Dr. G: Medical Examiner - Season 5, Episode 13 - Whispered Warnings - Full Episode | Forensic Files

[OMINOUS HUM] [DRAMATIC MUSIC] NARRATOR: When a healthy young man unexpectedly drops dead,
Dr. G is baffled. Healthy guys don't die suddenly. Something's going on. NARRATOR: But a trail of strange clues only deepens the mystery.
This body's whispering something to me, but I'm just not sure what it's saying. NARRATOR: Then, a woman is found dead on her bathroom floor.
DR. G: There's water on the floor. We don't know if she slipped and fell and hit her head.
Accidents happen. NARRATOR: But something about this case raises troubling doubts.
I've got 20 years of experience saying, this isn't adding up. [THEME MUSIC] NARRATOR: Altered lives.
Baffling medical mysteries. Shocking revelations. These are the everyday cases of "Dr. G: Medical Examiner."
[LIGHT MUSIC] This morning at the District 9 morgue in Florida, Dr. Jan Garavaglia has some news to share with her technicians
Brian and Kelly. DR. G: Well, you know, I got the pers-- did I tell you what I got for Christmas?
Yes. I'm not looking forward to it. I don't know. I haven't met with her yet. I want to see what kind of Attila the Hun she is.
Did you want to lose weight more so, or tone up? Uh, both. I need to lose 10 pounds, I've decided.
No, forget that. You think I'd tell you? Even if we weren't on camera, you think I'd tell you?
I have my-- this is like a top secret. You think that the missiles are top secret.
My weight's top secret. [CHUCKLING] NARRATOR: Dr. G knows all too well that exercise and proper nutrition
can go a long way to keeping you out of the morgue. But unfortunately, healthy habits aren't always enough.
And such seems to be the case with her next decedent, Jeffrey Woods. So he's a 42-year-old male.
No known medical problem. He eats right. He doesn't use drugs. He doesn't drink.
He doesn't smoke. But clearly, something's wrong. [LIGHT MUSIC] NARRATOR: It's mid-afternoon on a sunny Saturday,
and Jeffrey Woods is just finishing up his day shift at a restaurant in downtown Orlando.
He's been waiting tables here for over three years, and is a favorite with the regulars.
But today, something's not right. He told one of his co-workers he wasn't feeling well.
In fact, he didn't even feel well enough to drive home. So he kind of sat it out for about an hour and decided,
maybe he should call his girlfriend. He spends probably another hour or so waiting to get a hold of her.
Takes her another 45 minutes to get there. [CAR HONKING] NARRATOR: Finally, Jeffrey spots Grace
pulling into the parking lot. He exits the restaurant and walks toward her car. But after a few labored steps, his knees buckle.
Jeffrey! NARRATOR: Grace rushes to his side, but he's unresponsive. She calls 911.
Emergency crews get there. He's got irregular heart rhythm. NARRATOR: But as Jeffrey is rushed to the hospital,
his condition rapidly worsens. DR. G: Eventually, his heart stops. They try to work on him, but he dies in the emergency room.
They finally pronounce him. NARRATOR: Grace is crushed, and she can't imagine what could have killed her boyfriend so suddenly
and unexpectedly. According to Grace, Jeff was the picture of health. He's a karate instructor.
He's very into his health and what he eats. And she says he doesn't smoke. He doesn't drink.
He takes very good care of himself. Now, she says he doesn't have any medical history,
that he's in great shape. As far as she knows, he doesn't go to the doctor. [SOMBER MUSIC]
NARRATOR: But Dr. G knows Jeffrey can't possibly have been as healthy as he seemed.
Healthy guys don't necessarily die suddenly. Something's going on. NARRATOR: And she has a strong hunch
what that something could be. 42-year-old African-American male dies suddenly. It certainly can be a heart attack,
and that's what I'm thinking it's probably going to be. NARRATOR: Still, it's too early to rule
out other possibilities. DR. G: The girlfriend also says he doesn't use drugs. You know, I've heard that before.
You know, maybe he is using cocaine. That's certainly associated with sudden collapse.
NARRATOR: Now the pressure's on for Dr. G to find answers and explain Jeffrey's sudden death to those
he left behind. [DRAMATIC MUSIC] DR. G: So when I do the external examination, the first thing
I do is go through his clothing, look at his personal effects. NARRATOR: And here, Dr. G discovers
what could be her first clue. A roll of small bills that amount to $343. DR. G: Now, that's a lot of money
just to be carrying around. Now, he's a waiter. That's pretty good day's work. Or is he doing something else at work?
Is he selling drugs at work? I often see large amounts of money with small bills on drug dealers.
Only time will tell on that one. NARRATOR: Dr. G next turns her attention to Jeffrey's body.
