December 21, 2025 • 23 mins
Content Warning: This episode discusses the deaths of individuals. If you’re sensitive to this topic, this episode may not be for you.
In this episode of Mayhem in the Morgue, Chief Medical Examiner Dr. Kendall Crowns reflects on how celebration and death often share the same season. From Christmas music echoing through the medical examiner's office to a door-decorating contest that nearly led to suspension, he recalls the unusual ways morgue culture adapts to the holidays. Dr. Crowns also recounts a corporate holiday party that ended in homicide, explains the science behind neck injuries, and remembers the “death watch” he and his father kept while delivering newspapers to those who died alone during the most festive time of the year.
Highlights
• (0:00) Welcome to Mayhem in the Morgue with Dr. Kendall Crowns
• (0:45) Christmas music in the morgue and a memory that tested family tolerance
• (3:45) Door-decorating competitions from residency and the Rudolph controversy
• (7:30) Holiday parties, the rumored poisoning case, and the politics of the potluck table
• (11:00) The dangers of open bars at holiday office parties and a rivalry gone wrong
• (14:00) Understanding subarachnoid hemorrhages, vertebral artery tears, and blunt-force trauma
• (17:45) Decomposition and the reality of those who die unnoticed, leading to the “death watch” lessons learned on a paper route
• (22:15) Closing reflections: the importance of checking in on others during the holiday season
About the Host: Dr. Kendall Crowns
Dr. Crowns is the Chief Medical Examiner for Travis County, Texas, and a nationally recognized forensic pathologist. He las led death investigations in Travis County, Fort Worth, Chicago, and Kansas. Over his career, he has performed thousands of autopsies and testified in court hundreds of times as an expert witness. A frequent contributor to Crime Stories with Nancy Grace, Dr. Crowns brings unparalleled insight into the strange, grisly, and sometimes absurd realities of forensic pathology.
About the Show
Mayhem in the Morgue takes listeners inside the bloody, bizarre, and often unbelievable world of forensic pathology. Hosted by Chief Medical Examiner Dr. Kendall Crowns, each episode delivers real-life cases from the morgue, the crime scene, and the courtroom. Expect gallows humor, hard truths, and unforgettable investigations.
Connect and Learn More
Learn more about Dr. Kendall Crowns on Linkedin. Catch him regularly on Crime Stories with Nancy Grace and follow Mayhem in the Morgue where you get your podcasts.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Today's episode has information about the death of individuals. If
this sort of thing upsets you, this is once again
not the episode for you. May I suggest you read
a book something like My Travels with Charlie Welcome to
Mayhem in the Morning with their host Doctor Kendo Crowns.
(00:25):
Today's episode Holidays, Merry Christmas, and Happy Holidays from Mayhem
and the Morgue. As the weather gets colder outside and
the holidays are fast approaching, I thought in today's episode
we could discuss some things commonly associated with this time
of year, and those things are holiday celebrations and decomposition.
So let's get started. Now that Thanksgiving has past, offices
(00:49):
all over the US are preparing for their annual holiday festivities,
and medical Examiner's offices are no exception. Every office and
hospital I have ever worked at gets into the spear
of the season in a variety of ways. There is
usually holiday music, decorating, competitions, and of course parties. Every
morgue I have ever worked in has had music playing
(01:12):
except one, and that was the Cook County Medical Examiner's Office.
The chief medical Examiner there said music was distracting in
the morgue and disrupted the thought process, and it was
always quiet except for the sound of people working and
having discussions, and of course the only music that ever
occurred was the scream of the bone sauce grinding against
(01:32):
the skulls. But everywhere else music was always part of
the day, and during the holidays the music can take
a more festive turn. My first holiday season in a
morgue was as an autopsy tech. The hospital I worked
at was a Catholic hospital and during the holidays they
played Christmas music throughout the workday on the PA system
(01:53):
in the morgue. It came through a circular speaker covered
with a gray metal grate next to the clock above
the chalkboard where the doc wrote down the organ weights.
I remember one particular day I was assisting on an
autopsy of an individual who died of lung cancer due
to their love of nicotine. During the autopsy, we were
looking from metastases, and I have a very distinctive memory
(02:14):
of a traditional rendering of O. Tannenbaum as I was
opening up an intestine at the doctor's request, cleaning out
the feces and looking for lesions. Later on that day,
when we were done with the autopsy, I remember a
musical version of O Little Town of Bethlehem playing as
I was sewing the decedent back together. When I got
(02:35):
home that evening, my mother asked me how work went,
and I relayed the story that I have just discussed,
including the two songs that I distinctly remembered, and when
I got done with the story, she just started crying.
I asked her why she was so upset, and she
stated that such things should not occur with Christmas music playing.
It was at that moment I realized that my mother
(02:57):
really couldn't handle what I did for and after that
we didn't discuss the details of my work anymore. It
was just too difficult for her to hear. And over
the years, she would sometimes see something on TV about
a case that happened in a jurisdiction I worked in,
and she would call and ask me was that one
of my cases? And I would say yes, and her
(03:21):
response would be, oh my. In other morgues I have
worked at as a doctor, I actually asked during the
holidays for any other music than Christmas music to be played.
