Dr. G: Medical Examiner - Season 5, Episode 8 - Secret Lives - Full Episode | Forensic Files

[MUSIC PLAYING] [MUSIC PLAYING] NARRATOR: A young woman dies suddenly, with no apparent cause.
I love a mystery. I wouldn't be in this job if I didn't love mysteries. NARRATOR: But as the questions multiply,
the autopsy takes an unexpected twist. And there is where we got a surprise. Look what we have.
It was something I'd never seen before. It was black. NARRATOR: Then, a man and woman are found dead in bed.
[SIREN] It looks like it could be a double homicide. NARRATOR: And the only way to help police catch a killer
is to put the investigation, itself, under the microscope. I find something totally unexpected.
[THEME MUSIC] NARRATOR: Altered lives, baffling medical mysteries, shocking revelations.
These are the everyday cases of "Dr. G-- Medical Examiner." DR. JAN GARAVAGLIA: The bottom line-- it may just be alcohol.
NARRATOR: How well do we really know those closest to us? Says he drinks and smokes.
NARRATOR: As Dr. Jan Garavaglia, chief medical examiner for the District 9 Morgue in Orlando, Florida,
sees all too often, it is the people we claim to know the best that can surprise us the most.
Do we get that a lot, where families think they know somebody, they tell me it couldn't be,
and then we find the truth? We get that a lot, unfortunately. So I let the family tell me the story as they know it.
Oh, I didn't know that. And then we build the facts. NARRATOR: It's 7:00 PM on a Friday night,
and 39-year-old Maria Flores has just left the office where she works as a medical technician.
Unmarried, she divides her time between her job, her friends, and the occasional boyfriend.
Maria also shares a special bond with her grandmother, Berta. So when Maria begins to feel sick,
her grandmother is the first person she turns to. Abuelita. She called her grandmother up and said
she wasn't feeling very well. No, [SPANISH]. She felt, ew, like she'd had flu-like symptoms,
you know-- aches and pains. NARRATOR: Berta doesn't think too much of it. She advises Maria to get plenty of rest
and promises to check up on her in a few days. DR. JAN GARAVAGLIA: About two days later, she called her,
knowing that her granddaughter wasn't feeling well. [PHONE RINGING] Pick up, pick up.
And she couldn't get a response from her cell phone, from her apartment phone. And she started to worry about her.
So she went over to see what was wrong. NARRATOR: Berta lets herself into Maria's apartment.
At first glance, everything seems normal. But as she rounds a corner in the kitchen,
the 82-year-old gets the shock of her life, her only grandchild unresponsive on the floor.
Panicked, she immediately calls 911. But it's too late. Maria is pronounced dead on the scene.
Her sudden and mysterious death is now in the hands of Dr. G. Woo, today, we have a woman, 39 years old.
She's found dead in her apartment. The grandmother found her. NARRATOR: As the body is prepared for transport
to the morgue, Dr. G's field investigators begin searching the apartment for any relevant clues.
To me, this is going to be, is it natural? Is it accident? Is it trauma? Is it heart?
Is it brain? Or is it something we just don't know? Hola, Abuelita. NARRATOR: Devastated by the news of Maria's death,
Berta paints a heartwarming picture of her granddaughter. Happy and well-adjusted, Maria was in normal health
and led a quiet life. According to the grandmother, she didn't smoke. She drank socially, didn't use drugs.
NARRATOR: But back in Maria's apartment, Dr. G's investigators quickly uncover evidence that shatters
this picture-perfect image. Hey, look at this. They do find cigarettes, although the grandmother
said she didn't smoke. And they do find alcohol in the refrigerator. NARRATOR: The grandmother's account
does reveal one unsettling episode from Maria's medical past. 12 months earlier, she'd been hospitalized for a concussion
after a mysterious fall. Dr. G turns to Maria's medical records for more details.
We got those records, and it's nothing to do with a concussion. She literally had bleeding over the brain.
She had a subdural and a fractured skull. It looks like she'd passed out and hit the back of her head.
NARRATOR: A subdural hematoma occurs when blood from a damaged vein becomes trapped
between the surface of the brain and the layer of tissue just beneath the skull, the dura.
It's most often caused by a head injury. Maria was found lying dead on the kitchen floor.
The question is, could a second fall have killed her? DR. JAN GARAVAGLIA: She's on that tile floor.
She's had a subdural before. So there is a possibility that head trauma played a role in her death.
Hm. NARRATOR: Then, as Dr. G continues to pore through Maria's medical records, she stumbles across a startling and unexpected clue.
On that admission, she tested positive for cocaine. NARRATOR: And that's not all.
Also interesting is that I doubt that she just drinks a moderate amount of alcohol because she has been
