Dr. G: Medical Examiner - Season 2, Episode 12 - Kiss of Death? - Full Episode | Forensic Files

[MUSIC PLAYING] NARRATOR: A healthy woman rapidly succumbs to a virulent illness.
She gets antibiotics and ends up in the hospital. A week after that, dies. NARRATOR: Her body is covered with dozens
of raw, oozing sores. DR. G: Well, I looked at the body, and I'm kind of, like, taken aback.
She's got these vesicles all over her. Oh, gosh. NARRATOR: Can Dr. G identify the deadly disease
and find its source? I have never seen a case like this, and I know I will never see another case like this.
NARRATOR: And then a woman helps her husband recover from what appears to be a routine epileptic seizure.
I said, are you sure you don't want me to call 9-1-1? No, no. No, no. I'll be all right if you just let me sleep.
NARRATOR: But this time, he never wakes up. DR. G: She felt horrible. I knew that she was going to be dealing with some guilt right
from the start. NARRATOR: Altered lives, baffling medical mysteries, shocking revelations.
These are the everyday cases of Dr. G, medical examiner. It's just after 8:00 AM at the District 9 morgue in Orlando,
Florida, and preparations for the day's work are in full swing. OK. We need-- NARRATOR: When chief medical examiner
Jan Garavaglia arrives, she and her staff size up the day's cases. We've got three to x-ray.
NARRATOR: Dr. G's first autopsy will be the case of a 34-year-old woman who died
a bizarre and unexpected death. Claire Jackson was transferred to the District 9 morgue
last night after she died in the hospital due to a sudden illness, which appears to have
caused massive liver failure. We have this woman, and we've gotten her from the hospital.
And the doctors don't know why she died. She's in fulminant liver failure. It's massive death of your liver, and they don't know why.
NARRATOR: According to Dr. G's investigator's report, the woman's ordeal began approximately one week earlier.
Claire Jackson is feeling sick. She visits her doctor complaining of a fever, diarrhea, nausea, and pain in her mouth.
Her physician suspects she may have a minor infection. He prescribes an antibiotic and a painkiller
and sends her home to rest, but the treatment is ineffective. A week after she gets the antibiotic,
she just gets sicker and sicker. She goes to the hospital and they thought she was septic, or, you know, bacteria in her blood.
NARRATOR: Suspecting that Claire has developed an aggressive bacterial infection called septicemia,
doctors rushed to treat her with powerful antibiotics. But Claire's condition quickly spirals out of control.
Within only hours, her vital organs, including her liver, begin to fail, and she is put on life support.
Barely alive, she begins to develop a strange rash, and by the next day, Claire is dead.
The hospital is baffled by the woman's swift decline. Their suspicion? She died from septicaemia, a massive and often catastrophic
bacterial infection in the bloodstream, which caused her liver to fail. So that's what I've got, and they don't know.
They don't have anything diagnosed, really, in the hospital. NARRATOR: For Dr. G, the death of Claire Jackson
is a mystery with no easy answers and no clear hypothesis. She begins immediately with the external examination.
On the exam table, Dr. G gets her first look at Claire Jackson's body, but it's not at all what she expected.
Well, I walk over to the body and I'm kind of, like, taken back. She's got these vesicles all over her, like-- like blisters
on her skin. And I'm like, nobody told me about this. I was shocked. I mean, when I'm looking at the chart,
when I'm reviewing medical records, they don't mention that. They mentioned some kind of crusted thing on her forehead,
but she's got like 50 of them on her face, on the backs of her arms, on her back.
NARRATOR: In her 20 years as a medical examiner, Dr. G has rarely seen a body with such
an unusual affliction. DR. G: She looked really sick. I mean, when I looked at her, she looked really sick.
Her gums were all red. She had lesions on the gums. Her teeth were actually even falling out of the gums.
Oh, gosh. She looked very, very bad. NARRATOR: Dr. G has no explanation for Claire's condition or what would cause it.
But to her, it certainly does not look like a bacterial infection as the hospital thought.
However, she does learn from Claire's medical records that the victim had her own theory
