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Mayhem in the Morgue _ The Weather Outside Is Frightful · Crime Stories with Nancy Grace

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  Speaker 1: Today's episode includes information about the death of individuals. If
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  Speaker 1: this sort of thing upsets you, this is not the
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  Speaker 1: episode for you. May I suggest you watch a movie,
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  Speaker 1: maybe something like White Christmas, Welcome to Mayhem the More
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  Speaker 1: with their host Doctor Kinder crowns today's episode, the weather
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  Speaker 1: outside is frightful. Last week, winter storm Fern swept across
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  Speaker 1: the Midwest, south, and northeast. It affected thirty four states
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  Speaker 1: and two hundred and twenty million people, including where I
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  Speaker 1: live in North Texas. These winter storms bring freezing temperatures,
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  Speaker 1: high winds, sleet, ice and snow, and with that burst pipes,
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  Speaker 1: icy roads, and power outages. People are trapped in their
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  Speaker 1: homes without power or heat, and of course the homeless,
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  Speaker 1: if they can't find shelter, have to find a way
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  Speaker 1: to survive. Every year wherever I've worked, we will get
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  Speaker 1: a number of people dying from exposure to the cold,
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  Speaker 1: also known as hypothermia. And of course there were more
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  Speaker 1: cases of hypothermia when I've worked up north, but there's
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  Speaker 1: still a few every year here in Texas, particularly during
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  Speaker 1: these types of winter storms, because Texas is just not
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  Speaker 1: as well prepared for arctic temperatures. I thought on today's episode,
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  Speaker 1: I would discuss a few of the cases I've had
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  Speaker 1: and my experiences when Snowzilla comes to town. So let's
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  Speaker 1: get started. A normal body temperature in people is ninety
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  Speaker 1: eight degrees fahrenheit or thirty seven degrees celsius. Hypothermia occurs
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  Speaker 1: when the body temperature goes below this, and this is
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  Speaker 1: because the loss of heat from the body exceeds the
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  Speaker 1: heat production by the body. The most common cause of
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  Speaker 1: hypothermia is, of course, exposure to low environmental temperatures, but
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  Speaker 1: there are other causes, including hypothyroidism, hypoglycemia, strokes, sepsis, in
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  Speaker 1: a number of other things. But these cases are for
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  Speaker 1: another show, and today we're only going to focus on
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  Speaker 1: cases caused by cold weather. The cases of hypothermia that
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  Speaker 1: come into a medical examiner's office range from, of course,
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  Speaker 1: the unsheltered, homeless people, elderly people in homes without power,
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  Speaker 1: the demented or mentally ill that wander away from their
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  Speaker 1: care facility in the dead of winter, alcoholics that pass
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  Speaker 1: out on a snowy night and go to sleep outside
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  Speaker 1: or fall and sustain injuries in which they can't get
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  Speaker 1: themselves out of the cold environment. Hypothermia occurs, of course,
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  Speaker 1: on land, which is also known as dry hypothermia, and
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  Speaker 1: in water, which is known as wet or immersion hypothermia.
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  Speaker 1: In my career, the majority of the hypothermic cases I
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  Speaker 1: have dealt with have been on land, with a few
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  Speaker 1: coming from the frigid water. People dying of immersion hypothermia
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  Speaker 1: generally die quickly or suffer from acute hypothermia because of
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  Speaker 1: the intent its cold stress caused by falling into the
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  Speaker 1: freezing water. One of the cases I had of immersion
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  Speaker 1: hypothermia was an individual trying to fix the gears on
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  Speaker 1: a bascule bridge during winter. If you don't know what
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  Speaker 1: this type of bridge is, it's one that lifts up
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  Speaker 1: and lets river traffic through. He and a coworker were
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  Speaker 1: working on the stuck mechanism, and at some point both
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  Speaker 1: of them slipped and were caught by their harnesses. Other
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  Speaker 1: coworkers called for help. As time passed, one of the
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  Speaker 1: workers became frustrated dangling high above the river and slipped
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  Speaker 1: out of his safety harness and fell into the river.
