December 1, 2025 • 29 mins
Content Warning: This episode discusses eating disorders, starvation, and medical neglect. Listener discretion is advised.
This week on Pathology with Dr. Priya, a Zone 7 series, Sheryl McCollum and Dr. Priya Banerjee look at some of the most painful and complex ways a body can fail, from starvation and radiation exposure to delayed deaths that can take years to claim a life. Dr. Priya Breaks down the science of how the body deteriorates during starvation, explains why children in famine zones appear bloated, and discusses both abuse and eating disorder cases that show the psychological and biological devastation of prolonged deprivation. They also explore radiation-linked illnesses, the hidden risks of environmental exposure, and what happens when a wound or poisoning leads to death years later. Through every case, Dr. Priya explains the forensic details behind a “slow death” and why, for the body, nothing about it is slow.
Highlights
• (0:00) Sheryl welcome listeners and introduces the topic: slow deaths
• (3:00) Why Thanksgiving reminds Sheryl of slow deaths and what starvation really is
• (4:00) Dr. Priya explains how starvation breaks the body down from within, and how it can stem from both illness and abuse
• (12:45) Dr. Priya describes why starving children often appear bloated and the biology behind kwashiorkor• (16:15) Radiation exposure: how time, dose, and distance determine long-term damage
• (20:45) Delayed deaths, paralysis, and the challenge of proving causation
• (26:15) "Death by a thousand cuts": how blood loss from minor wounds can still be lethal, and how even old wounds can become deadly decades later
• (29:00) Closing thoughts: Sheryl and Dr. Priya reflect on the cruelty of slow deaths
About the Hosts
Dr. Priya Banerjee is a board-certified forensic pathologist with extensive experience in death investigation, clinical forensics, and courtroom testimony. A graduate of Johns Hopkins, she served for over a decade as Rhode Island’s state medical examiner and now runs a private forensic pathology practice. Her work includes military deaths, and high-profile investigations. Dr. Priya has also been featured as a forensic expert on platforms such as CrimeOnline and Crime Stories with Nancy Grace. She is a dedicated educator, animal lover, and proud mom.
Website: anchorforensicpathology.com
Twitter/X: @Autopsy_MD
Sheryl “Mac” McCollum is an active crime scene investigator for a Metro Atlanta Police Department and the director of the Cold Case Investigative Research Institute, which partners with colleges and universities nationwide. With more than 4 decades of experience, she has worked on thousands of cold cases using her investigative system, The Last 24/361, which integrates evidence, media, and advanced forensic testing. Her work on high-profile cases, including The Boston Strangler, Natalie Holloway, Tupac Shakur and the Moore’s Ford Bridge lynching, led to her Emmy Award for CSI: Atlanta and induction into the National Law Enforcement Hall of Fame in 2023.
Email: coldcase2004@gmail.com
Twitter/X: @ColdCaseTips
Facebook: @sheryl.mccollum
Instagram: @officialzone7podcast
Preorder Sheryl’s upcoming book, Swans Don’t Swim in a Sewer: Lessons in Life, Justice, and Joy from a
Forensic Scientist, releasing May 2026 from Simon and Schuster.
https://www.simonandschuster.com/books/Swans-Dont-Swim-in-a-Sewer/Sheryl-Mac-McCollum/9798895652824
If this episode gave you a new understanding of the science behind slow deaths, share it with a friend and leave a review. Your support helps others discover the science, the stories, and the heart behind Pathology with Dr. Priya | A Zone 7 Series.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:08):
Welcome to pathology with doctor Priya. Doctor Happy, Happy Thanksgiving
you too.
Speaker 2 (00:15):
I'm I must say I missed out on your baking.
Some of that Southern pecan pie look delicious.
Speaker 1 (00:22):
Oh honey, let me tell you made with Lord too.
We weren't even trying to hide.
Speaker 2 (00:27):
No, no, there's no there's no scrimping during the holidays, Nope.
Speaker 1 (00:32):
And there's just no substitution. I mean, either it's going
to be you know, great Grandma's recipe or it's not.
Speaker 2 (00:37):
Oh, I treasure those family recipes. Yes, So as as
we proceed, I want to share some funny holiday stories.
And you know, my upbringing was a little non traditional.
I think there's probably some listeners that can relate to
it because my parents were immigrants, right, so they didn't
grow up with Christmas.
Speaker 3 (00:56):
But so now I'm a parent.
Speaker 2 (00:59):
I think I've mentioned that in the past, and my
daughter is now going to be twelve next month, so
the charm of Santa's were worn off. But I did
want to say that some of the followers who see
me online, I shared a memory where I had So
this is a parenting hack, if you will. If anybody
has Santa believers in their house and I had put
(01:23):
the my cell phone number as an entry and I
called it Santa Claus, the Big Man in my phone.