about her strange illness, a very unusual theory. According to Claire, two weeks earlier she
was having a drink at a local bar when she kissed a man she had recently met, and then he bit her.
Claire believed that whatever made her sick, she caught from the bite. Ugh, you know?
Is it some kind of assault? What did she die of? NARRATOR: Death from a human bite
would be highly improbable, but at this point Dr. G needs to pursue any lead she can find.
First, she carefully inspects Claire's mouth for any signs of a bite mark. Inside of her mouth looked horrible.
The mucosa was sloughing off. She had these all sort of lesions. Bad teeth. NARRATOR: And yet, Dr. G finds no scarring
to corroborate Claire's claim. And I'm looking, because I have a history of a bite,
and I didn't find it. NARRATOR: With another theory apparently off the table, the mystery only deepens.
But there was another potential culprit Dr. G can pursue. Claire has a history of cervical cancer,
which required a hysterectomy and genital surgery. DR. G: She's got a large abdominal scar going down
basically from her belly button down to her bone-- pubic bone. And then we also have that she's got a history
that the cancer had recurred and was on the outside of her genitalia. They had to do vulvectomy, remove
some of the external genitalia. NARRATOR: But until she examines the body internally,
Dr. G has no clear answers as to whether the cancer was Claire's killer. A supposed bite, unusual lesions on the skin, cancer.
At the close of the external exam, the woman's case remains baffling. DR. G: None of it was making sense.
What exactly is going on, I wasn't sure. NARRATOR: However, Dr. G believes she might have a viable, albeit tentative,
diagnosis as to the cause of her strange disorder. Well, you know, I am looking--
I'm looking at her, and I'm thinking could it-- it might be chicken pox. It might have been chicken pox that killed her.
NARRATOR: Chicken pox, known clinically as the virus varicella zoster, is typically thought
of as a benign childhood rite of passage which causes a rash of itchy welts and a fever lasting about a week.
But for reasons unclear the disease can be exceptionally virulent and even deadly
for certain individuals. Especially vulnerable, according to Dr. Mark Wallace, are newborn babies and adults.
The older you are when you acquire chickenpox by and large, the more severe it is.
Sometimes when neonates acquire it, babies that are born to mothers with chickenpox, that can be quite severe,
but that's sort of an exception. NARRATOR: Because chicken pox is easily spread by direct contact
or through the air from a sneeze or cough, Dr. G knows that Claire could have been infected just about anywhere and never known it.
One way she can test if Claire was infected with chickenpox is to take samples of the pustules themselves,
and that's where she turns next. I had to do some special procedures, because I wanted
to know what the infection was. NARRATOR: Coming up, Dr. G inspects slides from Claire's sores and discovers that her death seems
to defy medical possibility when "Dr. G, Medical Examiner" continues. [MUSIC PLAYING]
At the District 9 morgue in Orlando, Florida, chief medical examiner Dr. Jan Garavaglia
is working on her first autopsy of the day, the case of Claire Jackson. Her next step is to collect a sample
from one of the many sores that covered the woman's body to examine later under the microscope.
DR. G: I took one of her vesicles and I opened it. I broke it open and scraped it so I could see the cells
that were inside that vesicle. NARRATOR: The woman died yesterday in the hospital
after a rapid onset of a bizarre illness that she believed was caused by a human bite during a kiss.
However, Dr. G found no evidence of a bite mark in the external exam, and she suspects
instead that Claire's death may have been due to chickenpox. She had an infection that was-- that was killing her.
It was pretty obvious by looking at her. NARRATOR: But there's also the lingering
possibility that Claire died from a relapse of cervical cancer. Chicken pox or cancer?
It's a question that can only be answered by completing the internal examination.
DR. G: OK, we ready? You took a picture? You did. NARRATOR: Claire's body is opened
with a Y-incision from the shoulder blades to the pubic bone. Immediately, the extent of her illness is apparent.
Well, when you open her up, she just looks sick. Sick on the inside, just like she looked sick on the outside.
