Episode Transcript
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Speaker 1 (00:00):
Today's episode includes information about the death of individuals. If
this sort of thing upsets you, may I suggest you
read a book, maybe something like East of Eden Welcome
to Mayhem in the More with your host, Doctor Kinder Crowns.
(00:22):
Today's episode is the third of four episodes discussing exposures
at autopsies. If you haven't listened to parts one or two,
I recommend you listen to those episodes before you continue
today's episode. Today's episode Exposure Part three Nuclear Option. I
have experienced many different chemical exposures over the years, and
(00:43):
most aren't even worth talking about. But a few of
the exposures are particularly notable, and these are the ones
I will be talking about on this episode. At autopsies,
chemicals can be very dangerous substances, and they can easily
cause secondary contamination a morgue staff, which can be dangerous.
It's less about what's on the inside of the body
and more about what is on the outside, coating the
(01:06):
clothing or the skin. Don't get me wrong, people can
swallow some pretty crazy stuff, but most of the truly
hazardous chemicals would be difficult to ingest. One of the
main chemical hazards we deal with every day is formaldehyde,
but we control this one. This is a chemical that
is used to preserve or fixed specimens that are taken
at the time of autopsy to then be processed and
(01:26):
turned into glass slides to look at under the microscope.
Formaldehyde can cause skin and mucosal irritation, and long term
exposure has been linked to cancer. It sits in big
dispensers at every morgue, and everyone in the morgue should
know proper handling of it, so it really does impose
much of a hazard unless there's a spill, which has
happened occasionally in my career after decades of being around formalin.
(01:50):
It actually causes me a lot of trouble. It causes
my eyes to water, my nose to run, and my
throat to burn. I figured that's out because a long
time ago I used to do autop with an open
jar of formuline or formaldehyde sitting next to me on
the cutting board so I could easily play specimens in it.
There was a time period for about a month I
kept getting sick every time my autopsied. I thought I
(02:12):
had the flu, but the symptoms they would go away
after a short period of time, and then would come
back again. When I autopsied again. I then realized it
wasn't the flu, and I thought I have to be
allergic to something. And I thought about everything associated with
the autopsies. Had something changed. Was I using different gloves,
different gowns, or a different mask. None of that had happened.
(02:33):
So then I started thinking it has to be something
in the air. Because I didn't have a rash. I
just kept having sore throat, running nose, irritation in the eyes.
So I figured the formaldehyde. It could be aerosolized sitting
next to me. So I removed the open jar of formaldehyde,
and suddenly I was cured. And I realized at that moment,
after all these years of being around it, I had
(02:55):
now become allergic to fermaldehyde. It's easy enough to work
around because you don't have to have a full bottle
of formaldeyde sitting next to you to do an autopsy.
So I removed it and I've never had a problem again.
There can be several chemical hazards from different scenarios that
come in with the bodies, particularly with workers in the
sewers or fertilizer plants, meth lab explosions, suicides with things
(03:17):
like hydrogen sulfide or cinide, chemical agents that the police
use for riot control or other scenarios, and finally drug
overdoses with unique substances. Law enforcement has a variety of
chemical agents that they use for numerous different scenarios. Some
of these are riot control or hostage standoffs, or any
other situation where they're trying to employ less than lethal
fource or disperse a crowd, and they usually do that
(03:41):
with chemical agents, and these agents are commonly known as
tear gas or pepper spray. Tear Gas is a generic
term that incorporates two different chemical substances. One is known
as chlorocetofenone, which was first synthesized in eighteen seventy one
by a German scientist. It was used in combat in
World War I, and after World War Two it was
(04:03):
begun to be used by law enforcement for riot control,
especially in the nineteen sixties, and it became the main
component of chemical maze. Chloroceta finone has mostly been replaced
by another chemical which is the other tear gas that
I deal with, which is oh chlorobenzomelanitrol. It was developed
during the Vietnam War and is less toxic and delivers
more immediate effects than chloroceta fino, so naturally it has
(04:26):
become more widely used than chloroceta finone, but some law
enforcement agencies still use chloroceta finoe. The other substance of
the police uses commonly is pepper spray. Pepper spray, I've
seen a lot of and we see it more often
than tear gas. If you don't know much about pepper spray,
its main active ingredient is capsation, which is extracted from
chili peppers, cayenne peppers, and halapanios. It was first isolated
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in eighteen sixteen, and initially it was used as a
homeopathic remedy for treating burning pain, and is actually still
used for this. Pepper's proclivity for irritation has been known
for century, but it wasn't until the nineteen sixties that
it was starting to be used by civilians, specifically postal
workers trying to prevent dogs from attacking them, and in
the nineteen eighties it was recognized by law enforcement as
(05:12):
a less lethal alternative to firearms and less problematic than
tear gas. It was incorporated into their gear. Pepper spray
and tear gas are both lachrymators, which is a substance
that causes tear production. They act a little differently though.