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  Speaker 1: He thought he could just fall into the river and
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  Speaker 1: swim to the shore and be okay, but he didn't
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  Speaker 1: account for the fact that the water was near freezing
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  Speaker 1: and he was an insulated gear. When he hit the water,
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  Speaker 1: he was seen struggling for a brief period of time
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  Speaker 1: and then slowly stopped moving, slipping under the water, all
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  Speaker 1: while his coworker watched in horror. The co worker was
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  Speaker 1: subsequently rescued by the way. A little later on, when
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  Speaker 1: this individual came into the medical examiner's office for autopsy,
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  Speaker 1: the first thing I had to do was remove all
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  Speaker 1: his gear, and once I got it off his body,
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  Speaker 1: I decided to weigh it, and it weighed over one
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  Speaker 1: hundred and twenty pounds due to all the water that
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  Speaker 1: had seeped into the clothing. With that and the fact
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  Speaker 1: that he was in freezing cold water, he didn't have
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  Speaker 1: a chance. He died from drowning, but I also contributed
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  Speaker 1: hypothermia to the cause of death. Cold water conducts heat
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  Speaker 1: twenty to twenty five times faster than dry air, so
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  Speaker 1: you will die quicker in cold water than you would
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  Speaker 1: on land. Factors that can affect your survival time can
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  Speaker 1: be dependent on your nutritional status, type of clothing you're wearing,
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  Speaker 1: and of course the temperature of the water. If you
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  Speaker 1: fell into thirty two degrees fahrenheit water or zero degrees celsius,
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  Speaker 1: which is almost freezing. You will probably lose consciousness in
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  Speaker 1: less than fifteen minutes, with a survival time range of
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  Speaker 1: fifteen to forty five minutes. Those who die at the
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  Speaker 1: shore or time interval. It is often because of the
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  Speaker 1: production of irregular heart beats or arrhythmius caused by the
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  Speaker 1: bodies sudden baso constriction of the blood vessels, and reflex
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  Speaker 1: stimulation of the heart due to hitting that sudden cold water,
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  Speaker 1: which is a little different than dry hypothermia, where the
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  Speaker 1: cold temperatures slowly cool you down. Clinically, hypothermia starts when
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  Speaker 1: the body temperature drops below ninety five degrees fahrenheite or
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  Speaker 1: thirty five degrees celsius from ninety five to ninety degrees
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  Speaker 1: fahrenheit or thirty five to thirty two degrees celsius. You
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  Speaker 1: start shivering, which is the body's involuntary contraction of muscles
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  Speaker 1: to help produce heat. You get impaired judgment, slight loss
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  Speaker 1: of coordination, and internally, the heart rate goes up in
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  Speaker 1: an attempt to increase pumping of warm blood throughout the body.
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  Speaker 1: The vessels vasa constrict to shunt blood away from the
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  Speaker 1: skin and towards the core, reducing heat loss. Alcohol can
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  Speaker 1: affect this part of the process by causing the vessels
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  Speaker 1: not to constrict but to dilate, which makes alcoholics lose
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  Speaker 1: heat faster. There is increased mucous production during this time,
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  Speaker 1: which causes a very runny nose. This is because the
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  Speaker 1: nose works to warm and humidify cold, dry air before
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  Speaker 1: it reaches the lungs. This, along with the condensation formed
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  Speaker 1: inside nasal passages, causes the nasal glands to produce excess
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  Speaker 1: mucus to protect the lining. At the moderate level of hypothermia,
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  Speaker 1: the body temperatures between ninety and ninety two degrees fahrenheit
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  Speaker 1: or thirty two and twenty eight degrees celsius. At this point,
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  Speaker 1: the brain's temperature regulation begins to fail. Shivering ceases because
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  Speaker 1: the body has run out of energy reserves and muscles
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  Speaker 1: are too cold to contract. The body shunts blood only
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  Speaker 1: to the core, abandoning the extremities, and this causes the
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  Speaker 1: kidneys to filter more fluid, resulting in excess urination. There
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  Speaker 1: is confusion hallucinations in delirium along with slurred speech, and
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  Speaker 1: you also have paradoxical undressing, which I will explain later.
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  Speaker 1: Your heart rate slows, your blood pressure drops, and your
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  Speaker 1: heart begins to beat irregularly, and breathing slows. At the
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  Speaker 1: severe level, the body temperature is between eighty two and
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  Speaker 1: seventy five degrees fahrenheit or twenty eight and twenty four
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  Speaker 1: degrees celsius. You're unconscious at this point, but with a
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  Speaker 1: pulse you're essentially in a coma. No reflexes, fixed dilated pupils.