in the hospital for alcohol-related illnesses, including pancreatitis. NARRATOR: Pancreatitis is simply the inflammation
of the pancreas, a vital organ that aids in digestion and helps regulate sugar in the blood.
The condition can have several root causes. But in Maria's case, the doctors at the hospital
concluded that her pancreatitis was caused by chronic alcohol abuse. So there's, you know, cocaine, alcohol, trauma,
maybe another fall. We have a lot of possibilities. We're really learning a lot about this woman
that this grandmother doesn't know. NARRATOR: It would appear that Maria had not one but several dangerous secrets, any one
of which could have killed her. Maybe she tripped and fell in the kitchen. Maybe she was, you know, drinking.
Maybe it's just a drug overdose from her cocaine. How bad was this habit? NARRATOR: It's time to take a closer
look at Maria Flores' body. But Dr. G will not be conducting this autopsy alone.
You get into the picture. And we'll let-- yeah. NARRATOR: Today, she will don her teachers hat--
You're a little dirty, but that's OK. NARRATOR: --as Dr. G's morgue prepares to receive some new visitors, medical residents
from the Orlando Regional Medical Center. If this was a homicide, the valuables would be put away.
These are doctors who've graduated from medical school, who are now getting specialized
training in pathology. It'd go right through here into the brain. And pathology residency requires that they
do a month in a morgue. You see how the brain-- And most of them don't want to go into forensic pathology.
And we realize this when they come in. So usually, the grosser, the better. No, no, no.
[CHUCKLES] We try to encourage them. That stretchy-- But I'm sorry, you know, gross is
a part of forensic pathology. And they have to see that part, too. That clearly turns off a large percentage of our trainees.
Above the dura, right? Did you notice how hard it was for me to tear that off? So that's--
Well, what's special when they're there is you have to watch them like a hawk [CHUCKLES]
because you don't know if they're going to miss anything or not. So you have to be really careful,
be in the room with them. You try to give them some autonomy but keep watching them.
You have to see everything. You just don't take their verbal. I've been burnt by that before.
You just don't, oh, that looked fine. No, let me see that. So-- because they don't know.
You know, there's hardly any autopsies anymore done in hospitals, very, very few.
And it's a shame because so much can be found out by the autopsy. You can sit here.
So in this case, we have Dr. Altenburger down here. She's one of the trainees that come and spend a month with us
to not only learn forensics but also learn the art of an autopsy. We already have made fun of you with your GI thing.
It's true. It's a great month, actually. Being over there, you get to see a lot of cases, a lot of variety.
We just thought it was cute that you want to go do GI, and you can't stand stomach contents.
OK. Dr. G's a great role model for women in medicine, and especially in pathology and in training.
She's very to the point. She's sort of a no-nonsense person. And that's how I am.
And that's why I felt we always worked well together. You can start taking off her clothes.
She's got some-- She is a shapely woman, attractive for 39 but kind of rough. She looks like she might be a party girl.
What are her nails like? Fits what I'm reading in her medical records more than the sweet, school marm that I'm
getting from her grandmother. She's out of rigor already. NARRATOR: With Maria's history of brain injury,
Dr. G focuses her attention on the head. Yeah, I'm concerned about head trauma, because we know she's already got one subdural hematoma.
She's got really thick hair. I don't feel anything. But it's, you know, when you have that, you know,
nice head of hair, it's kind of hard to feel. I don't know. You can see if you feel any.
NARRATOR: Despite the absence of any obvious trauma, a fatal head injury is still a likely suspect.
But Dr. G won't know for sure until she performs the cranial exam. That's why, you know, we'll really see
it once we cut the scalp off. What are her nostrils like? NARRATOR: For now, she continues with a physical examination
of Maria's nose. And here, she spots something amiss. Uh-oh. She's got one. She has a huge nasal septal perforation,
I mean, a hole between the two sides of her nose about that big. You want to take her picture?
Yes, ma'am. NARRATOR: The nasal septum is the tissue in the nose that divides the nasal cavity into two nostrils.
Based on her experience, Dr. G knows that a hole this large usually means one thing.
That tells me she's a sniffer of cocaine. And it's not just once or twice. She's got a chronic problem with sniffing cocaine.
NARRATOR: Dr. G completes her external exam with an inspection of Maria's mouth.