So every year I would tell Dia that I could
text Santa if she was misbehaving or not reading, et cetera.
Speaker 3 (01:39):
So I want.
Speaker 2 (01:39):
People if if my uh you know, forensic mind when
when you when you need parenting help, you pull out
all the stops, you know. So I still have it
in me and my my own numbers called Santa Claus
the Big Man in my phone. So maybe someone else
will use it and they can blackmail their kids a
little longer.
Speaker 1 (01:59):
Can I do tell you? I thought you were going
somewhere completely different. I thought you were going to say
you had David or a good friend call your phone
so that she could see who was calling to tell
her how great she was doing it, that she was getting.
Oh that is so f funny.
Speaker 2 (02:18):
I mean I would text myself and then it would
say Santa Claus and she was I was like, see,
if you don't do your reading, Sana, I have a
direct line of Santa. She said what And she would
grab my phone and check and then see, and I'm like, yep,
you know. So she hadn't figured out the loophole. But
some people on Facebook when I shared that memory have
been laughing because they were like, that's so smart.
Speaker 3 (02:41):
I was like, oh, yes, whatever it takes.
Speaker 2 (02:43):
So without further ado, but maybe with the month of
December approaching, maybe some people can use this tip. It's
not Unfortunately now it's not working for me because we've
outgrown it.
Speaker 1 (02:55):
Understood. Well, we just had Thanksgiving and you mentioned some
of the you know, dishes that were going to be
served all over the liace. So people had so much fun.
I know, I saw so many posts where people were
just celebrating with friends and family, and I know you
and I were just super grateful of all the people
we got to be around.
Speaker 3 (03:16):
And that's why it's my favorite holiday.
Speaker 2 (03:18):
I don't want it skipped over right, Like there's no gifts,
know nothing other than people, people you love far, you know,
near and far and grud food.
Speaker 3 (03:27):
We're not skimping on the diet, that's right.
Speaker 1 (03:30):
No, it's a wonderful holiday. It should not be overlooked
in any way, you know. But because of that, one
thing that was in my mind is slow deaths. And
you know, I think a lot of times people will
sometimes joke if there's somebody that don't care for and
an X or something, and they'll say, oh, I hope
his death is slow and painful. You know, yes, yes, yes,
(03:53):
But when you start looking at those deaths and the
one I want to start with just because we had Thanksgiving,
let's talk about starvation.
Speaker 3 (04:01):
Oh it's heartbreaking.
Speaker 1 (04:03):
Oh it's heartbreaking, and y'all the torture of it. I
just think for somebody like doctor Priya to walk us
through what happens to your body during starvation because you know,
in a southern household, if you're supposed to eat at
six and it's five point forty five, you're starving. You
will tell people my you know, stomach thinks, my throat's
(04:26):
been cut, Like I'm so hungry. I'm I'm starving to death.
But we're not starving to death. We're not even super
hungry yet. But we say starving to death. But if
you are literally starving to death, doctor, what happens to you?
Speaker 3 (04:41):
Oh?
Speaker 2 (04:42):
There's so much And I hate to say this. I
recently just I think last week, commented on a case
out of Wisconsin that was a starvation death in a
Oh god was it a teenager? But I mean she
weighed like thirty five pounds or something, you know, And
my daughter just went for her check up and DIAZ
five three and one hundred and ten pounds completely proportionate.
(05:04):
And I think that's eightieth percentile. So that just gives you,
like an idea. I think this girl was supposed to
be older than my daughter. And obviously, you know, hike
can differ, but just thirty five pounds or whatever it was,
it just gives you an idea, right, Like.
Speaker 3 (05:18):
You don't even think about thirty five pounds. It's like
a toddler, you know.
Speaker 2 (05:22):
I mean when we say skin and bones, the level
of torture that takes to get to that extreme level.
And I say extreme, you know, we you know, in
this diet culture, you know, can be taken too far.
And I want to say that starvation is not always
(05:46):
a homicide, okay, And I say that because unfortunately, eating disorders,
you know, I've had friends with eating disorders, body image issues,
and it's very much in the media, and that is
a severe illness and unfortunate. I have autopsy people who
have died from anorexia, believe it or not. So even
in this country where food is plentiful, you know, sometimes
(06:09):
it's self induced, right, so the anorexia bolima goes so
far that it is severe and leads to starvation.
Speaker 3 (06:17):
So whether it's.