Pepper spray itself is actually inflammatory to your body, so
your body reacts to the pepper spray, but tear gas
(05:33):
mixes with the oil and moisture on your skin to
form an acidic solution that is very irritating. They both
cause coughing, difficulty breathing, nasal and throat irritation, and running.
Nose and eye exposure can result in pain, redness, watery
eye is, difficulty opening the eyes, and light sensitivity. I
know from personal experience how pepper spray works with eye irritation,
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but I learned it from cutting up hot peppers and
then changing out my contacts. And let's just say that
it really really burns incredibly and I don't ever want
to experience that again. But pouring milk into your eye
can actually cause the irritation and inflammation to go down,
but I would not recommend trying that out. And remember
when you cut hot peppers, always clean your hands with
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rubbing alcohol afterwards to get that hot pepper oil off
your hand. The effects of pepper spray and tear gas
can last for twenty to thirty minutes, but it can
also last for several hours to days, depending on the
amount of exposure you have. Pepper spray and tear gas
have a fine parkle mist that is associated with them.
It clings to the surface of the body, the mucoastal
membrane's clothing, et cetera. And in cases that I've worked
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on that have been exposed to pepper spray and a
tear gas, I have dealt with these fine parkles. But
one of the worst cases I had was an individual
who was a thirty year old bank robber. He held
up a bank with a revolver in a semi automatic
handgun and stole about one thousand dollars. He then went
on a multitown police chase, shooting at police officers along
the way. He finally ditched his car, which was a Cadillac,
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and then ran through a wooded area and broke into
a home, prompting the residents to flee. Law enforcement and
the FBI caught up with him and then it became
a twenty seven hour standoff. Authorities used a variety of
methods to try and coax him out of the house,
including loud percussion like grenades and teargas. They tried to
talk to him using a cell phone that they tossed
into the home. They tried calling the homes landline, nothing worked,
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then they heard a gunshot. They continued to try and
contact him for a while, but without hearing any sounds
or having any communication with him, they decided to send
in a Mark five to a one bomb disposal robot,
which was equipped with sound and video equipment, to try
and locate him. The robot broke into the house and
drove around the first floor of the home, but the
(07:45):
problem was they couldn't find the body on the first floor,
so they thought he might be up the stairs, and
the robot couldn't climb up the stairs because it's just
a tracked vehicle. Finally, they had to send in sheriff's
officers and FBI agents to serve to the home. They
did find him on the second floor of the home
with an apparent gunshot wound of the head. They also
(08:06):
found the family's dog, which the decedent had evidently shot
when he broke into the home. Once the body was located,
the death investigators were called and they came out to
the scene and placed the body in a body bag
and brought it to the office that I was working
at at the time, which was a coroner's office, so
it's a little different from the medical examiner's office, but
my job was still essentially the same. The death investigators
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told me that acedent was coated in tear gas, so
before the autopsy even started, we knew what we were
dealing with. The body was x rayed in the body bag,
and we noticed on the x rays he still had
a semi automatic handgun tucked into one of his boots,
so we had to deal with that too. In chemical
situations like this, especially when we know what's going on,
we follow a particular procedure. Before we opened the body bag.