Immediately, she can see that Grace was not exaggerating. Jeffrey is in peak physical form.
DR. G: Very lean, muscular kind of guy. Looks the stated age of 42. Maybe even a little younger.
NARRATOR: As a first step, she carefully scans him for any signs of abnormality.
DR. G: I look in the arms to look for any vascular scars. They say he didn't use drugs, but is there any sign of it?
And there isn't. NARRATOR: Dr. G's next stop is Jeffrey's head. And there, she does find something odd.
The moist tissue lining his eyelids and mouth, called the mucous membranes, appear pale.
DR. G: But that could be from many things. Really doesn't alert me to anything at this point.
All righty, so I got that, I got that. So when I and my external examination, I really don't know any more than when I started.
He may look good on the outside, but he may not look good on the inside. [OMINOUS MUSIC]
All righty. So I do my normal Y incision. Huh. Nothing abnormal in the abdominal cavity
when I first open it up. Organs all appear to be in the right location, and there's no free blood or fluid there.
NARRATOR: Next she removes the chest plate. DR. G: I'm going to be looking for anything I find that's out
of the ordinary and that would fit with his symptoms, which would be feeling ill
and then a sudden collapse. NARRATOR: Taking into account the circumstances of Jeffrey's death, Dr. G goes straight to the prime suspect--
the heart. And with one glance, she can see that something is terribly wrong. He's got something right off the bat that
could have caused his death. [OMINOUS HUM] [LIGHT MUSIC] NARRATOR: Dr. G is examining the heart
of 42-year-old Jeffrey Woods. His girlfriend Grace insists he was the picture of health.
But Dr. G has just discovered something that indicates otherwise. DR. G: Immediately, we see something wrong.
The heart's enlarged. Typical weight for a guy this size would be 350. His is 570.
570 gram heart in a small guy is huge. NARRATOR: And that's not all. When she dissects the organ, she discovers
another serious condition in his arteries. DR. G: He's got at least an 80% narrowing
of one of his coronary arteries by atheroscleratic plaque. So he's got the double whammy.
The narrow blood vessels and the enlarged heart. Typically, we would see that with somebody
with longstanding high blood pressure. DR. MARIO MADRUGA: High blood pressure is the force that's exerted on the walls of the blood
vessels of your body-- namely, the arteries. NARRATOR: This added strain on the arteries
causes the heart muscle to thicken. And as it expands, the muscle has difficulty getting oxygen, making
it vulnerable to an arrhythmia. Now, could that have caused his death? It could have.
He could have been a sudden cardiac arrhythmia. NARRATOR: A fatal arrhythmia is an irregular
heartbeat that short circuits the entire organ. But it leaves behind no evidence.
So in order to determine if it's the cause of death, Dr. G must first rule out everything else.
DR. G: We've got to put all the pieces together, because it could be from his heart, but I would like to see
what the rest of him shows. Al right. Then we look at his lungs. Now, this is the guy that's supposedly
the picture of health, and his lungs don't look good either. NARRATOR: The first abnormality she sees
is in the pleura, the soft membrane that encases the lungs. DR. G: He's got some adhesions.
Little fibrous connections. Normally, your lungs should be able to move very freely in that space in your chest as you breathe out
and breathe in. And there's usually a thin amount of fluid, a little fluid that helps lubricate it in there.
And sometimes, because of an infection, or inflammation, those adhesions, little scar tissue
forms between the surface of the lung and the cavity where they sit. NARRATOR: Such adhesions can be insignificant--
simply the result of previous infections or other minor lung problems. But then she dissects Jeffrey's lungs
and finds something definitely alarming. DR. G: The lungs clearly have scar tissue in them.
Fibrosis throughout the lungs, and they also had a lot of fluid in them. NARRATOR: Both of these symptoms-- fluid
and scar tissue in the lungs-- point towards a dark possibility. One of the possibilities with that kind of fibrosis
could be, you know, drugs. NARRATOR: Many illicit drugs, including heroin and cocaine,
contain impurities such as talc. Dr. G wonders if Jeffrey had been injecting such drugs,
allowing the impurities to travel through his bloodstream and into his lungs. Over time, the particle buildup would
have caused the kind of fibrosis or scar tissue she's now seeing. But she won't know for sure until she
gets a look at the lungs under the microscope. DR. G: His girlfriend is saying he's not using drugs,