NARRATOR: Dr. G draws toxicology samples and then begins her search of Claire's body
cavity for any signs of recurring cancer. As medical records indicated, Dr. G find several of Claire's reproductive organs
previously removed as a result of the disease. Internally, she has no uterus, tubes,
or ovaries, which goes along with her history of cervical cancer. NARRATOR: But she finds absolutely
no evidence of a relapse. DR. G: There was no cancer. NARRATOR: Dr. G is now confident that the woman's rapid death
was not due to a cancer relapse. Could it have been from chicken pox? OK. So the right is 500--
NARRATOR: She isn't sure, but then she sees Claire's liver. DR. G: Her liver was-- had kind of a pitted surface.
It was somewhat soft and round. Her liver does not look good. NARRATOR: It's obvious that Claire succumbed
to liver failure, just as the hospital indicated in its records. Dr. G now needs to find a link between Claire's liver
and chickenpox, but infections like chickenpox can only be positively identified
through lab analysis. Oh, right. NARRATOR: Dr. G must take tissue samples of Claire's liver
and send those to the lab, along with the skin scrapings from the vesicles, to have microscopic slides prepared.
DR. G: So we've got to put it all together. We've got the vesicles. We have the vesicles on her skin,
the vesicles in her mouth, the mucosa sloughing off. We've got pretty much dead-looking liver.
And what does it all mean? NARRATOR: She must wait several weeks to find out. [MUSIC PLAYING]
I just have-- I have the one from today for the death certificate. First thing I got back was I got the slides stained
of the vesicle that I scraped. Yeah. [INAUDIBLE] And it's-- it's-- you see these kind of--
these cells almost kind of look like they fuse. It's big cells, and then they have
a-- like a little glob of kind of pink purple stuff, and that shouldn't be there.
Your cells shouldn't have these pink purple globs, and the cell's kind of enlarged.
And they look like several of them together. NARRATOR: Claire's liver samples and blood
cultures are abnormal as well, and they all point to the same disease. But it's not chicken pox.
It's something Dr. G never expected. It had the characteristic findings for herpes.
NARRATOR: But the type of herpes Dr. G finds in Claire's body is herpes simplex type 1, or oral herpes,
one of the most common viral infections in the world. Unlike genital herpes, herpes simplex type 1
is not considered a sexually transmitted disease because it is usually contracted through casual contact
in childhood. Typically, the virus causes only localized cold sores on the face, lips, and gums.
The idea that such a common virus, which usually remains localized on the mouth, could have spread through Claire's
entire body and caused her death seems almost impossible to believe. DR. G: Herpes, systemic herpes infection?
That's-- you know, I'm thinking, that's got to be ridiculous. I've never heard of, you know--
I mean, she's a healthy woman. I don't-- I don't know why she would get systemic herpes infection.
NARRATOR: It's impossible, and yet there it is on the slide. For Dr. G, the unbelievable finding begs one question.
Why? Why does she have herpes all through her body? I mean, I'm like, I don't know.
NARRATOR: Coming up next, the hunt for answers to Claire Jackson's stunning death
leads Dr. G to a shocking conclusion. I really couldn't get a handle on why she would be get systemic herpes.
NARRATOR: And later when an epileptic man dies after a seizure, his wife is stunned
by what killed him and blames herself for his death. If I'm such a smart nurse, why didn't I notice your symptoms?
NARRATOR: When "Dr. G, Medical Examiner" continues. [MUSIC PLAYING] In the case of Claire Jackson, Dr. G
has two findings that seem to contradict medical science, the death of a woman and absolute proof
that a massive herpes simplex 1 infection killed her. Her herpes took off and went all over her body.
She has acute fulminant liver necrosis from the herpes. NARRATOR: But now Dr. G might finally
have a logical explanation. After consulting with her staff and other infectious disease
experts, Dr. G theorizes that herpes might have become lethal in Claire because her immune system was
somehow significantly weakened. To me, to-- one reason for her to have systemic herpes
would-- maybe she's immunosuppressed. In the cases that I could find, the only people