Box of Rain, Shake It Off, Wildest Dreams, even Bad
Blood are always preferred to holiday songs because I just
like to keep death in Santa separate in my mind.
(03:44):
Holiday decorating is another very common thing that occurs at
medical examiner's offices. People decorate their offices or they often
decorate their door. Door decorating competitions have been part of
every level of my career. They can be simple placards
stating Merry Christmas or Happy Holidays, two elaborate designs, depending
on the artistic ability of those involved. When I was
(04:06):
in residency at the Veterans Administration Hospital, I shared an
office with two other residents. One was a second year
resident and the other was a fourth year or senior
resident almost ready to finish. We shared a medium sized
office that was a white and gray nondescript room with
a kind of light blue carpet. We each had a
workstation with a microscope and a computer that was connected
(04:29):
to the DA's computer system so we could access patient information.
There was a single communal computer along one wall that
had access to this crazy new thing called the World
Wide Web that had a download speed of a whopping
fourteen point four bits per second. In my first year residency,
I spent the holidays at the SPA Hospital in this
(04:52):
room and When the holiday season started, the pathology department
decided that we could all decorate our doors. The second
and fourth year pathology resident and I decided to participate.
We came up with a plan and the next day
the second year resident came in with construction paper and
we began cutting out and crafting our design. I traced
a picture of the VA Hospital on a morg light
(05:14):
table than we used for looking at old codochrome slide,
and then we obtained xerox copies of all the ID
badges of the staff pathologists as well as our ID badges.
The purpose of this was we were going to cut
out the faces from each of the pictures and use
them to decorate the construction paper figures that we were making.
The finished product showed Santa and two elves in a
(05:36):
sleigh being pulled by nine tiny flying reindeer through the
sky over the VA Hospital. We used the face of
the fourth year resident to decorate Santa, and Santa had
a whip in her hand and was whipping the reindeer.
The two elves were myself and the second year resident,
and we were throwing packages out of the back of
the sleigh. Glued on the reindeer bodies were the faces
(05:59):
of the staff pathologists, with cute little antlers on their heads.
The lead reindeer, or Rudolph, was the chief of the
pathology department. He had an extra decoration of a circular
red nose glued onto his face. We were very happy
with our creation and thought we were very witty. Several
of the staff pathologists and other employees came up and
(06:23):
saw our decorations and thought they were very humorous. After
about an hour or so, we heard the chief pathologist
walking down the hallway. He was a very big man.
He was from some European country that I can't remember
what one it was. His voice was always very booming,
and he was not someone that you ever wanted to
make mad, because he would get incredibly angry. When he
(06:45):
saw our door decoration, he took an instant disliking to
it and said that we were implying that he was
a drunkard by placing the red nose on it. The
fourth year resident said, Noah's Rudolph, you know, with his
nose so bright leading this, and it had nothing to
do with his proclivity towards intoxication. He didn't buy that
Rudolph crap and said it was totally us taking a
(07:08):
shot at him, and he told us to remove it
unless we would like to be suspended from the program,
which none of us wanted. We quickly complied, and for
the rest of the month, our decoration was Santa and
his elves being pulled in a sleigh by nine tiny reindeer,
with the lead reindeer, Rudolph, being the headless, decapitated reindeer
ghostly leading the sleigh through the night sky, which was
(07:32):
definitely not the story I had heard as a child.
The last component of the holidays of the Morgue is
the end of the year holiday party. There is always
one somewhere. Some are simple events with just cookies. One
time the only person who showed up with cookies was
my wife Beth, but everybody enjoyed them, and some were
questionably catered. And then there are, of course others that
(07:55):
were potlucks. At potlucks, there would always be a wide
range of food, and people who brought the food were
always excellent cooks, and there would always be way too
much food. It was hard to know what to eat,
and it could become a political minefield because some people
would get offended if you didn't eat what they brought,
and then carry a grudge for the rest of the year.
(08:17):
One time, I was not feeling particularly hungry, so I
just got a roll in some carrots and cucumber from
a vegetable plate that I had brought. I have always
been unsure where to sit at these affairs. I sat
down at an empty table to eat when the chief
medical Examiner and the chief of toxicology sat down at
the table with me. After that, no one else would
(08:39):
sit there. They both had plates full of food, and
the chief started asking me questions immediately about why I
had so little. Are you a vegan? Are you lactose intolerant?
Gluten issues, issues with shapes and colors of food? What
is it? Why do you have so little? My answer
was basically, well, no, I just didn't feel like eating
(09:00):
anything today. He said, interesting, that doesn't make any sense.
Is that the food you brought? And I said, well, yes,
it was the food I brought And he said that's suspicious,
and then he turned and started talking to the chief
toxicologists about office issues, and they forgot I was sitting there.