Speaker 2 (06:18):
Self induced or you know, food is restricted because of abuse,
you know, it's the same physical changes. Do you understand,
Like it's just restricting food, and during anorexia there could
be over exercising to compensate, you know, to burn more calories.
Speaker 3 (06:37):
So again, the rate of getting there.
Speaker 2 (06:40):
The path of getting there, the psychology behind getting their psychology, psychiatry,
if you will, of getting.
Speaker 3 (06:47):
There can be different.
Speaker 2 (06:48):
But when we say starvation it is bad, it is
not I'm trying to lose a few pounds before putting
on my black dress for a gala. Do you understand
this is pro law o months and months of nutritional depletion.
This is not I'm cleaning up my diet. So I
(07:08):
want to be you know, I sort of want to
have a trigger warning in this discussion as well, because
if anybody knows anybody with the eating disorder or you know,
can be triggered with this conversation, just to step away, please,
because it can be such a chronic condition. Now moving
away from I mean, I'm not a psychological expert. It's
(07:29):
just what i've you know, personally dealt with. And unfortunately,
even in this day and age, both in my medical training,
I had seen a young girl who I thought was beautiful,
and she was beautiful but like healthy, you know, on
the outside. I was seeing her in an outpatient setting
with another doctor when I was rotating, and I remember
(07:49):
she was a college student and she said, I have anorexia.
So we had to like work her up for electrolyte problems,
protein efficiency. I mean, you know, when we go for
a check up, she looked great, do you know what
I mean?
Speaker 3 (08:03):
She looked athletic.
Speaker 2 (08:04):
To me, she looked well dressed, meet and clean. I
still remember her face. She had a blonde bob. I mean,
no one on the streets would say, oh, she looked sick.
She was walking talking jolly, you know. And I think
that's the sad part is even when we are facing it,
people don't always register it as a active issue, you
(08:25):
know what I mean. So that's where the awareness has
to come in. And then there's the horrific part. We
just had an abuse case in Rhode Island. I did
not autopsy that person, but what was released on the
news was also sort of like a chronic abuse. And
I wonder if there was a malnutrition component to it
or a starvation you know, where she was kidnapped and
(08:46):
held hostage and abused in many ways. And so and
I also don't want to make it just a gender
like the female gender. There it's well known that men
or males, you know, people who identify as male can
be affected by eating disorders or they could potentially kidnapped
(09:09):
and also held hostage. So I mean, unfortunately, the stories
that I know of just happened to be in women.
But I don't want that to be to you know,
paint the wrong picture that the awareness everywhere.
Speaker 1 (09:24):
Well you know we've seen pictures even in wartime, I
mean starving people, men in concentration camps. I mean exactly
that standard. Yeah, right, But I know, for me, the
first time I ever heard anything about anorexia, I'd never
heard of it, didn't know anything about it was Karen Carpenter, Yes, yes,
(09:46):
And I mean I was a huge fan, you know,
and she was so popular, She was so popular and
so gifted.
Speaker 2 (09:53):
And I mean she had I mean, if you think
about it, in the circles that she traveled, I mean
there was people would probably cater to her any whim.
If she wanted to eat something flown across the world,
she could get it, you know what I mean. It
wasn't that it was a lack of food, but the
psychological it's a manifestation of how severe the psychological disease is.
You know, now, like when we think about either self
(10:17):
induced starvation aka anorexia, bolima, eating disorders or I mean,
in some ways you see starvation as the end result
of a complication, like let's say long standing dementia or cancer.
Even right, the cancer eats away at the body. I
mean when people people I hate to say don't die
(10:37):
necessarily have cancer or dementia. It's a complication. But oftentimes
you'll hear at the end of life, elderly people stop
eating and drinking, right, and then they waste away.
Speaker 3 (10:47):
So all of.
Speaker 2 (10:48):
These things that are happening is that you know, the
body is shutting down again. The rate at which they
get there, the severity, it can all differ. But we
you know, we regard regardless of what we're dieting and
what we're doing. If you think about it, I can
eat a cheeseburger tonight, that's terrible for me, then I
can turn around eat a salad like. Our body regulates
(11:08):
all that, right, the amount of salt we eat, the
amount of sugar, whether we have five thousand calories on
Thanksgiving like, and then we eat a lot less the
next day because we don't feel good. Whatever it is,
there's a very tight regulation, right. And then to the
body is built to retain that equilibrium, right, because everything
(11:29):
works within a very narrow range, and that's how our
body is built, and everything's connected.
Speaker 3 (11:34):
So as soon as we start pushing.
Speaker 2 (11:36):
Away from giving the body the energy, the water, the
electrolytes it needs, that's when things are going to shut down.