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  Speaker 1: The heart's electrical signals are disrupted, causing slow, irregular heart beats.
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  Speaker 1: The heart is no longer pumping blood enough to meet
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  Speaker 1: the body's demands. The lungs fill with fluid, and breathing
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  Speaker 1: becomes slow, labored, with gasping breasts. At less than seventy
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  Speaker 1: five degrees fahrenheit or twenty four degrees celsius, you appear dead,
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  Speaker 1: pulseless with no breathing. At this point, you can be saved,
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  Speaker 1: but it's unlikely, and after this you of course die.
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  Speaker 1: Wo There was one case I had of an elderly
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  Speaker 1: woman whose electricity and gas were shut off due to
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  Speaker 1: non payment of bills. During the coldest few days of
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  Speaker 1: the year. The temperature in the house had plummeted and
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  Speaker 1: her house was poorly insulated. She had areas of the
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  Speaker 1: house where there were gaps letting in cold air. She
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  Speaker 1: attempted to plug these with plastic grocery sacks, and also
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  Speaker 1: she had been putting plastic grocery sacks in between the
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  Speaker 1: walls to act as insulation because the house had no
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  Speaker 1: real insulation. No one had seen her for over a week,
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  Speaker 1: and eventually a well being check was performed by police.
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  Speaker 1: When police entered her home, her attempt at insulating with
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  Speaker 1: grocery sacks had failed. The inside of the house was freezing.
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  Speaker 1: The house was also in disarray, but not like a
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  Speaker 1: order home. There was instead a night stand tipped over,
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  Speaker 1: books and clothes piled on a couch and strewn about
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  Speaker 1: the house. They found her body naked and burrowed underneath
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  Speaker 1: her couch, with multiple items of clothing laying on top
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  Speaker 1: of her. There was initial concern of foul play because
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  Speaker 1: of how she was found, but what had happened was
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  Speaker 1: she was exhibiting the findings that occur in hypothermia cases,
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  Speaker 1: and these are paradoxical undressing, hide and die behavior, which
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  Speaker 1: is also known as terminal burrowing. Paradoxical undressing and hide
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  Speaker 1: and die behavior are not present in every case of hypothermia,
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  Speaker 1: but occur in fairly large percentages. Paradoxical undressing occurs when
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  Speaker 1: the individual is suffering from extreme confusion and disorientation coupled
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  Speaker 1: with the muscles of the blood vessels becoming exhausted, which
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  Speaker 1: causes the vasoconstriction to fail, resulting in widespread vasodilation. This
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  Speaker 1: causes a surge of warm blood from the core to
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  Speaker 1: be circulated everywhere, resulting in a hot flash. The confused
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  Speaker 1: brain thinks the person is burning up and solves this
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  Speaker 1: problem by removing all the clothing, making the individual naked,
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  Speaker 1: and this is often associated with the hide in die
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  Speaker 1: syndrome or terminal burrowing. With this behavior, people have been
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  Speaker 1: found burrowed into cabinets, pantries, under shelves with pulled down furniture, books,
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  Speaker 1: and clothes on top of them. The reason for this
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  Speaker 1: behavior is a primal response by the brain stem that
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  Speaker 1: causes the individual to seek small, confined spaces for protection,
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  Speaker 1: similar to hibernating animals. When this decedent was brought into
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  Speaker 1: the medical examiner's office, she showed the typical autopsy findings
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  Speaker 1: of hypothermia and nothing else, so her cause of death
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  Speaker 1: was hypothermia. Again, but before we go into the autopsy findings,
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  Speaker 1: I want to discuss another complication of hypothermia, and that
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  Speaker 1: is the frozen body. And my example of this was
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  Speaker 1: a case of a young man in his twenties. He
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  Speaker 1: was found dead by railroad workers in an open topped
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  Speaker 1: railroad car at the Union Pacific Railroad yard in Chicago.
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  Speaker 1: It was early February and two thousand and four and
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  Speaker 1: the temperature had been as low as six degrees fahrenheit
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  Speaker 1: with associated snow, ice and freezing fog. When the deceitent
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  Speaker 1: was found in the railroad car. He was dressed for
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  Speaker 1: winter thermal beanie insulated jacket, two shirts in thick pants
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  Speaker 1: as well as boots. He also had with him a
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  Speaker 1: red mountain bike. It was believed he might have been
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  Speaker 1: trying to get somewhere by jumping on the train and
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  Speaker 1: then getting off later to go biking. He had no identification,
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  Speaker 1: so who knows where he had come from. They tried
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  Speaker 1: fingerprinting him, but no prints matched anything where he came from.