I quickly ate my food and got out of there
(09:22):
before the next round of questions came. It's because of
incidents like that. Office parties and potlucks have always been
anxiety provoking affairs for me. At one office I worked at,
one of the employees was rumored to have done prison
time for having poisoned to her husband. I don't know
if this was true or something older employees like to
(09:42):
say to mess with the new guys, but at the
office potluck, the first thing I would do was determine
which item was hers. I would ask one of the
older employees and they would always point it out. It
was usually in a gray, medium sized slow cooker or
crop pot, often relegate to the rear of the table.
It would sit there and often be some sort of
(10:03):
super bean dipped concoction, slowly bubbling quietly. As soon as
I identified it, I would not touch it for fear
that it had been poisoned. I never noticed if anyone
else took anything from it. She always brought something for
the potluck, so if no one ate it, she was
evidently never discouraged by this. I do know that no
(10:24):
employee that ever worked there died or got sick right
after the potluck. I think back on this, and I
wonder did they make up this legend to convince the
new employees that her food was somehow tainted and it
was actually that it was really good and the long
term employees knew it, and by telling this to the
new people, there'd be less of it taken and more
(10:47):
food for them. If this is true, that was an
incredibly sneaky move. Wow Wow. We will now turn from
potlucks to the more dangerous and lethal office parties, and
these are catered off site parties with an open bar.
Parties like this are usually well received. They're outside of
(11:09):
the office, they're catered, they're somewhere fancy, somewhere employees don't
necessarily ever get to go, so they're very exciting and
the majority of employees love these types of parties. And
plus they have an open bar and that means free
drinks for all and people really enjoy this. But some
of the employees, too much alcohol brings out the worst
(11:30):
in them. When they're sober and at work, they're quiet, meek, mild,
keep to themselves and non confrontational. But when they're drunk,
they become loud and belligerent, argumentative, and even sometimes violent.
I had a case that's a very good example of
this particular problem. It occurred at a holiday party for
(11:51):
a big name corporation. It was a grand catered affair
at an expensive hotel in the downtown area. There was
plenty of food, refreshment's cake, and an open bar with
unlimited drinks. There were two employees that had an intense
rivalry over who had the most sales within their section,
(12:11):
and at that party, they became more and more intoxicated
and things began to escalate to the point that they
began shouting at each other about who could sell things
the best, and this turned into a shoving match, and
then punches were thrown. Other employees tried to intervene, and
then they started fighting, and the party turned into a brawl.
At some point, the original combatants found each other again
(12:34):
and continued their fight. One punched the other to his knees,
and as this employee was sitting there, dazed and confused
on his knees, witnesses said, the other employee lined up
and kicked him in the head like a football, causing
him to reel backwards into the refreshment table, landing in
a cake. The table collapsed, spilling everything, and the punted
(12:57):
employee laid unresponsive on his back with his head and
shoulders covered in cake. Someone noticed that he wasn't moving.
They tried to wake him up. They threw water on
his face, They shook him, and then someone said, hey,
he's not breathing. CPR was started, EMS was called, and
when they arrived, they rushed into a nearby hospital where
(13:17):
he was pronounced dead on arrival. The kicker had evidently
played high school football and was actually the place kicker
for the team, so his kick did carry a certain
amount of punch to it. When I performed the autopsy
that the scene was a well developed, well nurished male
appearing the reported age. His face and shoulders and neck
(13:38):
were covered in a red, green and white frosting. His
hair was matted with a thick layer of this frosting
with occasional sprinkles. There was bits of cake in his
hair as well. It appeared to be a white cake.
When his cranial cavity was open, there was marked subarachnoid
hemorrhage at the base of his brain, surrounding his brain
stem and cerebellum. Let's have a quick explanation of subarachnoid hemorrhage.
(14:03):
Subarachnoid hemorrhage is when there is hemorrhage along the ractnoid
layer of the brain. And what's the rachnoid layer. Well,
the brain has three protective layers, known collectively as the meninges.
The outermost layer is thick and tough and is known
as the dura. The middle layer is known as the arachnoid.
It's thin in lacy, and the final layer is known
(14:25):
as the pia, which is located directly on the surface
of the brain. The spaces between these layers can have
blood pool in them after trauma. Hemorrhage above the dura
is known as epidural hemorrhage, below the dura but above
the arachnoid is known as subdural hemorrhage, and below the
eractoid but above the pia is known as subarachnoid hemorrhage.
(14:46):
We'll discuss these different types of hemorrhages on different episodes
with different cases, But like I said, this case had
subarachnoid hemorrhage, meaning there was hemorrhage in the subarachnoid space
between the rachnoid and the pia. So there's a number
of ways that a subarachnoid hemorrhage can cause death. The
hemorrhage filling the subarachnoid space causes a massive pressure increase
(15:08):
inside the cranial cavity, and this compresses brain against the
sides of the skull, causing tissue death, and it can
lead to brain death from lack of oxygen getting to
the brain, triggering a demur or swelling the brain, which
causes the brain to push into the form and magnum
pushing on the brain stem shutting off basically your heart
(15:28):
in respiratory drive. When I saw this subarachnoid hemorrhage during
the autopsy, it was in a specific location at the
base of the brain, which is generally a sign of
two different things, a ruptured bary aneurysm or a torn
for tebral artery. A bary aneurysm is another topic for
another episode, but basically they are weaknesses of vessels at
(15:50):
the base of your brain that can suddenly burst for
any number of reason, resulting in hemorrhage in the subarachtloid space.