In her mouth looks fine, no bite marks to the tongue. And she has no lesions in her mouth.
And her teeth look pretty good, especially for a chronic cocaine user. NARRATOR: So far, the external exam has shed some light
on Maria's unhealthy lifestyle. But there is still no concrete clues as to how she died.
This death could go in a lot of different directions. NARRATOR: Her hope now is that the internal autopsy will offer
up some definitive answers. And there is where we got a surprise. It was something I'd never seen before.
It was black. [MUSIC PLAYING] NARRATOR: 39-year-old Maria Flores was discovered collapsed on her kitchen floor.
During the external exam, Dr. G was unable to find any sign of head trauma. We would go ahead and take it to there.
NARRATOR: Now, she's about to open Maria's head to take a closer look. But Dr. G has another reason to be especially
interested in Maria's brain. Unbeknownst to her family and friends, Maria was wrestling with some internal demons--
cocaine and alcohol addiction. I think there are some real possibilities drugs and alcohol
played a role in her death. NARRATOR: Cocaine use can cause a hemorrhagic stroke
or bleeding inside the brain from a burst blood vessel. Cocaine elevates your blood pressure.
And when your blood pressure goes up with that next cocaine dose, it might be enough to blow
that blood vessel. I'm coming up on your left, Dr. G. NARRATOR: First, morgue technician Sandy Ludwig
uses an oscillating saw to open the skull. Then, Dr. G steps in to remove the skull cap.
SANDY LUDWIG: No? I think I can get it. NARRATOR: It's the moment of truth. All righty.
Now, when I take the calvarium off-- when I cut the brain-- No, no, no, no. Look what we have.
--we have no fresh changes in the brain. They all look old, from old trauma. NARRATOR: Dr. G also fails to see
any evidence of hemorrhaging. Save the dura. DR. DANA ALTENBURGER: All righty. NARRATOR: After a painstaking examination of Maria's brain,
she's still without a cause of death. Dr. G makes a standard Y incision across the torso,
cutting carefully from shoulder to sternum to reveal the internal organs. I don't really see anything too abnormal.
NARRATOR: But as she takes a closer look inside the abdominal cavity, one organ in particular
grabs her attention. Oh, my. Look. There is something that stands out. She has a huge fatty liver.
Mm, that is one yellow liver. NARRATOR: A quick glance at the liver is all it takes for Dr. G
to reach another startling conclusion. Maria's drinking was out of control. It was one of the worst I've seen.
Oh, my. For a 39-year-old woman, she must be a huge drinker. Oh, thanks, Sandy. NARRATOR: But Dr. G is still concerned
about possible damage caused by Maria's other addiction, cocaine. And the organ most at risk--
the heart. Cocaine can damage the heart in several ways. One, because it does elevate your blood pressure,
it makes your heart work harder. [HEART BEATING] NARRATOR: With long-term use, cocaine can also
damage the lining of the blood vessels, accelerating plaque buildup and narrowing
the coronary arteries. So there's many ways it can affect your heart and cause you to go into arrhythmia and die.
Oh, shoot, she's got pleural effusions here. SANDY LUDWIG: There was a-- do we need to measure that much?
Yeah, let-- you might as-- well, this one's a little worse than the other. What's going on in here?
NARRATOR: But after a thorough inspection, Dr. G is surprised to find no signs of trouble whatsoever.
Her heart actually looks pretty good. Coronary arteries were fine, no atherosclerosis.
There's nothing wrong with her heart. You know, it's surprising that there's no heart
damage from the cocaine. She skated the effects of cocaine on her heart. And some people are like that.
Some people use cocaine once, and it kills them. Some people use it for years and have no problem with it.
NARRATOR: Next, Dr. G turns her attention to the lungs. Now, I look at her lungs.
Now, her grandmother said she didn't smoke. We did find some cigarettes in the apartment.
And I say, you can't lie. There's black pigment in her lungs. NARRATOR: This finding confirms that Maria
was, indeed, a smoker. But Dr. G notes nothing else remarkable about Maria's lungs.
My knife is dull already. I'll get a new one. That's fine. NARRATOR: Next stop, the pancreas.
Dr. G knows from Maria's medical records that she had been treated for pancreatitis
associated with alcoholism. You know, most of the pancreatitises, about 80%, are mild to moderate.
Severe pancreatitis, where the pancreas literally starts necrosing and dying, that's a medical emergency.
And you can die from that. NARRATOR: But once again, she's caught off guard by what
she sees, or doesn't see. When I look at it, I see the evidence of old pancreatitis.
But I don't see anything, ugh, that would cause her death today. NARRATOR: As Dr. G reaches the end of the autopsy,
she is still empty-handed. And her options are running out. You know, I've got some possibilities, why she died.