but we don't know until we test him. So I need to get toxicology, because toxicology
clearly is a player here. NARRATOR: Dr. G takes samples of Jeffrey's blood and eye fluid
to submit for testing. But it will take at least three weeks for the results to come back from the lab.
[DOORBELL RINGING] DR. G: Anybody I know? BRIAN: [INAUDIBLE] DR. G: Yeah. NARRATOR: For now, she continues to scour
Jeffrey's body for clues. And as she removes the liver, she can see right away that something isn't adding up.
Normally, when we have somebody die suddenly and unexpectedly, it's a very congested, kind of brown liver.
This liver looked more pale. NARRATOR: Dr. G now wonders if this finding could be connected to the clues she found
earlier in his eyes and mouth. It kind of matched the pale appearance of those mucous membranes.
NARRATOR: This indicates that none of these body parts were receiving enough oxygen-rich blood.
But at this point, she's uncertain what it means. DR. G: Things aren't looking right.
This body's whispering something to me, but I'm just not sure what it's saying to me.
And when she examined Jeffrey's kidneys, she finds another confounding clue. The organs are not only pale--
they're also spotted with areas of extreme discoloration. They had kind of a mottled appearance.
They're definitely something wrong with those kidneys. NARRATOR: But her naked eye isn't giving her any answers.
It's clear she'll need to take a much closer look at the evidence. DR. G: I don't know until I look under the microscope,
so I'm definitely going to have to start taking some microscopic slides here. NARRATOR: She takes tissue samples of the kidneys
and other organs, hoping a magnified view will shed light on their strange appearance.
Well, at the end of the internal, something's going on. There's some subtle findings.
There was a not-so-subtle big heart. You know, if I wasn't curious, that would've been the answer.
But something else is going on here. This body's telling me something, and I need to listen to it.
NARRATOR: And there's one body part left that could tell her what she wants to hear.
[OMINOUS MUSIC] Dr. G's morgue technician, Brian Machulski, saws through the skull so that she can access the brain.
DR. G: Now, the head might scream the answer to us if we have a big bleed. Because we already know he has some essential hypertension.
His heart's enlarged. Maybe he had a bleed in his brain, and that could explain everything.
NARRATOR: If that's how Jeffrey died, she may find an area of congealed blood within the brain tissue.
She removes the organ and sections it with her blade. There's no evidence of a bleed inside the brain.
NARRATOR: Still, she can see that something isn't right. The brain looks kind of pale too.
So the brain may be whispering something to me too, but I really can't put my finger on it,
and it doesn't really give me an answer. NARRATOR: The physical examination is complete,
but Dr. G has yet to decipher what Jeffrey's body is trying to tell her. DR. G: I'm going to have to wait for the toxicology,
and I definitely want to look at the microscopic examination. Hopefully, one of those two may give me the answer.
[OMINOUS MUSIC] [LIGHT MUSIC] NARRATOR: 20 anxious days pass before Dr. G receives
Jeffrey's toxicology report. The first thing she checks for is the one that would be most devastating to Jeffrey's
girlfriend, Grace-- evidence of illicit drugs like heroin and cocaine. He didn't have any drugs at all in the system.
NARRATOR: But there's more to the report. And as she reads on, Dr. G pays particular attention
to the body chemistries revealed in Jeffrey's eye fluid analysis. That's very valuable to us, because that's the only fluid
I can check for electrolytes. Your sodium, your potassium, your chloride, but also your creatinine.
Those give us indications of dehydration and sometimes kidney function. When I looked at what that vitreous fluid told me,
it was quite remarkable. NARRATOR: Jeffrey has extremely high levels of creatinine
in his system, a natural byproduct released by the body's muscles when converting food to energy.
Normally, the kidneys filter creatinine from the blood into the urine. But when your kidneys start to fail,
this creatinine will start going up because your kidney's not getting rid of it.
NARRATOR: Healthy kidneys keep the creatinine level between 0.6 and 1.2 milligrams per deciliter of blood.
But Jeffrey's level had far surpassed the danger zone. His is 23. He doesn't have any kidney function left.
NARRATOR: Looking at this figure, Dr. G now knows exactly how Jeffrey died. His kidneys literally shut down.
DR. G: It's clear he's in renal failure and this is what's killed him. But why? Why did he go into renal failure?
Renal failure isn't the answer for me. Now I've got to figure out, what's going on with him?