But that's not what happened with this case. He is
instead had what is called a vertebral artery laceration or
tear caused by trauma. Before we go any further, let's
discuss the vertebral arteries a little bit. There are two
(16:10):
vertebral arteries. There are branches off the subclavian artery, which
is a branch off the aorta. They travel up through
the neck along either side of the cervical vertebrae, passing
through openings in the vertebrae known as transverse foramena. When
the arteries reach the final cervical vertebrae cervical vertebrae number one,
or the atlas, they come out of the foramena and
(16:31):
curve around the top of it and enter the base
of the skull through a somewhat circular opening known as
the form and magnum, and fuse together forming the Basler
artery along the front of the brain stem. These vessels
provide twenty percent of the blood flow to the brain
stem and brain. Traumatic tears or lacerations of the vertebral
arteries are relatively rare and are caused by trauma ranging
(16:54):
from severe trauma like high speed car crashes to something
minor like coughing or sneezing. The mechanism causing this injury
is extreme movements of the neck commonly known as whiplash,
which is a hyper extension or hyperflexion and lateral rotation
of the neck. These extreme movements twist and pull the
vertebral arteries and can result in them ripping apart. When
(17:16):
this occurs, it results in bleeding in the tissue of
the neck surrounding the tear, and subarachnoid hemorrhage along the
base of the brain. And that was the finding seen
in this case. The extreme hyper extension from the kick
tore one of the vertebral arteries and it resulted in
subarachnoid hemorrhage of the brain and brain stim So the
cause of death was made blunt trauma of the head
and neck, and the manner death was homicide. The coworker
(17:38):
admitted guilt and it never went a trial. I don't
know what happened beyond this. I did learn from this
that be careful what you say at an office party
because you never know what will set Jerry or Fill off,
especially if they have a score to settle about how
many paper clips you use. Finally, at this time of year,
it can become abundantly clear that some of us are
(17:59):
completletely alone and there is nobody checking up on them,
especially if they don't work or are retired, and this
is particularly true of the elderly. When one of these
individuals die, they often aren't discovered for a long period
of time, and they end up decomposing and even becoming
mummified or skeletonized. The decomposition process is often how they
(18:21):
are discovered, because the smell becomes so severe that someone
that lives close by can smell them. Occasionally, in apartments,
they are discovered when the person living below them starts
experiencing an ever widening spot in the ceiling that begins
dripping from their decomposing neighbor that has begun to liquefy.
(18:42):
There are other findings found at the scene, unrelated to decomposition,
that can be markers that the individual is dead and
has been dead for a while. This is usually seen
when mail builds up in the mailbox or at the door. Sadly,
I didn't learn this fact as a medical examiner, but
instead I had learned it in middle school working at
(19:02):
my first job as a paper boy. It was a
large route that spanned several miles and included houses and apartments.
My dad and I worked on the route together four
am every day of the year. During rain, sleet, snow,
or tornadoes, we were out there. We didn't throw the
papers from a car, but instead walk the route, placing
the papers by the door. Were behind the screen door
(19:25):
if it was left unlocked during the holiday season. One year,
when I was in middle school, I was trudging through
the snow on the paper route. I noticed one of
our more elderly customers had papers building up at her
front door. I could see in the snow the only
footprints coming up to the house for days were mine,
and there were no others either coming in or out.
(19:46):
I could see her Christmas tree lights lighting up the
gray gauzy white curtains in her front window, and a
light was on in a room towards the back of
the house, and these lights never changed from one day
to the next. On the fifth day, when I met
my day back at the car, I said to him, Hey, Dad,
missus Smith, I actually don't remember her real name, doesn't
seem to be picking up her papers. There's mail filling
(20:09):
her mailbox, and the only footprints for days have been mine.
His response was well, that's interesting. She's probably dead. I
was taken aback by this and I said, well, how
is she dead? How do you know that? And he said,
what you've described mail overflowing papers at the door, no activity,
It sounds like someone who's dead. My dad had an
(20:31):
education in criminal justice. He had been around law enforcement
for a large part of his life, and he knew
what he was talking about. When we got in the
car and we drove down to the address, he got
out and he walked around, rang the doorbell, knocked on
the door, looked in the windows, and when he was done,
he walked back to the car, got inside and said, yeah,
(20:51):
she's probably dead. And I said, well, what should we do.
Shouldn't we call someone? And his response was well, of course,
but first we have to finish delivering the papers. She
won't be getting any debtor and people need to get
their papers on time, and off we went to the
next section of the route. Once we got home, he
called some of his officer friends and they did a
(21:12):
well being check and sure enough, Missus Smith was dead
and had been dead for some time. Unfortunately, this was
not the only time that's occurred on the paper route.