But we've got our work cut out. NARRATOR: Dr. Altenburger begins the dissection of the stomach
and the esophagus, the muscular tube which allows food and liquid to pass from the mouth
to the stomach. And there is where we got a surprise. And so the esophagus you sort of open
after you open the stomach. And I was opening it. And I didn't-- it was black. And then she goes, oh, we've got something weird.
And I'm thinking, oh, you know, she's not used to doing autopsies. Probably something that we see all the time.
So I go over. Oh, wow. And lo and behold, it is something weird. Huh. It was something I'd never seen before.
It was a black esophagus. NARRATOR: A healthy esophagus is usually white with a pink tinge.
Maria's is as black as coal. When you see something like that, when you're in training,
you don't know if it's rare because you've never seen it before or it's a rare entity.
And she says, what is that? And I look. And I said, it's a black esophagus. I've never seen that before.
I don't know what that is. I don't know. NARRATOR: The question now is, what could have
triggered this bizarre symptom? And did it have something to do with Maria Flores' death?
I love a mystery. I wouldn't be in this job if I didn't love mystery. So I have to go figure this out.
[MUSIC PLAYING] DR. JAN GARAVAGLIA: That is black. NARRATOR: Dr. G and medical resident Dr. Dana Altenburger
are still reeling from the discovery that 39-year-old Mario Flores' esophagus is black,
a first for Dr. G. You know, this is part of the process. You don't know everything.
You can't be ashamed to say you don't know things. NARRATOR: Dr. G's next step--
figure out what caused Maria's esophagus to turn black and what, if any, role it played in her death.
Dr. G's first thought is that Maria could have swallowed something, either accidentally or intentionally,
that was poisonous enough to destroy her entire esophagus. DR. JAN GARAVAGLIA: You know, something caustic
could do that. You know, one of the things that I was worried about is maybe lye that had maybe caused damage to the Esophagus.
NARRATOR: Lye is a caustic substance commonly used in the manufacturing of products, such as paper, soaps,
detergents, and drain cleaners. Because of its corrosive properties, lye can be highly toxic.
But Dr. G is forced to quickly abandon this theory for one very good reason. Maria's external exam showed no damage to the mouth.
Usually, people who drink lye will also have lesions on their lip. She had no lesions in her mouth.
NARRATOR: Dr. G also notes that the black coloration stops abruptly at the GE junction, the gastroesophageal junction,
where the esophagus meets the stomach. And what's in her stomach? Mostly nothing.
Huh. And her stomach didn't have any lesions with it also. I've never seen this before.
A caustic agent wouldn't just affect her esophagus. I'm not sure what it is. NARRATOR: At this point, the physical examination
of Maria Flores has gone as far as it can go. We definitely need to look under the microscope.
And we need to hit the books. We have to figure out what is causing this black esophagus.
NARRATOR: Dr. G begins by looking at sections of Maria's esophagus under the microscope.
And I look at those sections, and it's necrotic. It's dead. NARRATOR: Her next stops are the morgue library
and the internet. After several hours of painstaking research, she finally hits on a diagnosis, acute esophageal necrosis.
In this study, we analyze-- NARRATOR: Acute esophageal necrosis, or black esophagus,
is an extremely rare condition in which the esophagus literally dies inside a living body.
It's not in any book. I had to find some articles on it. I've been in practice 30 years.
And I've probably seen it three or four times spanning my entire career. In one article, they looked at all the cases
that have been reported in the literature over a 40-year period. And there were only 88.
But there's clearly, this is underreported. I know for over 20 years of doing autopsies,
I've never seen it. Nobody in my morgue had seen it. NARRATOR: Acute esophageal necrosis was first described
in 1990 and is found in approximately 1 out of every 10,000 endoscopies. It has a mortality rate of 50%.
If it's caught early, half the patients can survive. But if it is a deep injury, death is inevitable.
And it's usually within a few days. NARRATOR: In Maria's case, the damage to her esophagus
was so extensive that Dr. G's certain it trumps any other cause of death. At first glance, Mario Flores would
seem to be an unlikely candidate for such a rare disease, except for one thing. It does, in the literature, seem to be
associated with some things. And you know what it's associated with a lot of the cases?
Chronic alcohol abuse. In the cases I've seen over the years, there's either been alcohol and a predisposed individual
who has other medical problems, or alcohol and substance abuse. NARRATOR: Armed with this new information,