So specifically what happens is, you know when we go
to starvation. I mean, especially if you have stuff, you know,
pictures like unfortunately concentration camps or I mean you've seen
(11:57):
African countries that go through famine, right, all of those
are very uh what I would say, prototypical pictures of
what the bodies look like.
Speaker 3 (12:05):
They just look like skin and bones.
Speaker 2 (12:07):
You know, and the body ultimately has to eat away
at muscle and fat stores to try to survive. Right,
So everything is being broken down. So even people who
are you know when they get anorexic if you think
about it, or they lose so much body weight to
try to compensate anorexia being one pathway if you will,
(12:29):
you know, the body starts breaking down energy stores. Now
energy stores there are sort of smaller ones in the
liver and muscle, which are just what we use for
short term energy, like glucose like and but that's what
gets us through exercise, even a marathon or something like that. Right,
but days out, weeks out, months out, that's no longer present.
Speaker 1 (12:50):
Dodge, let me ask you this. In those famine countries,
why are the children's bellies poked out like they're stuffed?
Speaker 3 (12:59):
Sure, so if I.
Speaker 2 (13:00):
Could just keep going and then we'll get to the kids.
Speaker 3 (13:02):
Sorry, yes, because it looks like you're.
Speaker 2 (13:11):
Like you have a fat belly, right, almost like that
those toddler bellies, you know what I mean. So what
happens is it's actually this weird presentation of starvation. So
once we go down to like we can't we don't
have any more sugars to break down in our body,
we then go down to breaking down fat and then muscle. Okay,
(13:31):
and people don't see muscle as a form of energy.
But when everything is gone, you know, we think about
first sugars.
Speaker 3 (13:38):
Then fats, then muscle.
Speaker 2 (13:39):
Okay, we don't want to break down muscle because that's
a weakening. But what happens is at some point something's
got to give, right, the body is gonna self digest itself,
trying to keep itself alive, and then you get all
these weird manifestations, meaning the heart gets weaker, the lungs
get weak, or your immune system gets weaker where you
(14:02):
can be very susceptible to infections, and this weird sort
of bloating that you see. Okay, the starvation body habits,
especially in those kids, like when you know, you see
toddlers with bellies where their abdominal walls are weak and
they have these big toddler bellies sticking out. Well.
Speaker 3 (14:20):
In starvation, what happens is.
Speaker 2 (14:23):
Those abdominal muscles get weak because they get eaten away.
There's you know, the body's trying to hold onto any
fluid possible.
Speaker 3 (14:32):
Okay, and then you get.
Speaker 2 (14:35):
This nutritional wasting with severe protein deficiency. Now this is
a big word, but I had to look it up
in preparation. Quashy core all right, Uh no, it's quashio
core that is like severe protein deficiency associated with starvation.
So it really is disrupting your metabolism, like the body
(14:58):
slows down to basically like trying to regulate temperature and
expend as little energy as possible to function. Do you
understand this is not any kind of extra energy being expended,
So this koashier core is a it's like a type
of malnutrition, and you get like fluid and air building
(15:19):
up in the abdomen, you get that bloating. But the
rest of them, if you think about those pictures, you
get very gaunt faces, like there's no cheek fat, their
temples are sunken in because the temples have muscle, like
the rest of it's just wasted.
Speaker 3 (15:34):
So it's this very i would.
Speaker 2 (15:36):
Say, characteristic presentation. And then what the other thing you
see is that sometimes the body will grow very fine
hairs called lunugo.
Speaker 3 (15:50):
It's almost like baby hair.
Speaker 2 (15:53):
Some of you know, I have naked cats and then
sphinx cats and in the winter they get these like
almost like velvet type growth on their body because their
bodies are adapting to the colder environment. And that's literally
like analogous to what happens in the human body when
it's so cold and there's no fat and muscle to regulate,
that's when you know the body that's a very end stage,
(16:17):
like a very severe sign of starvation.
Speaker 1 (16:23):
Other than starvation, let's talk about radiation. So the radiation damage,
I think most people would think, like Aaron Brockovic, like
over time, like how long is this going to take?
Speaker 3 (16:35):
Well, that's harder for me to say.
Speaker 2 (16:37):
I think the big thing you have to talk think
about is, you know, because it's a dose dependent and
how much radiation you're getting exposed to, Like, so is
it environmental radiation? Like you know, you think about like chernobyl,
like no one can go in there right after that
that area is not safe. But they're supposedly like chernobyl
(16:59):
cats or something thing that are radioactive.
Speaker 3 (17:04):
And you know, so.
Speaker 2 (17:07):
You have to think about how much is in the environment,
and then you know, what is your proximity?