(08:52):
The body's taken into an intake bay. Usually at a
medical examiner's office or corner's office. There's a large garage
area where funeral homes come in and drop bodies off,
and it's this big, open garage space that has a
lot of ventilation. We'll also set up fans and get
the air moving around before we even open up the
body bag. So in this big space it makes the
(09:12):
chemical less concentrated. When the body bag is open and
when the autopsy is started, and the body bag's finally opened,
we'll photograph the body as is and then quickly remove
the clothing and place the clothes and bags that are sealed,
and then the body is scrubbed down with a soap
to get all the substance off of them. We usually
use dawn dishwashing liquid, the same soap you use to
wash your dishes. It is great for prepper spray, tear gas,
(09:35):
and really bad oily decomposed bodies. It's the go to
soap for most medical examiners' offices, and that's what we
did for this particular case. We put the body in
a large intake area and set up fans and got
ready to start, but at the last moment one of
the death investigators ran in and said, hold on, stop,
before you start anything, we have to get our grill
(09:56):
out of here because we don't want it to get
contaminated with this tear gas crap, and then we can't
have our brots and hot dogs later on in the day.
At that particular office, on slow days, they would have
cookouts and they stored their grill in the intake bay
area because they didn't really have it anywhere else to
put it, and They were very concerned that when we
opened up the body bag that the tear gas would
(10:16):
get on their grill and potentially disrupt the exquisite taste
of the broughtwers and hot dogs that they were planning
on cooking that day. It's odd to think back on
it and realized that they were never really worried about
when we had decomposed bodies in there, But it's best
not to think about so. Once the grill was removed
and secured, we started the decontamination process and followed the
procedure which I talked about. As soon as the bag
(10:39):
was opened, my eyes and throat started burning, even with
full ppe. The autopsy tech and I worked quickly as
a team removing the clothes. We secured the semi automatic
handgun that was found in a holster in his boot
and removed it. It was fully loaded, but we were
prepared for it, and law enforcement was there to take
the gun into evidence. The clothing was quickly removed, moved
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and placed in bags, and the body was washed down
with dawn until all the tear gas was gone. By
the time we had it all decontaminated, the autopsy tech
and I were both tearing up really bad coughing and
had headaches. So we took a brief break, changed out
our gear, and then started the autopsy. What I founded
autopsy was that seed and had a single intra oral
(11:20):
contact range gunshot wound of the head. The rejectile had
gone through his skull, his brain stem, and his brain
and exited out the back of his head. So the
cause of death was gunshot wounded the head, and her
death was suicide. And that was the end of that case.
And at the end of the day, after everything was
cleaned up and put away, we got the grill out
and had a cookout and the broughtwors and the hot
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dogs were excellent. Wow. And that brings us to the
final chemical exposure story for today, which is the only
chemical exposure that has caused me to go to the hospital.
That day began like any other day. I had several
autopsies due and one of them was a sixty two
year old male. He had been sick of being bitten
(12:03):
by mosquitos at his house and he told his friends
that he had come up with an extreme solution. He
told them he was going nuclear on those mosquitoes. Now,
how was he going to go nuclear? On the mosquitoes.
He did this by pouring several gallons of an insecticide
all over him. I know you're listening right now, and
you're thinking to yourself, shouldn't this be another installment of meth,
(12:26):
women or alcohol. The answer, shockingly, it's none of those,
so we won't be playing that game today. He was
just doing this completely on his own, completely sober, which
means it's even more ridiculous. He took several gallon containers
of the insecticide and started pouring them all over himself,
saturating his clothing, his skin, his hair, his beard. And
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after doing this, he just started going about his day
and walking around outside. His friend said, all of a sudden,
he started becoming dizzy, and he collapsed to the ground
right at the base of his tastefully decorated gazebo. He
began seizing and became unresponsive. Of course, his friends panicked,
which who really wouldn't, and called nine to one one,
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and when the emergency medical service personnel arrived, he was
unresponsive and not breathing. When they evaluated him, they found
he had no pulse. They initiated CPR, but eventually declared
him dead at the scene. The paramedics noted there was
a strong chemical odor that smelled like garlic about his body.