[OMINOUS HUM] [DRAMATIC MUSIC] NARRATOR: Dr. G is now certain that 42-year-old Jeffrey
Woods died from kidney failure. But she's still missing a key piece of the puzzle,
and the last place to look is the micros. The microscopics better give me the answer.
[UPBEAT MUSIC] The first thing I look at's his heart. His heart really doesn't give me the answer.
It just confirms what I saw with my eye. NARRATOR: Next, she examines the lung tissue
but finds nothing more than what was apparent at autopsy-- fluid buildup and scar tissue, or fibrosis.
I put two polarizing filters to see if there's any objects like talc or something
that would have caused that fibrosis. He doesn't have any. So it could be just idiopathic, meaning we don't
know why he's got fibrosis. A lot of the time, you never find a cause. NARRATOR: So far, she's found nothing
to suggest why Jeffrey's kidneys shut down so abruptly. But there's a critical slide left to check.
And I immediately go to the kidney, because I know he's in renal failure. And his kidneys look terrible.
NARRATOR: Dr. G twists the dial to sharpen the image, and what comes into focus is astonishing.
DR. G: The tissue is dying. The blood vessels are very damaged. NARRATOR: And this particular type of damage
can only mean one thing. DR. G: When I did the autopsy, there was something subtly
wrong with those organs, and it was whispering the answer to me, but I couldn't hear it.
But when I looked at the tissues under the microscope, the answer shouted out at me.
[OMINOUS MUSIC] [LIGHT MUSIC] NARRATOR: To everyone around him, Jeffrey woods is the picture of health.
But looks can be deceiving. Although he supposedly takes good care of himself, and exercises and eats right, something terrible
is going on inside of him. NARRATOR: Jeffrey's heart is severely damaged by high blood pressure, or chronic hypertension.
DR. G: You know, it's not that unusual to get a history that somebody's in great shape.
Then I open them up and find heart disease. Particularly high blood pressure. Chronic hypertension is a silent killer.
It goes along for years, affecting your blood vessels slowly over time. NARRATOR: But Jeffrey's kidneys showed evidence
of an unusual illness that's much more aggressive-- malignant or accelerated hypertension.
Malignant hypertension is a much higher blood pressure where it just goes way out of control really fast and really
high, causing havoc and damage very acutely to the blood vessels. DR. MARIO MADRUGA: The degree of pressure
can be so high that that inner lining of the blood vessel is damaged. NARRATOR: In turn, the damaged lining tears apart
the red blood cells that are trying to deliver oxygen. The condition is called microangiopathic hemolytic
anemia, and it explains why Jeffrey's eyes, mouth, and some of his organs appeared pale.
DR. G: You'll see these very pale organs, because although he's not bleeding out,
his blood's breaking up on the inside and not able to get through there. NARRATOR: But worst of all is how
the effects of malignant hypertension devastate his kidneys. DR. G: The blood can't get to the kidney.
The kidney starts to die. That's causing the waste products no longer to be filtered out.
His blood chemistries are completely out of whack. He's feeling tired. He's probably getting nauseous.
NARRATOR: Based on his creatinine levels, Dr. G suspects these symptoms began long before his collapse.
DR. G: If he had a normal creatinine, to get to a 23 would take at least 10 or 11 days.
He's going about his daily business trying to probably brush off some of these feelings.
He's probably getting a little fluid buildup, shortness of breath. But he's working through it.
He's not listening to his body. NARRATOR: Jeffrey doesn't share his symptoms with a soul--
not even his girlfriend. And as he begins his afternoon shift, his condition rapidly deteriorates.
And by the time he called his girlfriend, his kidneys were totally shot. NARRATOR: And as the waste products build up in his blood,
it places an unbearable strain on his heart. Most likely, the final straw is a cardiac arrhythmia.
DR. MARIO MADRUGA: And if you have arrhythmias of your heart, you can suffer cardiac arrest.
NARRATOR: At this point, there's simply no stopping the disastrous chain reaction, and Jeffrey collapses
with no hope of resuscitation. DR. G: His body, it's just got too much wrong with it.
Yes, this is Dr. Garavaglia at the medical examiner's office. Once we have the cause of death, I
called the girlfriend to try to explain it to her, and she was so surprised. She thought he was just in such good shape,
and he looked so healthy. NARRATOR: But Dr. G tells her there might be a reason why Jeffrey developed
malignant hypertension. DR. G: Malignant or accelerated hypertension is really rare.