Speaker 3 (17:16):
Does that make sense?
Speaker 2 (17:17):
Like how close you are to it now? And is
it in the soil? Is it getting in your food?
Is it in the water? You know, And that's the
kind of if I recall correctly, she was Aaron Brockovich
was concerned about like contaminated water. But if you think
about it, like you can have you can live near
a nuclear plant, you can live you know, there's all
these things we don't know of about, you know, whether
(17:41):
businesses are leaching chemicals or you know, into the environment.
When we work with radiation. When I've worked with radiation
both in a hospital in the emy setting, So usually
what happens is radiation can be used as cancer treatment, right,
And I have a friend's son who's actually getting pediatric cancer,
who's getting radiation quite a bit of it, and they're
(18:01):
monitoring him, and you know, he has to worry about
exposing the family, right if in a house. So then
what happens Sometimes I get patients who pass away but
they have received radiation beads for prostate cancer or colon
cancer or whatnot, and they will set off the.
Speaker 3 (18:24):
Detector for radiation.
Speaker 2 (18:25):
We scan them, you know, so because we would have
to let that deteriorate before we can safely do an autopsy,
you know.
Speaker 3 (18:33):
And so this goes back.
Speaker 2 (18:34):
To our exposures are work risks, right, So sometimes we
have to delay the autopsy until the Geiger counter reads zero.
Speaker 3 (18:45):
And so everything is slow.
Speaker 2 (18:47):
But there can't I mean, I think when you have
radiation exposure. I would think it's years of exposure to
cause enough DNA damage to then result in cancer. You understand,
because it's at the DNA level that this mutation's happening.
And then it has to happen, and the body has
(19:08):
to fail at getting rid of those pre cancerous cells,
do you understand, So it has to be multiple hits,
and then your body usually has a sort of monitoring system,
if you will, you know, trying to keep the house
clean and get rid of cancer cells. But sometimes that fails,
and then that one cell becomes the trigger for a
(19:30):
cancer's growth. Right, it evades the body systems and starts
taking over. But I suspect that is years to happen,
and I wouldn't say that it's one hundred percent of
people that are exposed to radiation are going to get cancer.
Speaker 3 (19:47):
Do you understand that?
Speaker 2 (19:48):
Like, I think there's incidences of higher like types of
cancer in certain areas. Like they think, what was that
thing in Boston or Boston area they were talking about
a few nurses that had there was a cluster of
nurses or something that had cancer.
Speaker 3 (20:05):
But I don't think there's a.
Speaker 2 (20:08):
I don't know that case I'm not involved in it,
so I could be misquoting it. But I don't think
there's been a direct cause and effect, you know. I
think there's a suspicion. And the cluster of nurses was
or hospital workers was very concerning, you know. And so
if you see that in kids, or or if you
see it you know there's a cluster of kids in
a certain area or a certain type of disease that
(20:31):
shows up, you know, that's when you think about environment
such as radiation or chemicals that are dumped, you know,
unknowingly in the area, toxins that then go to cause cancer.
Speaker 1 (20:43):
Well, the last thing I want to ask you about
this kind of comes to my mind every time I
think of a slow, crazy death. There was a guy
in Atlanta that got stabbed in the head with a
pretty significant butcher knife, and he's sitting up, he's talking
to the medical folks, he's talking to law enforcement, and
(21:04):
the result was if we leave it in, he's going
to die. If we remove it, he's going to die.
And it was just strange for me watching this man
sit there talking, you know, perfectly able to communicate and
move about, knowing he was on limited time.
Speaker 2 (21:23):
Well, That's so interesting because I had a very similar case,
unfortunately end in depth because it was an autopsy, but
similar stabbed in the head, sliced in the head the
side of the head where there was a huge gaping
wound and really bleeding to death from it. This guy
was able to drive around for quite a bit, not
(21:44):
just and he didn't go to the hospital unfortunately, and
so it became this. They could have stopped the bleeding
and sutured the wound and treated him, you know what
I mean, But it just didn't happen, and then he died,
and I'm like, oh my god. And you know, the
amount of blood loss was all throughout the car and
his clothing.
Speaker 3 (22:03):
It was voluminous, and we're like, my god.
Speaker 2 (22:05):
When I say that scalp wounds can bleed, this was
like the extreme manifestation of it because it was one slice,
you know, an argument gone wrong, and then now this
kid is dead, you know, so that is not I mean,
that could be hours, you know before someone like that dies.
If it's a simple what I would say, like your
(22:28):
case had a little bit more penetration into the brain
or the skull, but this one was absolutely uninjured. Skull
just completely slice the scalp diagonally and the muscle.
Speaker 3 (22:39):
And it's crazy.