Were there vampires about well, I guess I guess there were,
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because there were mosquitoes. Technically they are vampires, but the
smell they were smelling wasn't from garlic. It was actually
from the chemical he had poured all over himself. The
death investigators eventually arrived, got the information, placed the deceit
in a body bag, and he was brought to the
medical Examiner's office. The investigators were still trying to clarify
(13:54):
what he exactly had poured on himself, but they didn't
have that information for me. Before I started, we made
sure to follow the chemical hazardous procedures that we have
already discussed. So the body was brought in, it was
taken to our big intake area. Fans were put in
place to circulate the air, and the two autopsy technicians
and I put on our ppe and got started. We
(14:18):
opened the body bag and there was a very strong,
distinct chemical odor that indeed did smell like garlic. So
we quickly removed the clothing and began scrubbing the body
with dawn. And while we were cleaning him. One of
the autopsy technicians took a hose and she put her
thumb over the opening, trying to make it spray harder
to get the soap off. And when she did this,
she sprayed a portion of the body that had not
(14:39):
yet been cleaned and was still covered with the chemical
The water stream reflected off the body with the chemicals
and hit me on the only exposed portion of my body,
which was my neck, and it soaked me instantly, seeping
down my shirt, covering my back with water. It happened
incredibly quick. I had been hit with a significant amount
of chemically contaminated water, and I tried to get out
(15:01):
of the way, and of course the autopsy technician stopped immediately,
and she began instantly apologizing and saying she was sorry.
I stopped what I was doing. I drive myself off,
but it had soaked a good portion of my undershirt.
I didn't think much of it. I had gotten fluids
on me before and kept working, and I thought, well,
this is just water, I'll be okay. So I went
back to work. I put my ppe back on and
(15:23):
proceeded with the examination. But this wasn't normal bodily fluid.
It wasn't vomit, urine, blood bile, or any of the
other things that they had gotten on me over the years.
This fluid was contaminated with a chemical that I didn't
know quite what it was yet, and I should have
changed my clothes at that moment and cleaned it off myself,
but I had work to do, and I just didn't
(15:44):
really think much of it, and that was my fatal flaw.
I proceeded with the autopsy. The external examination had no
real findings. Internally, there was pulming, congestion and dima of
the lungs, which means there's fluid on the lungs, and
we see that in overdoses, heart failures, drownings, among other things.
His heart was enlarge, He had hardening of the arteries
of his heart or cornyathosclerosis, so he had significant heart disease.
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It could be a drug overdose, because his friends said
he wasn't using drugs, But actions of this kind don't
make sense, and when it doesn't make sense, you always
think what drugs are they on? And who knows what
the chemical was. So initially I made the case pending,
meaning I was waiting for more information before I could
determine the cause manner death. And then later that day
we finally got the name of the chemical that he
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had powered all over himself, and it was called malthione.
Malathion is an organo phosphate insecticide. It has a strong
smell of garlic associated with it. It is used to
control insects, especially mosquitoes, and it has been used by
public health in different states for mosquito control and fruitfly eradication,
and even life control. It's in some life's control shampoos.
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It doesn't really affect people in small amounts, but it
will kill the insects. Malathione works by inhibiting an enzyme
in the insects nervous system as well as in ours,
which results in elver stimulations of the nerves, which causes
the insect to eventually become paralyzed and not be able
to move or breathe, and then they die and humans
we can breathe it in or rapidly absorb it through
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our skin and add a high enough exposure, humans will
start exhibiting symptoms, and those are nausea, vomiting, muscle trimmers, cramps, weakness,
shortness of breath, headache, slowed heart, rate, abdominal pain, diarrhea,
blurred visions, salivation, sweating, dizziness, and loss of consciousness, and
at higher concentrations it can cause death. So let's get
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back to what happened to me. I finished the autopsy,
changed out of my work scrubs, but I still had
on the same undershirt, and a little bit later on
in the day, I started feeling sick, and so I
decided to go home. When I got home, I changed
out of my clothes, took a shower, put on some
comfortable clothes, and imnutally went to bed. This is where
things get a little fuzzy for me, my wife, Beth said.