Dr. G can now piece together the final moments of Maria Flores' short life. It's 7:00 PM on Friday evening, and Maria has
just returned home from work. Feeling unwell, she calls her grandmother for some support.
Clearly, she's sick. Flu-like symptoms, probably just not feeling well. [COUGHING]
NARRATOR: But what's going on inside of her body is far from the flu. [COUGHING]
NARRATOR: Maria's esophagus is damaged beyond repair. Black esophagus is caused by loss of blood supply
of the esophagus, whether that's injury due to a chemical constricting the arteries or a loss
of blood supply of the esophagus due to other causes. So it's probably multifactorial,
meaning, you know, the perfect storm that a lot of things have to come together to cause this.
NARRATOR: Due to this loss of blood, Maria's esophagus begins to die. When you start having necrotic tissue
or dead things inside of you, you know, your body starts reacting-- [COUGHING] DR. JAN GARAVAGLIA: --to that.
And it starts sending off chemicals that start a cascade. She's probably wondering what's happening to her.
She's getting lightheaded. She's probably throwing up blood. She's getting sicker and sicker.
And she probably just loses consciousness, and hits the floor-- [THUMP] --and dies.
NARRATOR: But why this happened to Maria remains a mystery. How does it happen, though?
And that's really the million-dollar question that nobody seems to know. Whatever this perfect storm is, alcohol
seems to play a prominent role. Why it occurs in some people and not others, and why it's so rare, nobody knows.
NARRATOR: It's a tragic end to a life that came all too soon for those she left behind.
Yeah, this is Dr. Garavaglia. NARRATOR: Finally, Dr. G is able to give Maria's grandmother some conclusive answers
about her granddaughter's death. DR. JAN GARAVAGLIA: Her grandmother was really surprised when I told her the cause of death.
But I think she was most surprised about her cocaine habit, and her alcoholism, and her lifestyle.
She had no idea that her granddaughter was like this, even though she felt very close to her.
You're only here a day or two, right? NARRATOR: As resident-in-training Dr. Altenburger prepares to leave the morgue,
she reflects on the challenges that come with doing Dr. G's job. I think being around death every day is kind of hard.
But it definitely makes you appreciate being young and healthy, and having your family around,
and having a good family. NARRATOR: As for Dr. G, the case serves as a reminder of why she became a medical examiner
in the first place. This case is what makes forensic pathology fun for me. You've never seen it all.
It's fun to see things you've never seen before that occur inside the body, to look up what's going on,
to teach it to trainees. That's what makes forensics so wonderful. You're always seeing something new.
[MUSIC PLAYING] NARRATOR: And Dr. G's next case is even twice the mystery, a bizarre double homicide.
They were not only in bed naked, they were dead in bed naked. [MUSIC PLAYING] NARRATOR: Orange and Osceola Counties'
chief medical examiner Dr. Jan Garavaglia starts her day like any ordinary working professional.
First, she checks in with her staff. NARRATOR: Then she settles into the office.
This is where Dr. G's job becomes different from most. And today's case is even more out of the ordinary than usual.
DR. JAN GARAVAGLIA: Today, I've got a double. We have a 39-year-old woman and a 48-year-old man.
NARRATOR: The woman's name is Carla Belden, and the man is Dylan Wright. Right now, they're on separate trays.
But yesterday they were together in bed. NARRATOR: It's Thursday afternoon. And Dylan's brother Jason stops by for an impromptu visit.
JASON WRIGHT: Dylan. NARRATOR: After finding the door unlocked, he lets himself in.
But no one appears to be home, until he gets to the bedroom. From the hallway, he can clearly see
his brother is still in bed. And he's not alone. He found his brother on top of this woman, naked.
NARRATOR: Embarrassed, he turns to leave. But then he makes a horrifying realization.
They are not moving, and the pillows are soaked in blood. They were not only in bed naked, they were dead in bed
naked. And he immediately is freaked. NARRATOR: Jason calls 911 in a panic. [SIREN]
Within minutes, police arrive and tape off the area, declaring it a crime scene.
Looks like they were in the act of love, and something bad happened, because it looks like they both have gunshot wounds to the head.
NARRATOR: Investigators immediately begin to document the crime scene. And as they separate Carla and Dylan,
they discover a surprising piece of evidence. There's a gun there. And the gun is still in his hand.
[CAMERA] NARRATOR: Two lovers shot dead, with the potential murder weapon lying between them.
Now, it's up to Dr. G to figure out exactly what happened. Dr. G begins her examination by ordering