who really get it systemically are immunosuppressed people, people whose immune system
can't control this virus. And I thought, well, what could have acutely caused her becoming immunosuppressed?
Well, AIDS is one of them. So immediately, I order an HIV to see if maybe she's immune--
has an immune problem. NARRATOR: Dr. G asks the lab to recheck samples of Claire's blood for HIV,
the virus that causes AIDS. This could be the explanation she needs in the case.
HIV and AIDS could have inhibited Claire's ability to fight off the infection, rendering
even the most benign viruses like herpes simplex 1 a potential killer. But when Dr. G receives the results from the lab,
once again, she's taken aback. DR. G: It was negative. She wasn't-- she didn't have AIDS.
She didn't have the virus that would cause immunosuppression. I cannot explain that.
I had experts that I contacted. I cannot explain why, with her, it went all over her body.
I thought surely she had to be immunosuppressed. I thought surely she must have AIDS, uh, something
that would cause immunosuppression. And I don't have an answer on why it happened to her.
NARRATOR: Despite her lack of answers as to why, she does make one shocking inference into how Claire
might have contracted herpes. After reviewing the entire case, Dr. G believes that Claire was right after all about the bite,
despite no evidence of scarring at autopsy. We clearly has a history that something happened,
so it's hard to believe that that didn't play a role. I just can't totally connect the dots
and totally blame him for this whole thing, because it still doesn't make sense why she got it systemically.
But it sure sounds about from the timeline that she got that herpes from that bar and from that kiss
from Prince Charming. NARRATOR: With her long awaited findings in hand, Dr. G can finally speculate about what
happened to Claire Jackson during her last two weeks alive. Two weeks before her death, Claire Jackson
stops into a local bar, looking for a drink and some company. She finds both. But unbeknownst to Claire, her impromptu suitor is likely
a carrier of herpes simplex 1. And tonight, the virus is active in his mouth. DR. G: She kisses someone.
Probably this someone has a cold sore. And during this kiss, we think that she was bitten either
on the lip or the tongue. Herpes simplex type 1 is usually acquired from contact
with saliva, so it's certainly possible that you might be exposed to more virus at one time
through a bite then-- then through just exposure to a sore or infected saliva. NARRATOR: For unknown reasons, Claire's body
is unable to fight the usually benign virus and it quickly spreads. DR. G: I don't think anybody has a good answer
on why a healthy person could then get systemic herpes. It just happens. NARRATOR: By the time she visits her doctor approximately five
days later, she is nauseous, suffers from a fever, and has diarrhea. She also complains of pain in her mouth.
Suspecting a bacterial infection, the doctor prescribes antibiotics, but the treatment is ineffective in quelling herpes.
And then from there she gets sicker and sicker and sicker. NARRATOR: Her decline is swift.
About two days after visiting her doctor, Claire was rushed to the hospital, critically ill.
Her body teams with a systemic herpes infection. Overrun with the rampant virus within only 22 hours,
her liver fails to function. By then, Claire's body has erupted with hundreds of herpes blisters.
And shortly thereafter, Claire dies. The herpes went into her body and went into her liver
and actually killed her liver. And she died from fulminant hepatic necrosis. NARRATOR: Amazingly, there have been only 21 people
in the world not suffering from immunosuppression who are known to have died from systemic herpes infections,
And Claire was one of those unlucky few. I have never seen a case like this, and I know I will never see another case like this.
It's just-- I'm never going to see it. Systemic herpes infection in a normal woman is really rare.
It is frightening. You know, I guess life is just full of uncertainties, and sometimes bad things happen that you just can't explain.
NARRATOR: Coming up next, did epilepsy kill this man? There was a small subset of people
who have these major seizures that can die suddenly from them. So what we've got here is a man who has a known
history of seizure disorder. NARRATOR: When "Dr. G, Medical Examiner" continues.