We had a number of elderly customers, especially on the
part of our paper route that the majority of which
were apartments. Over time, my dad and I developed a system.
I would come back to the car and say, five
point fifteen has built up a more than five papers,
(21:35):
positive mailbox sign no activity, and he would say note it,
and we'd finish up the route and go back by later.
He would check to make sure that nobody responded by
checking the door, knocking on it, he would look in
the windows, and he would call it in and the
next day we wouldn't be throwing the paper anymore. I
eventually quit asking what they found when they entered the
apartment or the house, because it was always the same
(21:57):
decomposed individual for days, with some very of pet scavenging
and of course flies in the window in summertime or
something similar. And over the years it was just a
common occurrence, and in the end we were not just
the paper carriers, but we were also the local death
watch for our route. And that's the thing. It's a
fairly common occurrence for someone to be found dead and
(22:20):
decomposed at their house because no one's checking up on them.
I see it almost every day at my job, so
do me a favor and just check up on your family,
neighbor or friends this holiday season, because there really aren't
paper boys anymore carrying on the tradition of the death watch.
(22:42):
And that brings us to the end of the episode.
I hope you learn something like careful what you say
at an office party, and I hope you were entertained
until the next time
Today's episode has information about the death of individuals. If
this sort of thing upsets you, this is once again
not the episode for you. May I suggest you read
a book something like My Travels with Charlie Welcome to
Mayhem in the Morning with their host Doctor Kendo Crowns.
(00:25):
Today's episode Holidays, Merry Christmas, and Happy Holidays from Mayhem
and the Morgue. As the weather gets colder outside and
the holidays are fast approaching, I thought in today's episode
we could discuss some things commonly associated with this time
of year, and those things are holiday celebrations and decomposition.
So let's get started. Now that Thanksgiving has past, offices
(00:49):
all over the US are preparing for their annual holiday festivities,
and medical Examiner's offices are no exception. Every office and
hospital I have ever worked at gets into the spear
of the season in a variety of ways. There is
usually holiday music, decorating, competitions, and of course parties. Every
morgue I have ever worked in has had music playing
(01:12):
except one, and that was the Cook County Medical Examiner's Office.
The chief medical Examiner there said music was distracting in
the morgue and disrupted the thought process, and it was
always quiet except for the sound of people working and
having discussions, and of course the only music that ever
occurred was the scream of the bone sauce grinding against
(01:32):
the skulls. But everywhere else music was always part of
the day, and during the holidays the music can take
a more festive turn. My first holiday season in a
morgue was as an autopsy tech. The hospital I worked
at was a Catholic hospital and during the holidays they
played Christmas music throughout the workday on the PA system
(01:53):
in the morgue. It came through a circular speaker covered
with a gray metal grate next to the clock above
the chalkboard where the doc wrote down the organ weights.
I remember one particular day I was assisting on an
autopsy of an individual who died of lung cancer due
to their love of nicotine. During the autopsy, we were
looking from metastases, and I have a very distinctive memory
(02:14):
of a traditional rendering of O. Tannenbaum as I was
opening up an intestine at the doctor's request, cleaning out
the feces and looking for lesions. Later on that day,
when we were done with the autopsy, I remember a
musical version of O Little Town of Bethlehem playing as
I was sewing the decedent back together. When I got
(02:35):
home that evening, my mother asked me how work went,
and I relayed the story that I have just discussed,
including the two songs that I distinctly remembered, and when
I got done with the story, she just started crying.
I asked her why she was so upset, and she
stated that such things should not occur with Christmas music playing.
It was at that moment I realized that my mother
(02:57):
really couldn't handle what I did for and after that
we didn't discuss the details of my work anymore. It
was just too difficult for her to hear. And over
the years, she would sometimes see something on TV about
a case that happened in a jurisdiction I worked in,
and she would call and ask me was that one
of my cases? And I would say yes, and her
(03:21):
response would be, oh my. In other morgues I have
worked at as a doctor, I actually asked during the
holidays for any other music than Christmas music to be played.
Box of Rain, Shake It Off, Wildest Dreams, even Bad
Blood are always preferred to holiday songs because I just
like to keep death in Santa separate in my mind.
(03:44):
Holiday decorating is another very common thing that occurs at
medical examiner's offices. People decorate their offices or they often
decorate their door. Door decorating competitions have been part of
every level of my career. They can be simple placards
stating Merry Christmas or Happy Holidays, two elaborate designs, depending
on the artistic ability of those involved. When I was
(04:06):
in residency at the Veterans Administration Hospital, I shared an
office with two other residents. One was a second year
resident and the other was a fourth year or senior
resident almost ready to finish. We shared a medium sized
office that was a white and gray nondescript room with
a kind of light blue carpet. We each had a
workstation with a microscope and a computer that was connected
(04:29):
to the DA's computer system so we could access patient information.
There was a single communal computer along one wall that
had access to this crazy new thing called the World
Wide Web that had a download speed of a whopping
fourteen point four bits per second. In my first year residency,
I spent the holidays at the SPA Hospital in this
(04:52):
room and When the holiday season started, the pathology department
decided that we could all decorate our doors. The second
and fourth year pathology resident and I decided to participate.
