool of blood

that shouldn't be there.

Where is it coming from?

NARRATOR She extracts the heart for a closer look.

[suspenseful music]

And there, right on the outside, she sees it--

a soft yellow patch of dead heart muscle and a half inch

tear right through it.

For Dr. G, the defect is all too familiar.

He's had a heart att*ck, probably

occurred five to days out.

Because I know that about five to days,

you start seeing yellow.

The heart muscle is dying and softened, so soft

that when the heart tries to pump

and there's increased pressure, it blew out.

It blew out that opening.

NARRATOR Deep within the heart, she can even

spot what caused the att*ck.

I looked at his coronary arteries

and sure enough, he has a thrombus or blood clot, which

then totally blocks off blood flow to a segment

of the heart muscle.

NARRATOR She can also see that he has coronary artery

disease, a buildup of plaque.

This means that the clot did not arrive from elsewhere

in the body as with a pulmonary embolism,

but rather formed on the spot.

JAN GARAVAGLIA That plaque ruptured,

causes then a clot to form.

NARRATOR Her findings in Dimitri's heart

add up to a sequence of deadly events

that Tr*mp any possibility of a poisoning.

Ultimately, he d*ed from a cardiac tamponade, compression

of the heart from the blood in the heart sac, which

is due to the rupture, which is then due to the thrombus

in his coronary artery.

NARRATOR Finally, Dr. G can explain to the Russian embassy

exactly how Dimitri Petrov d*ed.

[dark music]

It's just a few days before -year-old Dmitri

Petrov is to begin an exciting sabbatical in Orlando, Florida.

But as he prepares to board a plane in Moscow,

little does Dimitri know he's in the crosshairs

of two deadly diseases.

He has a tremendous cancer, which

has spread all over his body, appears

to be from the pancreas.

And he also has coronary artery disease.

NARRATOR Together, these conditions

deliver a lethal blow--

a major clot in his heart.

JAN GARAVAGLIA There's a good chance the cancer could have

played a role, and it would have made

him more apt to form that clot in that coronary artery.

NARRATOR By the time of his flight,

the clot has completely obstructed the blood vessel,

and Dimitri suffers a heart att*ck.

That segment of the heart muscle dies.

NARRATOR Incredibly, he survives

all of this with no pain.

JAN GARAVAGLIA , % of heart att*cks are silent.

He has no symptomatology from his heart att*ck.

He had no symptomatology from the cancer.

NARRATOR But just a few days after his safe arrival,

Dimitri's body finally gives in.

The heart's still trying to pump,

and the pressure was just too much.

It tears open the muscle.

Blood starts rushing out of the heart.

NARRATOR Blood fills the pericardial sac.

JAN GARAVAGLIA It surrounds the heart

and compresses the heart that that heart

can't expand anymore to pump.

NARRATOR Stifled, the heart eventually stops b*ating

and Dimitri collapses.

Not poisoned by a secret agent, but k*lled by a devastating one

two punch of cancer and heart disease.

[emotional music]

Apparently satisfied by Dr. G's report,

neither the Russian embassy nor the FBI

calls again about Dmitri Petrov.

Never was determined why the embassy and the FBI

were concerned about his cause of death.

I could make a good story out of it, but I just don't know.

(SINGING) I knew you do what you have to to get by.

JAN GARAVAGLIA It's unusual to have that much cancer

and not know it.

Certainly, if I had the cancer spread that he had,

I don't think I would be wanting to work

and go to another country.

(SINGING) I can see the bad side.

Lulling like a store that's out at sea.

White against the coastline.

You won't find me.

[music playing]

Atlas.