[MUSIC PLAYING] Krishell is here looking-- looking pretty today. And because Krishell decided to show up,
we have a pay statement for her. Oh, thank you. There you go. She was looking rough yesterday,
but she looks good today. Oh. And she's doing this on camera, Krishell. Oh, yeah.
That's right. Dr. G was saying such nice things about us yesterday. She was vicious.
I was not. She put her head in the fan like she was one of those dogs, sticking it out the window for air.
Yeah. So that's nice. Call me a dog. NARRATOR: Dr. G's next case involves the death
of a 56-year-old man named Dale Ennis, who has suffered from epileptic seizures since childhood.
OK. NARRATOR: As her morgue assistant Krishell [INAUDIBLE] prepares the body for examination,
Dr. G familiarizes herself with the case history. So what we've got here is a man who is a known
history of seizure disorder. The seizure disorder started when he was a little kid
after an episode of what they think was meningitis encephalitis. He would sleep for a long time afterwards [INAUDIBLE]..
NARRATOR: According to Dr. G's investigator's report, yesterday afternoon Dale was discovered by his wife,
collapsed in the backyard. PAULA: I went outside, and he was down on the ground.
And I could see that he'd had a seizure. I shook him, and I said, are you all right?
And he goes, yeah, yeah. I had a seizure. Just let me lay here and sleep for a few minutes
and I'll get up. And I said, are you sure you don't want me to call 9-1-1? No, no. No, No.
I'll be all right. Just let me sleep. He's been quite firm with her not to call EMS, not to transport him to the hospital.
He sleeps for about 20 minutes in his post ictal state, you know, after the seizure, and then he's fine.
NARRATOR: Paula, a nurse, places a pillow under Dale's head and an umbrella over him
to shield the sun. Then she waits for her husband to wake as usual. OK. NARRATOR: But 20 minutes pass and Dale is still unconscious.
Well, you see, something horrible happens this time. He doesn't wake up. NARRATOR: Sensing something is wrong, Paula calls 9-1-1.
PAULA: The ambulance pulled in. They came over, and she checked him. And she goes, he doesn't have a pulse.
And I said, what do you mean he doesn't have a pulse? I just checked him. He had a pulse. - No pulse.
PAULA: And she said, well, he doesn't have one now. Initially they feel a pulse, and then
he had some jerking movements. And then he-- they lose the pulse and they start CPR.
NARRATOR: Dale is rushed to the hospital in full cardiac arrest. But only four minutes after his arrival, he is pronounced dead.
Um, it was just-- you just go into a state of shock. You feel like somebody rips open your chest
and pulls out your heart and your lungs. And your brain shuts down. NARRATOR: According to medical records,
Dale had no major health problems, only mild high blood pressure and epilepsy. And at this point, it's his brain disorder
that concerns Dr. G the most. Epilepsy is a malady where, for unknown reasons, nerves in the brain signal abnormally
and trigger recurrent seizures. DR. GARY PEARL: Epilepsy is a state where a person has
enhanced electrical activity. This electrical activity may then spread through other areas of the brain
and cause the manifestations of the seizure. NARRATOR: But while epilepsy is generally
considered a manageable disorder, for some it can and does kill. The deadly but mysterious phenomenon
is known as SUDEP, or Sudden Unexpected Death in Epilepsy. DR. GARY PEARL: SUDEP is a diagnosis of exclusion.
You have an individual who has a history of seizures who is found dead, most often at home, and no cause of death
is found. So all we have is a history of seizures and no findings to explain the death.
So it looked like it was going to be pretty straightforward. I wouldn't find anything, and he was going to be a sudden death
associated with seizure. NARRATOR: But if SUDEP is Dale's killer, it would leave his widow Paula with a tremendous burden.
According to investigator Bill Stratton, who spoke with Paula at the hospital, she feels partially responsible
for her husband's death. When I first met with her, she seemed very upset by his death.
But she also was concerned that she hadn't called 9-1-1 earlier. It was clear from what my investigators got from the wife
is that she felt horrible because she followed his directions and didn't call EMS.
NARRATOR: Could Paula have saved her husband's life by acting sooner? Only an autopsy can tell.