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  Speaker 1: Who knows who he was? Who knows? I don't think
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  Speaker 1: he was actually ever identified and in a few days,
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  Speaker 1: that case will be nearly twenty two years old. At
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  Speaker 1: the scene, there was no signs of foul play. Law
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  Speaker 1: enforcement felt it looked like he had just laid down
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  Speaker 1: and went to sleep after getting on the train. On
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  Speaker 1: the day I performed his autopsy, I got the body
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  Speaker 1: out of the cooler, and when I opened the body
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  Speaker 1: bag to evaluate him, I found he was frozen hard.
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  Speaker 1: The thing about it is the average adult body is
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  Speaker 1: made up of about sixty percent water, and when a
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  Speaker 1: body is left in freezing conditions, it will freeze as
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  Speaker 1: solid as a rock. You can't even cut into their
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  Speaker 1: skin with a scalpel blade because it is so hard.
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  Speaker 1: So what do we do in this situation, Well, it's
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  Speaker 1: like taking a frozen turkey out. You let them thaw.
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  Speaker 1: This can be done at room temperature, which takes a
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  Speaker 1: long period of time. But in Chicago, what we did
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  Speaker 1: was we put them under warming lights or heat lights,
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  Speaker 1: or is the autopsy text like to call them fry lights.
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  Speaker 1: You don't want to warm the body too fast because
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  Speaker 1: it can create artifacts, So you place the body under
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  Speaker 1: these lights and every day you go check to see
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  Speaker 1: if they had thought enough to be autopsied. You would
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  Speaker 1: do this by poking them in the abdomen. What's your finger?
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  Speaker 1: I know, real scientific, right, And when you poke the
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  Speaker 1: abdomen if it feels like poking plato. They were warm
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  Speaker 1: enough to autopsy, and that's what I did with this case.
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  Speaker 1: Once he was thought out enough, we did the autopsy.
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  Speaker 1: And cutting into these thought bodies is always difficult. The
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  Speaker 1: skin and muscle can still be somewhat frozen and less pliable,
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  Speaker 1: which makes it more difficult to separate. The organs can
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  Speaker 1: still be stiff and frozen and hard to cut through,
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  Speaker 1: and the blood and other bodily fluids are semi solid
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  Speaker 1: to ice crystals. Everything is cold and it makes your
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  Speaker 1: hands hurt. I typically have warm water running to combat this,
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  Speaker 1: but not too hot. One time I had the water
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  Speaker 1: too hot and cooked all the organs that I had
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  Speaker 1: out in a pan, making them all a kind of
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  Speaker 1: dull gray color. Plus it gave off an auto odor
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  Speaker 1: best described as hot dog vomit with a twist of iron.