X-rays on both victims. When you have a gunshot wound, X-rays are always taken first.
We want to see if there's a projectile that needs to be recovered. Or should I be looking for an exit wound?
NARRATOR: While technician Brian Machulski X-rays Carla and Dylan, Dr. G pours over the investigator's report.
Shoes were in the bathroom, clothes on the top of the dresser. NARRATOR: And midway through, a critical detail
catches her eye. This is not his wife. This is his girlfriend. Hm. This is a married woman.
And her husband is alive and well. JASON WRIGHT: They've been together for a while.
NARRATOR: Police learn from Dylan's brother that Carla's marriage had been failing for years,
and that she was working up the courage to leave her husband, Lee. Now, investigators wonder if Lee finally
discovered Carla's affair and decided to put an end to it permanently. DR. JAN GARAVAGLIA: I don't know about the husband.
Maybe he caught them by surprise and shot them. Maybe the husband just put the gun in his hand.
So it could be a double homicide. We know that they both died of gunshot wounds.
That's not the mystery. The mystery is going to be, really, who shot who, what happened?
NARRATOR: From the X-rays, Dr. G can clearly see that both Carla and Dylan each have
one bullet in their brains. The bullet completely goes through the brain but only partially exits the skull.
Now, people think that a bullet is just going to make a little hole right through your brain,
and that's the only damage you get. No, because there's kinetic energy, which gets
departed from that bullet to your brain. And at-- and it's almost as though like a temporary cavity forms.
So the bullet may be only, you know, 5/8 of an inch across. But the damage to your brain is much wider
than the width of that bullet. NARRATOR: But the extent of the damage doesn't tell Dr. G who fired the gun.
For that, she must scour the bodies for any evidence that could point her in the direction of a suspect.
So we've got our work cut out. And we're going to have to get started. I think I'm going to do her first.
NARRATOR: Right off the bat, Dr. G observes a possible sign of trauma on Carla's face.
Huh. The upper eyelid is swollen and kind of blackish-blue. There's blood coming out of her nose.
There's blood coming out of one of her ears. If you looked at her face, it would
look as if somebody hit her. Let's get a towel. We'll clean it up, and just take another picture this way.
I think it's a little easier-- NARRATOR: Now, Dr. G considers the possibility that Carla was
beaten before she was murdered. Maybe they held her down. Somebody-- there was a struggle.
There was a fight, you know, bringing her to the bed. Yeah, she's got a little on her face, too.
NARRATOR: But on closer examination, she recognizes that there is another explanation
for these gruesome injuries. You have to look at the whole picture. Sorry. The bruising of the eye is not bruising of the eye.
It's actually blood seeping down from a fracture of the base of her skull, from that gunshot wound.
The blood coming out of her ears, from a fracture, same as the blood coming out of her nose.
NARRATOR: Dr. G concludes that these injuries appear to be the direct result of the gunshot wound.
But she must examine the wound to be sure. As she completes Carla's external exam,
she finds no further indication of trauma or a physical struggle. But she's still no closer to answering who shot Carla
and how. I really need to look at the wound. We need to know all the facts. [MUSIC PLAYING]
NARRATOR: Using a digital camera, morgue technician Tom Hemphill assists Dr. G as she documents
Carla Belden's gunshot wound. And I'll look at that wound very carefully before I do anything.
But all that blood there makes it difficult to really see what's going on. So we gently clean the wound.
NARRATOR: Yesterday afternoon, Carla was found with her lover, Dylan, naked in bed, each with a bullet wound to the head,
and a gun in Dylan's hand. Police suspect that Carla's enraged husband, Lee, discovered the affair and shot them both,
then planted the gun to cover his crime. Now, detectives are relying on Dr. G to help them catch the killer.
The pressure is to come up with anything I can to help them out. All right, let's see.
The only thing that's going to give us a hint is looking at the wound, itself. So that's going to help me determine maybe what happened.
6 inches. NARRATOR: Dr. G's next step is to carefully examine Carla's gunshot wound.
What's the angle of the gunshot wounds? Were they distant gunshot wounds? TOM HEMPHILL: Do you want the whole thing
or just close up here? DR. JAN GARAVAGLIA: Nah, I just want kind of like this, just so you could see that the scalp
is, there's nothing else there. You know, it would make my autopsy a lot faster if I could
just look at the wound, say, yeah, this is what it is, and let's go. But there are some steps you have to take.
That's good. So I measure it how many inches above the ear canal, and how many inches in front of the ear canal,