Speaker 2 (22:41):
Because you know, the attorney generals were very distraught, like
how are we going to prove this is a murder
because he drove around for a while, you know, and
and it is like if not for that wound, would
he have died? You know, That's really what you have
to think. And I don't actually remember how that case went,
so you know, it's not a bias. It was just
(23:01):
something I handled years ago. But you have to remember
whether it's hours delayed or days, weeks, even years, right,
Like sometimes we have people who have an injury, then
become paralyzed, then die of a complication that's like a
medical complication, right, kind of like bleeding to death if
you will, right, and then it's still a homicide. Now
(23:25):
that's not again, right, we are always going back. That's
a manner of death. That doesn't imply what will happen
in the court system. You know whether there'll be charges
or not, but or what the charges will be. But seriously,
like if you think about it, if someone dies, if
someone gets shot in the back and then five, ten, fifteen,
twenty years later they die of I don't know an
(23:47):
infection because they're paralyzed, but the paralysis was due to
the gunshot wound.
Speaker 3 (23:53):
It all goes back. Yep.
Speaker 1 (23:54):
We had those cases too, absolutely, yeah.
Speaker 2 (23:57):
And it's interesting, like I remember there's some cases where
and unfortunately those people are passing away, But there were
war veterans, you know, where someone got shot in the
war and then they were paralyzed and lived throughout and
then passed away at the veterans home, and then we're like,
oh my god, like they were shot at wartimes, so
(24:18):
like we had to we don't know all the intricacies
of the event even you know, you're like nineteen whatever, right,
like you might put Vietnam, or you might put abroad
like because people don't know necessarily, and his family's deceased, whatever.
But if you think about it, it could be decades later,
you know. So it could be not going to the
(24:39):
hospital because you're bleeding from a moon, I'll be fine
to all the way to decades later having a complication
that doesn't seem.
Speaker 3 (24:48):
Like a trauma complication, but it is.
Speaker 2 (24:51):
And so that is oftentimes some of the hardest cases
to explain in court as well, because people don't see
the connection.
Speaker 1 (25:00):
Right, he shot him five years ago, when you're charging
him with murders today, right, and.
Speaker 2 (25:05):
Then there may have already been assault with the deadly
weapon or you know what I mean, they may have
already been charges, so they're like, why are we punishing
this twice?
Speaker 3 (25:13):
Or you know, but then they up charge it.
Speaker 2 (25:14):
Right, there's a you know, so that's really where it's
finessing the legal you know, aspects of it and then
showing that, oh, look, this is still if not for
this one event, right five years ago, ten years ago,
a week ago, hours ago, whatever it is, he would
have been he or she would have been in the
(25:35):
same healthy state. And in the interim they didn't bounce
back to that healthy state.
Speaker 3 (25:41):
Right, there's nothing.
Speaker 2 (25:42):
That's if they go they get injured, and like if
I break a leg, I don't know in a fight,
but my leg heels fine and I'm running and acting
and then something happens to me and I die of
an infection in the same leg. That's not related because
I was able to get healthy again. Right, But really
understanding that it's always downhill, even if the slope is
(26:02):
very very shallow, takes years, you know, you can still
get to the end and have to connect the dots
back up to the initial event. That's a delayed death,
I mean, the ultimate delay.
Speaker 1 (26:14):
I've heard people say death by a thousand cuts, but
you know that was a torture practice. I'm not sure
I'm pronouncing it right, but ling cha lin Kai, I'm
not sure I pronounce it, but it was straight up real.
I mean, it was a torture mechanism for sure, right.
Speaker 2 (26:33):
And you know the other thing is when we have
we're talking sort of going into manner of death, but
when we look at injuries and bleeding out or whatnot,
they all contribute, right, and then you have some that
are more serious than others, but they can all I mean,
you can have superficial what seems to be non lethal
wounds when I say superficial that cause bleeding, but if
(26:56):
you have enough of them, like a thousand, they're going
to cause enough wait, blood loss, excuse me, and so
then you die from that mechanism, you know, And these
are really this is why I like to say, you know,
I like to teach, but it's not black and white
like TV. You know, this is where the nuance of
death certification. I mean, when someone dies twenty thirty years later.
(27:19):
Think about it. We have to review as many medical
records as possible to then connect those dots. I think
I just reviewed a case in private practice and I
told them please, it was two or three thousand pages
of records and I was like, oh my or eight
thousand it was something insane. And I was like, I can't, Like,
we really need to narrow this down. I just don't
(27:42):
have the time or you know, and you know, things
can be repetitive, and it was such a long process,
and you know, it was very tedious, and I don't
like billing for needless work, you know. So I was like,
if we can rehone hone down on what's important, then
I can and you know, do it. And I think
that thousands of pages, that's five or eight thousand something
(28:04):
insane was brought down to like eight hundred pages, like,
you know, a tenth of it. So that makes more sense.