(17:54):
When I laid down, I pulled the covers up to
under my chin, and I was shaking and sweating, and
my lips looked blue. The sickness had come on so quickly,
unlike anything else I had ever experienced. I told Beth,
I felt like I had the flu, But she looked
at me and she felt like it didn't look like
the flu at all. She felt like it came on
too fast, and she asked what had happened that day,
(18:15):
and I told her that several autopsies like usual, and
I got splashed by some water, but nothing really of note.
And that's when Beth said, was there anything special about
the one autopsy that you got splashed by? Because she said,
what's going on? Isn't right? I told her, yeah, the
body had some sort of chemical on it, and I
was thinking, what did it get exposed to? Could it
really have been a simple ill directed splash from a
(18:37):
hose that started this chain of events. At that moment,
all I knew was the name malothion. I hadn't had
time to read about what it was or what the
symptoms were associated with it. I just knew the name.
And Beth said, something is really wrong and you should
call poison control because they'll know what that chemical is
all about. And I thought, you know, she's correct. I
(18:58):
got up and for some Rea and I went into
our closet and I called poison control. When the poison
control operator answered, I told her my name. I told
her I'm a medical examiner. I was doing an autopsy
today and an individual who got exposed to a chemical
and I'm experiencing symptoms. The operator said, okay, well, that's
all very interesting. Do you know the name of the
chemical or what it looked like? And I told her,
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I do indeed know the name of the chemical. It's malathion.
And she asked, what are the symptoms you're experiencing right now?
And I told her exactly what was going on. I
felt nauseated, was sweating profusely. It felt like I had
the flu, and I was shaking, and I had started
experiencing diarrhea. And in a very calm, clear voice, she said,
you need to go to the hospital right now. You've
(19:41):
been exposed to an organophosphate pesticide and you are following
the classic symptoms. This could end up being deadly. I
heard this. I thanked her. She didn'thaps tell me twice.
I hung up, and I thought I'd already done an
autopsy and a guy who killed himself with this stuff,
and it could kill me, so I took it very seriously.
It was early in the evening on a Friday. Beth
(20:03):
and I usually had plans to go out for dinner,
but that night it was going to be different. I
came out of her room and I told her I
need to go to the hospital immediately because the poison
control person said I had been exposed to a hazardous chemical.
And I explained what she had said to me, And
Beth said, Okay, let's go to the hospital right now.
You're just getting sicker and sicker and we need to go.
And she said, I'm driving. I was in no shape
(20:25):
to drive anyway. My vision was actually a little blurry.
When we got to the local hospital and explained to
the emergency room staff who I was and what I
had been exposed to, they got actually quite excited and said,
oh boy, it's a poisoning exposure, and a rare one
at that. You know, when you go to the emergency room,
you never want the staff to be excited to see
you because of what you've been exposed to, what's happened
(20:47):
to you, because that means it's really bad. And so
quickly they got me into a room and they drew
blood and did blood tests and urine tests, took me
up to an IV, made sure I was on a
pulsax seminar, checked my oxygen levels, did an X ray
and EKG and the er doctor said to me, what
exactly was the chemical again, and I said malathione. And
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I told him call poison control they had all the information,
and he did and when he came back to the room,
he knew what he was dealing with, and they did
have the antidote, which is atropine, but the emergency room
doctor decided, based on the information, he didn't think I
needed the antidote right at that time. He wanted to
wait and see if I started to get better. He said,
(21:30):
malithione has a short half life, and right now you're
showing the classic symptoms of being exposed to this toxin.
But let's see if things get worse over the next hour,
and then if we have to, we'll give you the antidote.
Over the next hour, my symptoms did indeed start to
become less and less. The nurses kept checking, and over
the next several hours, I was getting a lot better.
(21:52):
The doctor came back and said he didn't think I
needed the antidote. He still wanted me to stay to
just make sure I was going to be okay. One
of the nurses came in during this time period and
asked we were hungry because it was starting to get late,
and I said, well, yes, you know, usually Beth and
I go out to dinner on Fridays. Like the nurse cared,
so hooray we can still enjoy date night. The nurse
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made an odd face to this statement, left the room
and later returned with the menu. The hospital was actually
trying out a new food service, and the menus she
brought was a fancy trifle menu with glossy photographs of
glorious food items. There was steak, salmon, chicken, and classic hamburgers.