DR. G: So basically at autopsy, the first thing I look at him is how he came in.
He's got-- he's got some little minor trauma to him that we could see right away.
He's got a little abrasion on his nose, some little abrasions on his forehand. And if you feel, you could see that he's got a small abrasion
on the back of his scalp. He's got a little [INAUDIBLE] a little abrasion up there.
NARRATOR: On his scalp Dr. G also finds evidence of the seriousness of Dale's epilepsy.
There was a large scar near his right temple from brain surgery 20 years earlier.
He's got this craniotomy scar. His seizures were so bad at one point 20 years ago
that he actually went into a major hospital to get part of his brain taken out. NARRATOR: Most people with epilepsy
can control their symptoms with medication. But for some, like Dale Ennis, drugs alone are ineffective.
Brain surgery, the removal of the irregular and localized parts of the brain responsible for seizures,
is sometimes an effective albeit risky alternative. After Dale's surgery he was free of seizures for many years
until just several months before his death. PAULA: He loved it. He was thrilled.
He could go back to work. He could drive again. He was able to just live like a normal person.
NARRATOR: For Dr. G, the autopsy so far is straightforward, exactly what is anticipated in a case of SUDEP.
But the internal exam will not be so routine. Coming up next, Dr. G opens Dale Ennis's body
and discovers that despite what his medical records state, epilepsy was not his only medical problem.
I said, I have no idea what you're talking about. He's never made any complaints about this.
NARRATOR: The unexpected findings and their consequences when "Dr. G, Medical Examiner" continues.
[MUSIC PLAYING] Dr. G is now ready to open Dale Ennis's body. An epileptic since childhood, Dale
died without warning yesterday afternoon after a seizure. Dr. G believes that Dale might have succumbed
to a fatal but little known phenomenon associated with the disease, Sudden Unexpected Death in Epilepsy,
or SUDEP. And his widow, Paula, wonders if calling 9-1-1 sooner would have saved his life.
PAULA: I was just basically in a wait mode. I couldn't lay still. I couldn't think.
I just wandered the house and cried. NARRATOR: Once Dale's chest cavity is opened,
Dr. G gets her first look at his internal organs. And then the chief medical examiner comes
face to face with a bombshell. Look at the heart. He's got a-- he's got a big heart.
Right off when we weigh his heart, we see there's something wrong. He's got an enlarged heart.
Normal heart should-- for him shouldn't be over 400. His is 550 grams. So his heart was enlarged, 550 grams.
And then I look at the coronary arteries, and he has very significant narrowing to the coronary arteries that they didn't know about.
His left anterior descending is at least 90% narrowed. His first diagonal is at least 90% narrowed.
Dilated there's not much left where the blood is supposed to be. NARRATOR: Dale's heart has severe atherosclerosis,
or clogged arteries, and it is also enlarged from the effects of chronic high blood pressure.
That heart could have killed him easily from an arrhythmia. NARRATOR: The finding of heart disease
seems to contradict Dr. G's original hypothesis. However, some physicians theorize
that the heart might actually be a contributing factor in SUDEP deaths. DR. G: We don't really know the true mechanism
of why these seizures kill. And one theory is that it affects your heart, and it's possibly the electrical component
of the heart with the seizure kind of short circuits also. So if you already have a bad heart on top of that,
that certainly could play into it. Appendix present. NARRATOR: Her tentative conclusion?
Dale Ennis died from two causes of death. You can't really separate. It'll be sudden death associated with seizure or epilepsy
with hypertensive and atherosclerotic cardiovascular disease. NARRATOR: It is a finding that comes
as a shock to Paula, who had no knowledge that her husband had heart disease. I'm like, you're kidding me.
I said, he has never had any complaints. NARRATOR: But before closing the case, there's one more organ that Dr. G must examine, the brain.
Will there be any hidden surprises there? OK. I'm coming. NARRATOR: Coming up next, the unpredictable case
of Dale Ennis takes yet another left turn. DR. G: Well, I reflect the scalp and something