But think about the voluminous details that happen in that
time frame, right when we're talking about years and this
person was in the nursing home needing exquisite care. That
it then gets really complicated to really prove it. You
(28:28):
know that there isn't an intervening event, you know, and
that's where defense lawyers are going to come in and say, hey,
you know, they had a stroke or they had something
completely unrelated.
Speaker 3 (28:37):
Why are you saying it's the gunshot? Right?
Speaker 2 (28:39):
They're just getting old and they had a natural medical event,
and it's you.
Speaker 3 (28:43):
Know, that's really where it becomes you know, difficult.
Speaker 2 (28:47):
You really have to sort out the facts, you know,
the timing, the extent, the location, whatever. Absolutely, you can't
just start charging people without being sure that the events
are in men.
Speaker 1 (28:58):
Well, doctor, appreciate it. I tell you, next time I
hear somebody say, well, I hope they have a slow,
painful death, you know what, I hope you know what
you're talking about because it is horrifying.
Speaker 2 (29:11):
Well yeah, and even our eye drop keis right, that
wasn't that wasn't an instant death, right, think about I mean.
Speaker 3 (29:19):
Different, Yeah, that's right, that's right.
Speaker 1 (29:25):
Well, I appreciate you so much and we will talk again.
Speaker 3 (29:28):
Money, Yes, take care of them, thank you, ma'am. Right,
Welcome to pathology with doctor Priya. Doctor Happy, Happy Thanksgiving
you too.
Speaker 2 (00:15):
I'm I must say I missed out on your baking.
Some of that Southern pecan pie look delicious.
Speaker 1 (00:22):
Oh honey, let me tell you made with Lord too.
We weren't even trying to hide.
Speaker 2 (00:27):
No, no, there's no there's no scrimping during the holidays, Nope.
Speaker 1 (00:32):
And there's just no substitution. I mean, either it's going
to be you know, great Grandma's recipe or it's not.
Speaker 2 (00:37):
Oh, I treasure those family recipes. Yes, So as as
we proceed, I want to share some funny holiday stories.
And you know, my upbringing was a little non traditional.
I think there's probably some listeners that can relate to
it because my parents were immigrants, right, so they didn't
grow up with Christmas.
Speaker 3 (00:56):
But so now I'm a parent.
Speaker 2 (00:59):
I think I've mentioned that in the past, and my
daughter is now going to be twelve next month, so
the charm of Santa's were worn off. But I did
want to say that some of the followers who see
me online, I shared a memory where I had So
this is a parenting hack, if you will. If anybody
has Santa believers in their house and I had put
(01:23):
the my cell phone number as an entry and I
called it Santa Claus, the Big Man in my phone.
So every year I would tell Dia that I could
text Santa if she was misbehaving or not reading, et cetera.
Speaker 3 (01:39):
So I want.
Speaker 2 (01:39):
People if if my uh you know, forensic mind when
when you when you need parenting help, you pull out
all the stops, you know. So I still have it
in me and my my own numbers called Santa Claus
the Big Man in my phone. So maybe someone else
will use it and they can blackmail their kids a
little longer.
Speaker 1 (01:59):
Can I do tell you? I thought you were going
somewhere completely different. I thought you were going to say
you had David or a good friend call your phone
so that she could see who was calling to tell
her how great she was doing it, that she was getting.
Oh that is so f funny.
Speaker 2 (02:18):
I mean I would text myself and then it would
say Santa Claus and she was I was like, see,
if you don't do your reading, Sana, I have a
direct line of Santa. She said what And she would
grab my phone and check and then see, and I'm like, yep,
you know. So she hadn't figured out the loophole. But
some people on Facebook when I shared that memory have
been laughing because they were like, that's so smart.
Speaker 3 (02:41):
I was like, oh, yes, whatever it takes.
Speaker 2 (02:43):
So without further ado, but maybe with the month of
December approaching, maybe some people can use this tip. It's
not Unfortunately now it's not working for me because we've
outgrown it.
Speaker 1 (02:55):
Understood. Well, we just had Thanksgiving and you mentioned some
of the you know, dishes that were going to be
served all over the liace. So people had so much fun.
I know, I saw so many posts where people were
just celebrating with friends and family, and I know you
and I were just super grateful of all the people
we got to be around.
Speaker 3 (03:16):
And that's why it's my favorite holiday.