We came up with a plan and the next day
the second year resident came in with construction paper and
we began cutting out and crafting our design. I traced
a picture of the VA Hospital on a morg light
(05:14):
table than we used for looking at old codochrome slide,
and then we obtained xerox copies of all the ID
badges of the staff pathologists as well as our ID badges.
The purpose of this was we were going to cut
out the faces from each of the pictures and use
them to decorate the construction paper figures that we were making.
The finished product showed Santa and two elves in a
(05:36):
sleigh being pulled by nine tiny flying reindeer through the
sky over the VA Hospital. We used the face of
the fourth year resident to decorate Santa, and Santa had
a whip in her hand and was whipping the reindeer.
The two elves were myself and the second year resident,
and we were throwing packages out of the back of
the sleigh. Glued on the reindeer bodies were the faces
(05:59):
of the staff pathologists, with cute little antlers on their heads.
The lead reindeer, or Rudolph, was the chief of the
pathology department. He had an extra decoration of a circular
red nose glued onto his face. We were very happy
with our creation and thought we were very witty. Several
of the staff pathologists and other employees came up and
(06:23):
saw our decorations and thought they were very humorous. After
about an hour or so, we heard the chief pathologist
walking down the hallway. He was a very big man.
He was from some European country that I can't remember
what one it was. His voice was always very booming,
and he was not someone that you ever wanted to
make mad, because he would get incredibly angry. When he
(06:45):
saw our door decoration, he took an instant disliking to
it and said that we were implying that he was
a drunkard by placing the red nose on it. The
fourth year resident said, Noah's Rudolph, you know, with his
nose so bright leading this, and it had nothing to
do with his proclivity towards intoxication. He didn't buy that
Rudolph crap and said it was totally us taking a
(07:08):
shot at him, and he told us to remove it
unless we would like to be suspended from the program,
which none of us wanted. We quickly complied, and for
the rest of the month, our decoration was Santa and
his elves being pulled in a sleigh by nine tiny reindeer,
with the lead reindeer, Rudolph, being the headless, decapitated reindeer
ghostly leading the sleigh through the night sky, which was
(07:32):
definitely not the story I had heard as a child.
The last component of the holidays of the Morgue is
the end of the year holiday party. There is always
one somewhere. Some are simple events with just cookies. One
time the only person who showed up with cookies was
my wife Beth, but everybody enjoyed them, and some were
questionably catered. And then there are, of course others that
(07:55):
were potlucks. At potlucks, there would always be a wide
range of food, and people who brought the food were
always excellent cooks, and there would always be way too
much food. It was hard to know what to eat,
and it could become a political minefield because some people
would get offended if you didn't eat what they brought,
and then carry a grudge for the rest of the year.
(08:17):
One time, I was not feeling particularly hungry, so I
just got a roll in some carrots and cucumber from
a vegetable plate that I had brought. I have always
been unsure where to sit at these affairs. I sat
down at an empty table to eat when the chief
medical Examiner and the chief of toxicology sat down at
the table with me. After that, no one else would
(08:39):
sit there. They both had plates full of food, and
the chief started asking me questions immediately about why I
had so little. Are you a vegan? Are you lactose intolerant?
Gluten issues, issues with shapes and colors of food? What
is it? Why do you have so little? My answer
was basically, well, no, I just didn't feel like eating
(09:00):
anything today. He said, interesting, that doesn't make any sense.
Is that the food you brought? And I said, well, yes,
it was the food I brought And he said that's suspicious,
and then he turned and started talking to the chief
toxicologists about office issues, and they forgot I was sitting there.
I quickly ate my food and got out of there
(09:22):
before the next round of questions came. It's because of
incidents like that. Office parties and potlucks have always been
anxiety provoking affairs for me. At one office I worked at,
one of the employees was rumored to have done prison
time for having poisoned to her husband. I don't know
if this was true or something older employees like to
(09:42):
say to mess with the new guys, but at the
office potluck, the first thing I would do was determine
which item was hers. I would ask one of the
older employees and they would always point it out. It
was usually in a gray, medium sized slow cooker or
crop pot, often relegate to the rear of the table.
It would sit there and often be some sort of
(10:03):
super bean dipped concoction, slowly bubbling quietly. As soon as
I identified it, I would not touch it for fear
that it had been poisoned. I never noticed if anyone
else took anything from it. She always brought something for
the potluck, so if no one ate it, she was
evidently never discouraged by this. I do know that no
(10:24):
employee that ever worked there died or got sick right
after the potluck. I think back on this, and I
wonder did they make up this legend to convince the
new employees that her food was somehow tainted and it
was actually that it was really good and the long
term employees knew it, and by telling this to the
new people, there'd be less of it taken and more
(10:47):
food for them. If this is true, that was an
incredibly sneaky move. Wow Wow. We will now turn from
potlucks to the more dangerous and lethal office parties, and
these are catered off site parties with an open bar.