Less than 1% of people who have chronic high blood pressure ever get anything like this.
But there's something that he possibly has that's even rarer than just the malignant hypertension.
Maybe he has scleroderma, a very rare connective tissue disease. NARRATOR: Jeffrey didn't have any clear external signs
of scleroderma, such as scarred or discolored skin. But internally, the disease can also
cause scarring in the lungs, and it's known to trigger malignant hypertension. DR. G: So it could explain his kidneys and his lungs,
and it would unify the whole thing. It's a hunch. It's a theory. But I think it's a pretty good one.
NARRATOR: Still, all the theories in the world can't account for the tragic nature of Jeffrey's death.
This guy could've done a lot to save himself. He should have listened to his body,
because there are good treatments now, and chances are that they would have been able to treat this.
So I think what people should take away from this is that, listen to your body. If it's trying to whisper to you, listen.
[OMINOUS MUSIC] NARRATOR: Understanding the chain of events that precede a sudden death can be
the key to closing any autopsy. But when a woman is found in a pool of blood on her bathroom floor, Dr. G is left with precious little
to go on. We've got a woman who on the floor face-down. What happened to her? How did she end up on the floor in her house?
[OMINOUS HUM] [LIGHT MUSIC] NARRATOR: It's early in the morning in Orlando, Florida,
and Dr. G is on her way to the District 9 more. DR. G: [YAWNS] Let's see what we got going on today.
Think the news is coming. NARRATOR: It's a demanding job, but after more than 20
years as a medical examiner, Dr. G still finds her work exciting. Every day, it's a new mystery.
It's a new challenge. NARRATOR: And her next case is no exception. [LIGHT GUITAR MUSIC]
53-year-old Florida resident Melinda Lopez never had children of her own, but she loves her niece Bree
as if she were a daughter. They talk almost daily, even though Bree goes to graduate school more than 2,000 miles
away in San Diego, California. Until one morning in October, when Melinda suddenly
stops answering her cell phone. Her niece tried to get a hold of her over a couple days,
and she didn't answer the phone, and she became very worried about her. She called her neighbor, hoping that the neighbor
would go over there. NARRATOR: Using a spare key, the neighbor lets herself in. NEIGHBOR: Melinda?
NARRATOR: At first, it seems as if no one's home. NEIGHBOR: Melinda? NARRATOR: But as she turns a corner
at the end of the hallway, she makes a gruesome discovery. Melinda face-down on the bathroom floor
in a pool of water and blood. She calls 911, but she's clearly been dead there for a while.
[SOMBER MUSIC] NARRATOR: When Bree learns the news, she's devastated and overwhelmed with questions.
She's in another city, and she's very upset. And she really is wanting to know why she died.
NARRATOR: Dr. G begins by reading through Melinda's case file. And based on the circumstances at the scene,
one theory immediately jumps to mind. DR. G: Is it one of our thousands of home accidents
that we see come through medical examiners' offices around the country? She's on the floor face-down.
There's water on the floor. There's a bucket there that she appears to have been filling the toilet with.
Maybe she slipped and fell on the water and hit her head. You know, accidents happen.
Falls are one of the number one ways, in the house, that you can die. And there's a lot of hard things in the bathroom.
The edge of the tub, the edge of the toilet. So a fall in the bathroom can be quite deadly.
NARRATOR: But then, in Bree's statement to investigators, Dr. G discovers a clue that could
suggest a more tragic scenario. DR. G: We talked to the niece. They say she's been depressed for a while.
She thought she was taking antidepressants. So overdose is a possibility. Could this be maybe a suicide?
Families are always upset when you call something an overdose, a suicide, especially when it's out of the blue.
NARRATOR: Bree is now terrified that she may have missed important clues, and that her aunt could be alive today
if she'd only been a better listener. But like so many deaths in the morgue, it's also possible that Melinda simply died of natural causes.
Her heart is a possibility. Maybe a heart attack, and she just goes down. NARRATOR: A key detail in the report heightens her suspicion.
She smokes about a pack and a half of cigarettes a day and has been doing that for a long time.
Smoking really does nothing good for you. It certainly increases the chance of having atherosclerosis.
Smoking adds just a whole 'nother dimension to the way you can die. We're really not going to know why