The photograph of the hamburger showed a hamburger with a
sesame seed bun, bacon, and a thick, juicy patty with
(22:35):
all the trimmings. They looked so good to us, and
we decided to get the hamburgers, fries, and a dessert.
The nurse said, unfortunately, the food was for patience only,
so Beth was out of luck unless she wanted to
leave the hospital, which she did not want to do.
She was going to stay with me until this was over,
so we decided to share. When the food arrived, it
(22:56):
was not like the pictures. It showed up in a
styrofoam takeout container. The hamburger was a thin, overcooked, dry
patty with nothing else on it. There was no condiments
on the burger or included with the meal. It was
not as glorious as previously pictured. The fries were soggy,
and had no salt on them. It was just sad,
(23:17):
just really really sad hospital food, just like always like
the food I experienced in medical school and residency when
I used to work at the hospitals. And the worst
part was the dessert wasn't even my favorite hospital dessert,
which is banana pudding with little vanilla wafers. I loved
that stuff. It was this eerie green jello that looked
(23:38):
like it had a disease of its own. As pathetic
as the meal was, Beth and I still split it
and each had our share of the hamburger and fries.
We threw away the infected jello, and I am sure
it later crept out of a trash can and is
taking over someone's mind as we speak. And we waited.
Eventually I started sweating last my heart right came down.
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I didn't even feel nauseated anymore, and the diarrhea was
long gone. It was getting close to midnight. The emergency
room doctor came in and asked me how I was doing.
I told him what was going on, and he said, well,
it appears the worstest behind us, but we still want
to see what happens. So a little after one am
I was feeling pretty much back to normal, and around
two am, the doctor decided I was no longer experiencing
(24:21):
any of the problems associated with malth ion and I
got to go home. On Monday of the next week.
I told my boss what had happened. He actually made
sure the county paid for my entire hospitalization, even my dinner,
so that was kind of nice. I got a free
meal out of it. Wasn't the best way to get
a free meal, wasn't the best meal, but free is free.
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I found out later from the autopsy technicians I was
working with that day that they did not actually end
up having any of the symptoms associated with the malthion,
just me because I was the only one that got sprayed.
The two paramedics that had responded initially to the nine
to one one call actually had to be hospitalized because
there exposure to the chemical and they had to be
(25:02):
admitted to the hospital for greater than twenty four hours.
So really I got off lucky in the end. The
paramedics and I were all okay. Anyway, When the decedents
toxicology came back, it showed the absorbed a fair amount
of the malothion into his system, and he had no
other drugs on board, so his cause of death was
actually from the malothion with a contributing factor of his
(25:22):
heart disease. His manner death was accident. Sure, he was
trying to kill the mosquitos. I don't think he meant
to die, so it wasn't a suicide. And that was
the end of the case. The nuclear option, well it
it worked, but a little too well because it just
didn't kill the mosquitos. It also killed him and almost
killed me and two paramedics. And after all these years,
(25:44):
nothing else has gotten me that ill like the maloth
ion did on that day, and I've had no long
term consequences from it, at least I don't think so.
The hospital I went to actually changed food services shortly
after I was there and brought in his bucks, so
I'm sure the food is much higher quality now. There
was one consequence from this case, though Beth Forever referred
(26:08):
to that autopsy technician as Splashy. Sadly, this was not
a one time occurrence, and Splashy ranks as the autopsy
technician that has splashed me the most with different fluids
in her very short career. Before we close the episode out.
If you ever think you've been exposed to something anything,
Poison Control is always there to help, and they are
(26:28):
incredibly knowledgeable and very patient, and we'll explain everything to
you in the most calm and patient manner. So if
you think you've been exposed or poisoned, give them a
call at Poison Control one eight hundred two two two
one two two two. I even have their number taped
on the side of my toolbox that I put my
autopsy equipment in it, and that brings us to the
(26:53):
end of the episode. I hope you learn something like
don't coach yourself in Malithion to kill mosquitos, because you
will die. And I hope you were entertained until the
next time.