Parties like this are usually well received. They're outside of
(11:09):
the office, they're catered, they're somewhere fancy, somewhere employees don't
necessarily ever get to go, so they're very exciting and
the majority of employees love these types of parties. And
plus they have an open bar and that means free
drinks for all and people really enjoy this. But some
of the employees, too much alcohol brings out the worst
(11:30):
in them. When they're sober and at work, they're quiet, meek, mild,
keep to themselves and non confrontational. But when they're drunk,
they become loud and belligerent, argumentative, and even sometimes violent.
I had a case that's a very good example of
this particular problem. It occurred at a holiday party for
(11:51):
a big name corporation. It was a grand catered affair
at an expensive hotel in the downtown area. There was
plenty of food, refreshment's cake, and an open bar with
unlimited drinks. There were two employees that had an intense
rivalry over who had the most sales within their section,
(12:11):
and at that party, they became more and more intoxicated
and things began to escalate to the point that they
began shouting at each other about who could sell things
the best, and this turned into a shoving match, and
then punches were thrown. Other employees tried to intervene, and
then they started fighting, and the party turned into a brawl.
At some point, the original combatants found each other again
(12:34):
and continued their fight. One punched the other to his knees,
and as this employee was sitting there, dazed and confused
on his knees, witnesses said, the other employee lined up
and kicked him in the head like a football, causing
him to reel backwards into the refreshment table, landing in
a cake. The table collapsed, spilling everything, and the punted
(12:57):
employee laid unresponsive on his back with his head and
shoulders covered in cake. Someone noticed that he wasn't moving.
They tried to wake him up. They threw water on
his face, They shook him, and then someone said, hey,
he's not breathing. CPR was started, EMS was called, and
when they arrived, they rushed into a nearby hospital where
(13:17):
he was pronounced dead on arrival. The kicker had evidently
played high school football and was actually the place kicker
for the team, so his kick did carry a certain
amount of punch to it. When I performed the autopsy
that the scene was a well developed, well nurished male
appearing the reported age. His face and shoulders and neck
(13:38):
were covered in a red, green and white frosting. His
hair was matted with a thick layer of this frosting
with occasional sprinkles. There was bits of cake in his
hair as well. It appeared to be a white cake.
When his cranial cavity was open, there was marked subarachnoid
hemorrhage at the base of his brain, surrounding his brain
stem and cerebellum. Let's have a quick explanation of subarachnoid hemorrhage.
(14:03):
Subarachnoid hemorrhage is when there is hemorrhage along the ractnoid
layer of the brain. And what's the rachnoid layer. Well,
the brain has three protective layers, known collectively as the meninges.
The outermost layer is thick and tough and is known
as the dura. The middle layer is known as the arachnoid.
It's thin in lacy, and the final layer is known
(14:25):
as the pia, which is located directly on the surface
of the brain. The spaces between these layers can have
blood pool in them after trauma. Hemorrhage above the dura
is known as epidural hemorrhage, below the dura but above
the arachnoid is known as subdural hemorrhage, and below the
eractoid but above the pia is known as subarachnoid hemorrhage.
(14:46):
We'll discuss these different types of hemorrhages on different episodes
with different cases, But like I said, this case had
subarachnoid hemorrhage, meaning there was hemorrhage in the subarachnoid space
between the rachnoid and the pia. So there's a number
of ways that a subarachnoid hemorrhage can cause death. The
hemorrhage filling the subarachnoid space causes a massive pressure increase
(15:08):
inside the cranial cavity, and this compresses brain against the
sides of the skull, causing tissue death, and it can
lead to brain death from lack of oxygen getting to
the brain, triggering a demur or swelling the brain, which
causes the brain to push into the form and magnum
pushing on the brain stem shutting off basically your heart
(15:28):
in respiratory drive. When I saw this subarachnoid hemorrhage during
the autopsy, it was in a specific location at the
base of the brain, which is generally a sign of
two different things, a ruptured bary aneurysm or a torn
for tebral artery. A bary aneurysm is another topic for
another episode, but basically they are weaknesses of vessels at
(15:50):
the base of your brain that can suddenly burst for
any number of reason, resulting in hemorrhage in the subarachtloid space.