kind of popped out right away. I'm like, what? I was beyond surprised. NARRATOR: When "Dr. G, Medical Examiner" continues.
[MUSIC PLAYING] [INTERPOSING VOICES] NARRATOR: At the outset, the death of 56-year-old Dale Ennis
seemed straightforward, a case of sudden death during an epileptic seizure. But during the internal exam, Dr. G
has discovered that Dale suffered from advanced heart disease. And she now believes that both his heart and the epilepsy
contributed to his death. DR. G: I mean, at this point I'm feeling fairly confident.
But we still have to look at the head, and there's always-- you know. You never know until you finish the head.
Ew. I reflect the scalp and something kind of popped out right away. I knew going in that he'd already
had a craniotomy to get part of his brain taken out where the seizure focus was.
And, you know, they have to take out a little bony window, and then they cut out the brain and then
put the bony window back and the bone heals very nicely. It's remodeled. I mean, your bone will reabsorb.
And then the little area that they cut, it grows back and there's union. But in his case, something was amiss.
It never grew back together. There's a huge non-union, particularly in the area of temporal lobe--
temporal bone kind of going on the inferior lower aspect, pretty big area. [INAUDIBLE] his part.
It's about almost an inch and a half, I'd say. NARRATOR: In other words, Dale's surgery 20 years ago
left him with an actual opening in the temporal region of his skull, an extremely unusual and potentially
dangerous condition. DR. G: You could have easily put a-- a quarter in that space.
It was actually very pliable. You could just press on that temporal bone, and it would move back and forth.
NARRATOR: Moreover, Dr. G discovers that the abrasion on the back of Dale's head, which was first
noted in the external exam, is much deeper than she originally thought. Now I didn't know what significance that had,
so I just noted it and then proceeded in having my technician remove the calvarium, the skull cap.
And then I go and remove the brain. [INAUDIBLE] Oh. Lo and behold, we see a surprise.
NARRATOR: There was abnormal bleeding in Dale's brain, very close to the non-fused portion of his skull.
He's got-- Well, you know, it should be nice and white. You notice it's awfully bloody?
NARRATOR: For Dr. G, the diagnosis is immediately apparent. He's got a subdural hematoma, and that's not what
we usually see with a seizure. He does have a subdural. NARRATOR: A subdural hematoma is a bleed
that occurs in the tiny blood vessels between the brain and the dura, the protective sheath that
covers the brain. Such bleeding can be life threatening as the pooling blood compresses the brain within the skull.
And it's almost always caused by trauma, not seizures. In an instant, the real cause of Dale Ennis's death is clear.
He did not die from epilepsy or advanced heart disease. He died from a head injury.
He actually died from the subdural. PAULA: She said that the vessels in his brain
were just very friable. You know how old cloth falls apart in your hands? His vessels were just falling apart in her hands.
I was beyond surprised. I had to pick my jaw up and put it back on my face where it fell off.
And then I called his family to let them know, and they were surprised. NARRATOR: The question is, how did this trauma occur?
Dr. G removes the brain to get a closer look. And what she discovers will add yet
another unbelievable revelation to an already complicated case. When we took the brain out, what
was interesting is he'd had a previous subdural hematoma. Look at that. And this previous subdural hematoma
looked a couple weeks old, definitely less than a month. And that was in the area where there
was non-union of the bone. NARRATOR: And at the dissecting table, Doctor G discovers another abnormality.
DR. G: Lo and behold, the brain had trauma, too, some contusions or bruising. We've got contusions on the tip of the temporal lobe,
some inferior frontal. He fell on the right-- also he had a little bit of trauma
which appeared to be a contusion in the area of the pons or the brain stem, which is a bad area.
NARRATOR: A history of epilepsy, advanced heart disease, two subdural hematomas and evidence
of critical brain trauma, a skull that never fully healed from brain surgery. The autopsy of Dale Ennis has been anything
but straightforward, and has uncovered complex forensic evidence. But Dr. G believes she now knows exactly how Dale Ennis died.