and then how far from the top of the head. The central defect's a little more than a half
inch by half inch. It's about an inch or so above and a little bit in front of the ear, in the left temporal region.
NARRATOR: After measuring the dimensions of the wound, Dr. G prepares to look inside it.
When you fire a gun, not just the bullet comes out. But you have gases that were produced
by the explosion of the primer and the gunpowder. You have the soot and the smoke, which is
the product of the combustion. And you have also unburnt gunpowder that comes out.
NARRATOR: If the shot was fired from a distance, there will be little or no residue inside the wound.
With a steady hand, she cuts the scalp from ear to ear, then peels it back. And there, she gets her first look at the inner aspect
of the bullet hole. I see the soot. And the gunpowder is deposited on the inside
of the wound, not the outside. So what that tells me is it's a tight contact wound.
And the end of the barrel was in tight contact with the skin. So it's not like she was shot from the other side
of the room. NARRATOR: Now that Dr. G is certain that Carla suffered a contact wound, her next step is
to map the bullet's fatal path. The path goes through both the left and the right cerebral hemisphere,
through the deep structures of basal ganglia, and partially exits the skull on that right side.
Basically goes from left to right, slightly back to front. NARRATOR: This direct line from the left temple to the right
gives Dr. G a crucial clue. Oh, gosh. This is very consistent with a suicide. NARRATOR: And the unexpected finding
leads her to wonder about another even more bizarre scenario, one that she hadn't considered until now.
Could this be maybe a double suicide? Maybe she shot him herself, and he gets on top
and shoots himself? Was it some kind of suicide pact? NARRATOR: Having already uncovered a trail of baffling
clues, Dr. G begins the next autopsy in this mysterious double killing, and is shocked by what she sees.
I find something totally unexpected. [MUSIC PLAYING] NARRATOR: Carla Belden and Dylan Wright
were both found naked and dead in the same bed. Were they murder victims or driven to a bizarre suicide
pact? We're hoping that, actually, his autopsy adds a little bit more to this puzzle to give us some answers.
NARRATOR: Repeating the same steps on Dylan as she did with Carla, Dr. G methodically studies the bullet
hole on Dylan's right temple. Once I do all those measurements, take all those pictures, and document it on my diagram,
then we can look on the inside and see what that wound did. NARRATOR: She carefully cuts through the scalp
and peels it back over the bone. I see the same thing on the inside of his wound
that I saw on her wound. I saw that blackening. All the soot, all the gunpowder is deposited inside the wound.
And then there's a slight amount of searing on the edge of that wound-- pretty classic contact wound.
NARRATOR: Now, Dr. G can confirm that both Carla and Dylan have contact wounds to the head.
But this finding alone is not enough to prove either a homicide or suicide. Next, Dr. G begins a careful review
of all the facts before her. And it isn't long before she homes in on one seemingly mundane detail.
That's one of the pieces of information we find out is that she is right-handed.
The most telling part is that it's on her left temporal region, and she's right-handed.
She didn't pull that gun herself. NARRATOR: This, along with the findings from the scene,
leads Dr. G to conclude that Carla's death is not a suicide. To really understand what's going on here,
you really have to do the totality and see how all these facts are put together.
NARRATOR: And with the clues falling into place, she now has a clear picture of how Dylan died.
It's on his right temple. He's right-handed. The gun is in his right hand, and it
is also a tight contact wound. NARRATOR: The evidence of two contact wounds provides Dr. G with the missing link needed to disprove
the double homicide theory. You can maybe do one contact wound. But the other person's going to get the heck out of there,
or at least move away. I would find it difficult that the husband could have surprised them both with two contact wounds.
NARRATOR: This leads Dr. G to her final conclusion. So it really looks as if this is a homicide-suicide.
She's a homicide, but he's a suicide. And it looks like he did both of them. NARRATOR: Dylan killed Carla and then killed himself.
But the question now is why? And as Dr. G turns this over in her mind, she comes across a critical piece of the puzzle
that might just explain it. I find something totally unexpected. I forget about that gunshot wound for a second
because there I see a mass. I see a meningioma, a tumor. NARRATOR: For Dr. G, this finding
may impact the entire case. And, finally, she can describe for the police and the families exactly what transpired