she died until we do the autopsy, so we'll just have to see. [DRAMATIC BEATS] I should've got a cup of coffee before I started this.
The first thing we do is, really, we sit back and get an overview. In the overview, really, she didn't look that good.
She looks older than her stated age of 53. Clearly has a lot of wrinkles. She's got dirt on her feet, dirt under her nails, thin arms,
and not a lot of muscle on her. She is a woman who looks like she's neglected herself.
NARRATOR: The question is, could this state of neglect reflect a worsening state of depression?
It's possible, but it's not something Dr. G can determine from an external autopsy.
What she can investigate is whether or not Melinda sustained some type of fatal injury.
DR. G: I'm looking for evidence of trauma, any trauma. Because even a subtle bruise could maybe give
us a clue to what happened. NARRATOR: And it's not long before she spots what appears to be a large suspicious bruise.
DR. G: There's some green discoloration going from the lower abdomen onto her thigh and a little bit
onto the lower chest. NARRATOR: But on closer inspection, she can see that the discoloration
is not a result of trauma. DR. G: I think it was more a combination of congestion,
where the blood is settling, and that also is the area that was starting to decompose.
She's face-down, so that's very common. NARRATOR: Moving on, Dr. G checks Melinda's head
for injuries and right away takes note of the blood around her mouth. DR. G: I think that's post-mortem, when
the little blood vessels break inside the mucous membranes after death. Let's get a towel.
We'll clean it up, and let's take another picture this way. She doesn't have a lot of trauma to the face that I could see.
I palpated her scalp. I don't really feel anything. NARRATOR: But more than 20 years' experience
tells Dr. G that negative findings on the outside do not necessarily indicate an absence
of injuries on the inside. You may not always see the trauma because of a full head of hair on particularly a woman.
One of my hypothesis is that she hit her head on the side of the toilet. And so we'll go ahead and just see
if that's where the money is. [OMINOUS HUM] NARRATOR: Dr. G slides her blade across the scalp of 53-year-old
Melinda Lopez, who was found dead on the bathroom floor in a pool of blood and water.
Her grieving niece Bree is terrified at the prospect that Melinda may have killed herself,
and is hoping Dr. G will find another explanation. DR. G: A loved one dies in another city,
and they're looking for me for answers. NARRATOR: And although the clues are scarce,
Dr. G has her own hunch. She's in the bathroom face-down. Maybe she slipped and fell on the water and hit her head.
[OMINOUS MUSIC] All righty, now. So we peel the scalp off. That's a good place to look for bruising.
And she didn't have any. NARRATOR: But Dr. G can't be certain until she removes Melinda's skull cap
and looks inside for any internal bleeding. And then I will take the calvarium off and look at the brain.
But her brain didn't have any swelling, and when I slice it, it showed no evidence of hemorrhage.
You name it, that brain didn't have it. NARRATOR: It's definitive. Melinda did not die of a head injury.
But it's still possible that a fall in the bathroom caused fatal trauma elsewhere.
DR. G: We've got the whole rest of the body to look at to hopefully come up with the cause of death.
OK. NARRATOR: Dr. G makes her standard Y-shaped incision, then peels back Melinda's skin and continues her search
for signs of internal injury. DR. G: It could be broken ribs and a punctured lung.
We want to look for rib fractures. We want to look for bruising. NARRATOR: She closely examines the organs in situ
and is surprised by her findings. DR. G: There's really nothing like bleeding or bruising on the inside to say that that
had any role in her death. I think we've safely ruled out trauma. NARRATOR: With the prime suspect now ruled out,
it's looking even more possible that Melinda may have succumbed to a long battle with depression and took her own life
with a drug overdose. But the only way to find out for sure is to run a series of toxicology tests.
So I remove blood to check for drugs. That should be enough. We'll look to see if there are any substances
that could have caused death. And we'll take eye fluid, the vitreous fluid. We'll look at her eye chemistry, because-- like a doctor
can go and check your blood. I can't do that because your cells have already started to break up, and all those things
are messed up in your blood. But your eye fluid is still a little protected, because there's no free cells,
like red blood cells that are breaking up in there. And so that will stay a little more pristine
for a longer period of time. So the vitreous fluid is very important in somebody who's