The intricate findings point to an unusual chain of events, and it's a conclusion that Dale's widow, Paula,
will find difficult to fathom. Based on findings at autopsy, Dr. G knows that several weeks before his death, Dale
must have suffered some minor trauma to the right side of his head, the side that had been weakened by brain
surgery 20 years earlier. DR. G: How he got it, I don't know if we'll ever know,
but it caused a subdural. And because of this weakness of the bone, it somehow caused the little blood
vessels that go between the dura and the surface of the brain to tear. NARRATOR: Dale is apparently unaware
that he sustained a minor subdural hematoma, and in the following weeks the delicate torn blood vessels
in his brain begin to heal. Subdural hematoma aren't always killers. A lot of people, particularly older people
because their brains shrink, can have small subdural from some-- from minor trauma that they didn't know they had.
NARRATOR: Then yesterday, Dale suffers an epileptic seizure and collapses in his backyard.
He strikes the back of his head on the ground with force, resulting in a contusion to the back of his skull and critical
trauma to the brain stem. The jarring fall also jostles the weak portion of his skull,
shearing delicate blood vessels under the dura, including those healing from his previous subdural.
Problem is with these old subdurals, they get at a vulnerable stage when they're starting to heal
and can easily be damaged with more minor trauma. NARRATOR: Soon the bleeding begins to irritate
and compress Dale's brain. When his wife Paula checks on him, she believes he's recovering from a seizure as usual.
Actually, he's dying of massive head trauma. DR. G: Most likely his brain is starting to swell.
His brain is irritated from that subdural. So there is just a lot of little findings in his brain
that it basically gets short circuited. There's trauma there, and he dies. [AMBULANCE SIRENS WAILING]
NARRATOR: Based on her findings, Dr. G draws one final conclusion. Dale's injuries were not survivable, even if his wife
had called 9-1-1 sooner. A lot of different twists, but I'll call the wife and tell her.
I don't think-- I think-- you know, tell her there's really not much she could have done.
I will always try to look and see, you know, would it have mattered? Do-- could I get some information to tell
her that said, you know what? You're-- you know, there's nothing you could have done for him or-- it does.
I mean, it affects me, and I-- it's a one small way I can help the living. You always want to say, was there
some way that I could have figured out to change this course? And you come to realize at a point in time,
you couldn't have. [MUSIC PLAYING] (SINGING) You are the pillow on which I rest my tired head.
My alarm is set, but you're the rising sun that woke me up instead. You're the peaceful sleep I never want to end.
If you're not mine to hold. Honey, love you. I miss you. I'm sorry you're not here, but I can understand that you're
a lot happier up there. So there is nothing in this world that I would do to make you come back down here.
And I let you go. MAN (WHISPERS): Atlas.

After a brief illness, 34-year old Claire Jackson dies suddenly in the hospital from massive liver failure and winds up in Dr. G’s morgue.

A Florida medical examiner takes viewers through puzzling cases while explaining procedures and conclusions.

Brief Summary

Dr. G investigates a woman's mysterious death from herpes and a man's fatal seizure linked to heart disease and head trauma.

Key points

A Mysterious Death. Claire Jackson's sudden illness leads to her baffling death, leaving doctors puzzled.
Unusual Findings. Dr. G discovers shocking lesions on Claire's body that defy medical expectations.
The Unbelievable Diagnosis. Dr. G uncovers that Claire's death was caused by systemic herpes, a rare occurrence.
Dale's Seizure and Unconsciousness. After a seizure, Dale remains unconscious, prompting Paula to call for help.
Paula's Guilt. Paula grapples with feelings of guilt over not calling for help sooner.
The Heart Condition. Dale's autopsy uncovers severe heart disease that complicates the cause of death.

Episode highlights

Episode quotes

Life is just full of uncertainties.

Dr. G on the unpredictability of life and illness.

22:01WatchJun 1, 2021

Tension

75/ 100High tension

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