in the couple's final hours. [CHIMES] It's a sleepy Sunday afternoon. And Carla Belden is busy enjoying it with her boyfriend,
Dylan Wright. Sadly, she probably has no idea that he's in the crosshairs of a serious natural disease, a brain tumor
called a meningioma. Finding that meningioma was a complete surprise. Although we took an X-ray of his head,
you wouldn't see that, necessarily. Well, it would be easy to see with a CAT scan or an MRI.
But we just took regular plain films to look at the bones and to look for bullets.
And you don't really see the soft tissue very well. This was a big mass. This is about, you know, almost 3 inches
in size, kind of a white-tan color. And when you cut it, it's firm and kind of rubbery feeling.
And this is compressing into the brain in the right parietal region, over the top of the brain.
And it's like driving itself into that brain and causing a divot in that brain, which was quite deep.
OK. So when you remove it, you could actually remove this in a whole piece. And the brain is left with an indent--
a very marked indentation. Another, probably, of this one. Just, like-- It's like an indentation, like you'd leave, you know,
a heavy object on a cushion. And you'd leave it-- but this isn't going to bounce
back, at least anytime soon. NARRATOR: Dylan's family confirms that he suffered severe headaches
and was increasingly despondent from the pain. So whether this tumor could have affected his personality,
and maybe made him more depressed, you know, that's a possibility, too. NARRATOR: And as Dr. G reviews the toxicology report,
she discovers another factor that may have contributed to Dylan's fragile state of mind.
He's over twice the legal limit of intoxication, which isn't surprising. A lot of our suicides have alcohol on board,
maybe even up to a third, because what does alcohol do? Alcohol decreases your inhibition,
maybe just enough to cause you to act upon some of these impulses. NARRATOR: Under the influence of alcohol,
and suffering from the effects of a brain tumor, Dylan does the unthinkable. He wanted to commit suicide.
And on their weekly meeting, their little tryst, he had the gun hidden somewhere, possibly under the mattress.
NARRATOR: Carla slips into bed with Dylan. And when their bodies are fully intertwined, he makes his move.
He takes the gun from his hiding place, places it tightly to her left temple, pulls the trigger.
[GUNSHOT] NARRATOR: The bullet explodes into her skull and kills her instantly. Why he wanted to take her with him
is only going to be known to him. But, you know, maybe he truly wasn't in his total right
mind because of that tumor. NARRATOR: Now, it's his turn. He takes the gun, also puts it tightly
against his right temple, and pulls the trigger. NARRATOR: A victim of his own violence, Dylan
dies in a tragic embrace. [MUSIC PLAYING] Dr. G's autopsy findings bring closure
to those whose lives were devastated by this double shooting. MALE SINGER: (SINGING) In the background.
I think her husband's off the hook. The forensic evidence suggests that he didn't have a role in this.
He also had an alibi, which checked out quite well. NARRATOR: Most gratifying of all, Dr. G
provides Dylan's family with something tangible to help them come to terms with the catastrophe.
DR. JAN GARAVAGLIA: But I talked to the brother. And I think the tumor, and finding that tumor, helped
them somewhat understand why their brother would have just, out of the blue, do this.
[MUSIC PLAYING] You never know in forensics what piece of information is going to be important and what piece isn't.
[CHORDS] MAN: (WHISPERING) Atlas.

In an unprecedented double autopsy, Dr. G is determined to find out who is accountable for these odd deaths and solve the mystery of a love triangle gone awry.

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

Brief Summary

Dr. G investigates Maria's mysterious death and a double homicide, uncovering substance abuse and a brain tumor's role in the tragedies.

Key points

A Mysterious Death. 39-year-old Maria Flores is found dead in her apartment, leaving many questions behind.
Unexpected Findings. Dr. G discovers shocking truths about Maria's lifestyle that contradict her grandmother's account.
The Black Esophagus. Dr. G uncovers a rare condition in Maria's esophagus that could be linked to her death.
Maria's Mysterious Death. Dr. G uncovers the tragic circumstances surrounding Maria Flores' death, linked to alcohol abuse.
Double Homicide Investigation. Dr. G investigates a shocking double homicide involving a couple found dead in bed.
The Tumor's Role in Tragedy. A brain tumor is discovered in Dylan, potentially influencing his tragic actions.

Episode highlights

Episode quotes

I find something totally unexpected.

0:54WatchJun 15, 2021

Tension

75/ 100High tension

More from True Crime Files

Solve the Crime

Read a real case one clue at a time, then see how your call held up against the investigators.