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  Speaker 1: I only did that once in this particular case. He
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  Speaker 1: had again the typical findings associated with hypothermia and no
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  Speaker 1: other signs of injury or medical condition, so as cause
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  Speaker 1: of death was made hypothermia manner of death accident. Determining
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  Speaker 1: the cause of death of hypothermia autopsy can be difficult
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  Speaker 1: because there are no definitive findings a point only to
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  Speaker 1: a diagnosis of hypothermia. All of the findings can be
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  Speaker 1: found in other conditions. But when you get a combination
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  Speaker 1: of these findings along with the scene findings and especially
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  Speaker 1: a body temperature, you can determine hypothermia quite easily. And
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  Speaker 1: there are a triad of findings that are usually found
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  Speaker 1: that traditionally point to a diagnosis of hypothermia, and these
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  Speaker 1: are Wishnooski's ulcers, frost airthema, and hemorrhage in the muscles,
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  Speaker 1: particularly the iliosoas muscle. Let's go through the findings of
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  Speaker 1: the triad as well as other findings. The one most
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  Speaker 1: people agree is associated with hypothermia is called Woshnowski's ulcers
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  Speaker 1: or spots. These spots were found by a Russian doctor
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  Speaker 1: by the name of S. M. Wushnouski, who in eighteen
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  Speaker 1: ninety five describe these dark brown or black gastric mecosal
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  Speaker 1: lesions in association with cold exposure. They have been described
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  Speaker 1: as altars, but are really more hemorrhagic areas than the
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  Speaker 1: gastric mecosa that vary in size from about a millimeter
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  Speaker 1: to two centimeters in diameter, and sometimes you can have
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  Speaker 1: a few of them to hundreds, making the mecosa surface
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  Speaker 1: of the stomach look like a leopard's pelt. They vary
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  Speaker 1: in presence in hypothermia cases. In the literature, it's said
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  Speaker 1: that it occurs in about forty to one hundred percent
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  Speaker 1: of cases. They're not ulcerations and they're not erosions, but
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  Speaker 1: they're believed to be possibly hemorrhages of the gastric glands
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  Speaker 1: in the lining of the stomach, but this is also
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  Speaker 1: not one hundred percent certain. Wishnuski's spots can also be
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  Speaker 1: seen in numerous other conditions, including diabetic chutoacidosis, fatal burns,
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  Speaker 1: and methanol and ethylene glycol poisoning, so they aren't specific
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  Speaker 1: to hypothermia. The next finding is frost to arithema, which
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  Speaker 1: was first described by a German naturalist named Wilhelm Keferstein.
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  Speaker 1: Frost arethema are reddish to purple to violet or brownish
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  Speaker 1: areas of skin discoloration that are found located over extensive
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  Speaker 1: surfaces of large joints, usually like the elbows or knees.
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  Speaker 1: Typically we see them most in the knees, so it
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  Speaker 1: can be called the red knees of hypothermia. Lividity can
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  Speaker 1: also be bright red or pink in coloration, but this
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  Speaker 1: isn't specific to hypothermia. Other conditions that you may see
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  Speaker 1: this in is carbon monoxide toxicity in exposure to cyanide. Also,
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  Speaker 1: if a body's been left in the cooler too long,
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  Speaker 1: they'll take this pink coloration on, so again it's not
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  Speaker 1: very specific for hypothermia. The pancreas can be hemorrhagic, which
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  Speaker 1: was traditionally thought to be part of cold exposure, but
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  Speaker 1: in recent literature this has been ruled out as a
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  Speaker 1: diagnostic criteria because it occurs in other conditions, and some
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  Speaker 1: believe the person may have had hemorrhagic pancreatitis and just
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  Speaker 1: happen to be in a cold environment, so it's difficult
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  Speaker 1: to say. The last part of the triad is hemorrhage
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  Speaker 1: or bleeding in the skeletal muscle, particularly the iliosoas muscle,
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  Speaker 1: which is located in your lower back. It's postulated that
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  Speaker 1: these hemorrhages are associated with intense shivering. Associated with hypothermia. Microscopically,
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  Speaker 1: there can be a number of specific findings as well,
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  Speaker 1: depletion of the liver's glycogen, fatty degeneration of the renal
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  Speaker 1: tubular epithelium, various areas of hemorrhage and necrosis of the pancreas,
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  Speaker 1: as well as hypoxic and fatty changes of the cardiac myocytes.
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  Speaker 1: There's also reports of postmaron biochemistry where there's been findings
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  Speaker 1: of alterations in the blood ketones, corhizol, free fatty acids,
• 17:49
  Speaker 1: as well as urine catecholamines, but I have never actually
• 17:52
  Speaker 1: run those tests, so I won't comment on those further. Ultimately,
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  Speaker 1: there are several findings that can be found and in
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  Speaker 1: the setting of an individual found in a cold environment
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  Speaker 1: with paradoxical undressing, cold body temperature, findings of Kushnouski's ulcers,
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  Speaker 1: red knees, as well as hemorrhages and musculature all can
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  Speaker 1: point to hypothermia. Inclosing, hypothermia is a complex cause of death,
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  Speaker 1: determined with clinical investigative findings and a combination of autopsy
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  Speaker 1: and laboratory findings. All these combined can give you the
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  Speaker 1: final answer. And I just want to say winter weather
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  Speaker 1: can be fun, or remember to take a break and
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  Speaker 1: warm up, and that brings us to the end of
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  Speaker 1: the episode. I hope you learned something and I hope
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  Speaker 1: you were entertained until the next time.