died, because they will allow me to check some things which I normally wouldn't be able to check
for after you die. NARRATOR: But the toxicology results won't be in for several weeks.
For now, she pushes on with the autopsy, looking for anything that could help explain Melinda's sudden death.
DR. G: So I have to take each organ out one by one and examine it. NARRATOR: She begins with the lungs,
and right away, she spots trouble. DR. G: They don't look that great. They've got a lot of black pigment from smoking.
They've already got some breakdown-- what we'd call emphysema from smoking. Doesn't look like it's bad enough to kill her.
NARRATOR: Still, Dr. G suspects that Melinda's heavy smoking may have caused her death
by inducing heart disease. And that's where she goes next. Scalpel in hand, Dr. G carefully slices through the membrane
that envelops the heart. DR. G: I open up the pericardial sac. There's no excess fluid.
And of course, there's no free blood. NARRATOR: She then removes the heart from the chest cavity
and dissects the arteries, where she immediately finds her first concrete clue. DR. G: She does have atherosclerosis,
or narrowing to the coronary arteries, one of which is getting severe. Her right coronary artery was filled up 70%, 75%
from plaque buildup. That's when it starts to get really critical, and you easily have problems with that.
We often see it as a result of years of smoking. NARRATOR: Smoking contributes to heart
disease and at least two ways-- by constricting the arteries and by causing bad cholesterol to accumulate in the same narrowed vessels.
In Melinda, Dr. G even finds damage in the aorta, the largest artery stemming from the heart.
DR. G: Well, her aorta is typical of a long-term smoker. It's actually-- the cholesterol is built up in the wall,
and it's broken through the lining, and so it's just-- you see this gooey necrotic stuff just coming out of the wall of your aorta.
It is not a pretty sight. NARRATOR: Although Dr. G now has evidence that Melinda's smoking
definitely took a toll on her heart, she doesn't see any sign of an acute heart attack,
such as pale, dead tissue. The heart's a possibility, but it's right there on the borderline of causing her problems.
It's not a slam dunk. And we'll have to see what the rest of the autopsy shows. NARRATOR: Her next stop is the abdominal cavity--
the stomach, spleen, and pancreas, where she's looking for any sign of natural disease.
Let's see what we have here. Nothing's giving me any clear-cut indication of what went on.
NARRATOR: But when she gets to Melinda's liver, she spots another clue. This is a lot of fat on here.
It has kind of a pale yellowish appearance. It's enlarged. The anterior edge, the front of it is rounded.
Usually, you have a nice sharp edge. It really appears to have some-- what we call fatty metamorphosis,
or fat within the cells. I'm seeing really a severe fatty liver. NARRATOR: Though severe, Dr. G doesn't believe it's fatal.
But it is puzzling, because a fatty liver is most often caused by obesity or alcoholism, and Melinda
has neither in her profile. She's clearly not obese, and I don't have a history of drinking.
But the number one reason for fatty liver is alcohol consumption. NARRATOR: Now, Dr. G wonders if Melinda
could have been hiding an alcohol problem from her niece Bree. Decedents give up their secrets to me in the morgue.
Sometimes things that they don't tell their family, especially drugs, alcohol. NARRATOR: While the liver may reveal secrets
about Melinda's life, it doesn't shed any new light on how she died. With the autopsy complete, Dr. G has just one chance
left to uncover the truth behind this mysterious death. But a haunting scenario weighs heavily on her mind.
There's a possibility that it could be some type of overdose. So I'm hoping toxicology's going to give me the answer.
And we're just going to have to wait and see. What happened to her? How did she end up on the floor in her house?
[OMINOUS HUM] NARRATOR: Three weeks after Melinda Lopez is found dead on her bathroom floor, her toxicology
report lands on Dr. G's desk. Melinda's niece Bree fears the worst-- that her aunt tragically took her own life.
Dr. G is hoping the report will tell a different story. DR. G: The first thing I look at is to see if there's
any drugs or alcohol. She's negative on drugs and alcohol. It's clearly not an accidental overdose.
It's clearly not a suicide. NARRATOR: It is an enormous relief to Bree. But the results pose another problem.
Dr. G still has no idea what could have killed Melinda Lopez. Sometimes, at the end of the autopsy,
you don't know why they died. I was hoping for the answer, because these are a lot of work
when you can't figure it out, and you got to start at square one, and start rethinking it out.