But that's not what happened with this case. He is
instead had what is called a vertebral artery laceration or
tear caused by trauma. Before we go any further, let's
discuss the vertebral arteries a little bit. There are two
(16:10):
vertebral arteries. There are branches off the subclavian artery, which
is a branch off the aorta. They travel up through
the neck along either side of the cervical vertebrae, passing
through openings in the vertebrae known as transverse foramena. When
the arteries reach the final cervical vertebrae cervical vertebrae number one,
or the atlas, they come out of the foramena and
(16:31):
curve around the top of it and enter the base
of the skull through a somewhat circular opening known as
the form and magnum, and fuse together forming the Basler
artery along the front of the brain stem. These vessels
provide twenty percent of the blood flow to the brain
stem and brain. Traumatic tears or lacerations of the vertebral
arteries are relatively rare and are caused by trauma ranging
(16:54):
from severe trauma like high speed car crashes to something
minor like coughing or sneezing. The mechanism causing this injury
is extreme movements of the neck commonly known as whiplash,
which is a hyper extension or hyperflexion and lateral rotation
of the neck. These extreme movements twist and pull the
vertebral arteries and can result in them ripping apart. When
(17:16):
this occurs, it results in bleeding in the tissue of
the neck surrounding the tear, and subarachnoid hemorrhage along the
base of the brain. And that was the finding seen
in this case. The extreme hyper extension from the kick
tore one of the vertebral arteries and it resulted in
subarachnoid hemorrhage of the brain and brain stim So the
cause of death was made blunt trauma of the head
and neck, and the manner death was homicide. The coworker
(17:38):
admitted guilt and it never went a trial. I don't
know what happened beyond this. I did learn from this
that be careful what you say at an office party
because you never know what will set Jerry or Fill off,
especially if they have a score to settle about how
many paper clips you use. Finally, at this time of year,
it can become abundantly clear that some of us are
(17:59):
completletely alone and there is nobody checking up on them,
especially if they don't work or are retired, and this
is particularly true of the elderly. When one of these
individuals die, they often aren't discovered for a long period
of time, and they end up decomposing and even becoming
mummified or skeletonized. The decomposition process is often how they
(18:21):
are discovered, because the smell becomes so severe that someone
that lives close by can smell them. Occasionally, in apartments,
they are discovered when the person living below them starts
experiencing an ever widening spot in the ceiling that begins
dripping from their decomposing neighbor that has begun to liquefy.
(18:42):
There are other findings found at the scene, unrelated to decomposition,
that can be markers that the individual is dead and
has been dead for a while. This is usually seen
when mail builds up in the mailbox or at the door. Sadly,
I didn't learn this fact as a medical examiner, but
instead I had learned it in middle school working at
(19:02):
my first job as a paper boy. It was a
large route that spanned several miles and included houses and apartments.
My dad and I worked on the route together four
am every day of the year. During rain, sleet, snow,
or tornadoes, we were out there. We didn't throw the
papers from a car, but instead walk the route, placing
the papers by the door. Were behind the screen door
(19:25):
if it was left unlocked during the holiday season. One year,
when I was in middle school, I was trudging through
the snow on the paper route. I noticed one of
our more elderly customers had papers building up at her
front door. I could see in the snow the only
footprints coming up to the house for days were mine,
and there were no others either coming in or out.
(19:46):
I could see her Christmas tree lights lighting up the
gray gauzy white curtains in her front window, and a
light was on in a room towards the back of
the house, and these lights never changed from one day
to the next. On the fifth day, when I met
my day back at the car, I said to him, Hey, Dad,
missus Smith, I actually don't remember her real name, doesn't
seem to be picking up her papers. There's mail filling
(20:09):
her mailbox, and the only footprints for days have been mine.
His response was well, that's interesting. She's probably dead. I
was taken aback by this and I said, well, how
is she dead? How do you know that? And he said,
what you've described mail overflowing papers at the door, no activity,
It sounds like someone who's dead. My dad had an
(20:31):
education in criminal justice. He had been around law enforcement
for a large part of his life, and he knew
what he was talking about. When we got in the
car and we drove down to the address, he got
out and he walked around, rang the doorbell, knocked on
the door, looked in the windows, and when he was done,
he walked back to the car, got inside and said, yeah,
(20:51):
she's probably dead. And I said, well, what should we do.
Shouldn't we call someone? And his response was well, of course,
but first we have to finish delivering the papers. She
won't be getting any debtor and people need to get
their papers on time, and off we went to the
next section of the route. Once we got home, he
called some of his officer friends and they did a
(21:12):
well being check and sure enough, Missus Smith was dead
and had been dead for some time. Unfortunately, this was
not the only time that's occurred on the paper route.
We had a number of elderly customers, especially on the
part of our paper route that the majority of which
were apartments. Over time, my dad and I developed a system.
I would come back to the car and say, five
point fifteen has built up a more than five papers,
(21:35):
positive mailbox sign no activity, and he would say note it,
and we'd finish up the route and go back by later.
He would check to make sure that nobody responded by
checking the door, knocking on it, he would look in
the windows, and he would call it in and the
next day we wouldn't be throwing the paper anymore. I
eventually quit asking what they found when they entered the
apartment or the house, because it was always the same
(21:57):
decomposed individual for days, with some very of pet scavenging
and of course flies in the window in summertime or
something similar. And over the years it was just a
common occurrence, and in the end we were not just
the paper carriers, but we were also the local death
watch for our route. And that's the thing. It's a
fairly common occurrence for someone to be found dead and
(22:20):
decomposed at their house because no one's checking up on them.
I see it almost every day at my job, so
do me a favor and just check up on your family,
neighbor or friends this holiday season, because there really aren't
paper boys anymore carrying on the tradition of the death watch.
(22:42):
And that brings us to the end of the episode.
I hope you learn something like careful what you say
at an office party, and I hope you were entertained
until the next time
Host
Nancy Grace
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