NARRATOR: Line by line, she scours the rest of the toxicology report, looking for anything that could shed light on Melinda's death.
And it isn't long before she comes across something unexpected in the vitreous levels.
DR. G: When I look at that eye fluid, she has a high glucose level, which we typically see
in somebody who is diabetic. NARRATOR: Diabetes. This would explain Melinda's fatty liver,
because it's known to increase the risk of developing liver disease. But Melinda has no history of diabetes,
and it rarely leads to an unexpected death. DR. G: But it's uncommon to see somebody
dying at home from diabetes. So what's going on? NARRATOR: Then, Dr. G makes another discovery
in Melinda's lab results, and she can hardly believe her eyes. DR. G: Something that I really didn't expect was there.
It really all points to one thing. I know why she died. [DRAMATIC BEATS] NARRATOR: It's a sunny fall day in Florida,
but Melinda Lopez is having trouble enjoying it. She's stuck inside, feeling ill.
But she has no idea how sick she really is. DR. G: Even though she probably didn't know,
and no one in her family obviously knew, she had diabetes. NARRATOR: Toxicology results confirm that Melinda was
suffering from diabetes, a condition that causes glucose levels to rise because the body is
unable to produce enough insulin or is resistant to it. Insulin is the hormone that is made by the pancreas that takes
your blood sugar, your glucose, and brings it into your cells so your body can use that for energy.
What happens is, without the insulin, the glucose levels just keep getting higher and higher in the blood, but your cells are starving.
Your cells don't have any energy. NARRATOR: Melinda does her best to manage her mounting fatigue,
but her body is growing increasingly starved of glucose. DR. G: When your body can't use glucose for fuel,
it has to break down other things. And one of the things it breaks down is fat. NARRATOR: But burning fat for fuel
causes a highly acidic byproduct, acetone, to build up in the blood. In the tox report, Dr. G saw that Melinda's acetone level
was extremely elevated, and this is what gave her the final clue. DR. G: That acetone then starts making you feel horrible.
As your blood becomes more and more acidic, your muscles ache. You feel like you have the flu.
You're nauseated. You're vomiting. You have abdominal pain. She probably was having symptoms for extended period of time.
NARRATOR: And with no medical intervention, her condition eventually erupts into a full-blown crisis
known as diabetic ketoacidosis. DR. G: Because of the increased acid in your blood,
your organs don't work well. When you feel horrible, you go to the bathroom. So I don't think it's a coincidence
that she dies in the bathroom. There gets to be a point when you just don't have enough fuel
to the brain, and your brain stops functioning, and she passes out. And she's slipping further and further into a coma
until she dies. [LIGHT MUSIC] DR. G: She died from diabetes. But this is 100% treatable.
The root cause of why she died is that she ignored her symptoms and she didn't take care of herself.
Why is it that she would ignore these symptoms? Maybe the bottom line is the depression that
kept her from seeking help. NARRATOR: For Bree, the confirmation that Melinda didn't take her own life
provides some measure of peace. But the revelation that her aunt disregarded so many warning signs comes as a sobering lesson.
DR. G: You don't want to run to the doctor all the time, that's fine. But there are few things you're just
going to have to get checked out occasionally, and that's going to be your blood sugar, cholesterol
level, and blood pressure. Because those are silent killers, and you may not have any symptoms.
You just occasionally need to go to the doctor. If nothing else, get those three things checked.

A woman fears the worst when her aunt stops answering her calls. When her greatest fear is confirmed, Dr. G must determine one thing: was this a fatal fall?

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

Brief Summary

Dr. G investigates Jeffrey Woods' sudden death from kidney failure and Melinda Lopez's fatal diabetic ketoacidosis, highlighting the need for health awareness.

Key points

A Healthy Man's Sudden Death. Dr. G investigates the mysterious death of a seemingly healthy young man.
The Mystery Deepens. A trail of strange clues emerges as Dr. G examines the body.
The Shocking Truth. Dr. G uncovers the real cause of death: malignant hypertension.

Episode highlights

Episode quotes

This body's whispering something to me, but I'm just not sure what it's saying.

Dr. G expresses her uncertainty during the autopsy.

0:28WatchJun 17, 2021

Tension

75/ 100High tension

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