Speaker 2 (03:18):
I don't want it skipped over right, Like there's no gifts,
know nothing other than people, people you love far, you know,
near and far and grud food.
Speaker 3 (03:27):
We're not skimping on the diet, that's right.
Speaker 1 (03:30):
No, it's a wonderful holiday. It should not be overlooked
in any way, you know. But because of that, one
thing that was in my mind is slow deaths. And
you know, I think a lot of times people will
sometimes joke if there's somebody that don't care for and
an X or something, and they'll say, oh, I hope
his death is slow and painful. You know, yes, yes, yes,
(03:53):
But when you start looking at those deaths and the
one I want to start with just because we had Thanksgiving,
let's talk about starvation.
Speaker 3 (04:01):
Oh it's heartbreaking.
Speaker 1 (04:03):
Oh it's heartbreaking, and y'all the torture of it. I
just think for somebody like doctor Priya to walk us
through what happens to your body during starvation because you know,
in a southern household, if you're supposed to eat at
six and it's five point forty five, you're starving. You
will tell people my you know, stomach thinks, my throat's
(04:26):
been cut, Like I'm so hungry. I'm I'm starving to death.
But we're not starving to death. We're not even super
hungry yet. But we say starving to death. But if
you are literally starving to death, doctor, what happens to you?
Speaker 3 (04:41):
Oh?
Speaker 2 (04:42):
There's so much And I hate to say this. I
recently just I think last week, commented on a case
out of Wisconsin that was a starvation death in a
Oh god was it a teenager? But I mean she
weighed like thirty five pounds or something, you know, And
my daughter just went for her check up and DIAZ
five three and one hundred and ten pounds completely proportionate.
(05:04):
And I think that's eightieth percentile. So that just gives you,
like an idea. I think this girl was supposed to
be older than my daughter. And obviously, you know, hike
can differ, but just thirty five pounds or whatever it was,
it just gives you an idea, right, Like.
Speaker 3 (05:18):
You don't even think about thirty five pounds. It's like
a toddler, you know.
Speaker 2 (05:22):
I mean when we say skin and bones, the level
of torture that takes to get to that extreme level.
And I say extreme, you know, we you know, in
this diet culture, you know, can be taken too far.
And I want to say that starvation is not always
(05:46):
a homicide, okay, And I say that because unfortunately, eating disorders,
you know, I've had friends with eating disorders, body image issues,
and it's very much in the media, and that is
a severe illness and unfortunate. I have autopsy people who
have died from anorexia, believe it or not. So even
in this country where food is plentiful, you know, sometimes
(06:09):
it's self induced, right, so the anorexia bolima goes so
far that it is severe and leads to starvation.
Speaker 3 (06:17):
So whether it's.
Speaker 2 (06:18):
Self induced or you know, food is restricted because of abuse,
you know, it's the same physical changes. Do you understand,
Like it's just restricting food, and during anorexia there could
be over exercising to compensate, you know, to burn more calories.
Speaker 3 (06:37):
So again, the rate of getting there.
Speaker 2 (06:40):
The path of getting there, the psychology behind getting their psychology, psychiatry,
if you will, of getting.
Speaker 3 (06:47):
There can be different.
Speaker 2 (06:48):
But when we say starvation it is bad, it is
not I'm trying to lose a few pounds before putting
on my black dress for a gala. Do you understand
this is pro law o months and months of nutritional depletion.
This is not I'm cleaning up my diet. So I
(07:08):
want to be you know, I sort of want to
have a trigger warning in this discussion as well, because
if anybody knows anybody with the eating disorder or you know,
can be triggered with this conversation, just to step away, please,
because it can be such a chronic condition. Now moving
away from I mean, I'm not a psychological expert. It's
(07:29):
just what i've you know, personally dealt with. And unfortunately,
even in this day and age, both in my medical training,
I had seen a young girl who I thought was beautiful,
and she was beautiful but like healthy, you know, on
the outside. I was seeing her in an outpatient setting
with another doctor when I was rotating, and I remember
(07:49):
she was a college student and she said, I have anorexia.
So we had to like work her up for electrolyte problems,
protein efficiency. I mean, you know, when we go for
a check up, she looked great, do you know what
I mean?
Speaker 3 (08:03):
She looked athletic.
Speaker 2 (08:04):
To me, she looked well dressed, meet and clean. I
still remember her face. She had a blonde bob. I mean,
no one on the streets would say, oh, she looked sick.
She was walking talking jolly, you know. And I think
that's the sad part is even when we are facing it,
people don't always register it as a active issue, you
(08:25):
know what I mean. So that's where the awareness has
to come in. And then there's the horrific part. We
just had an abuse case in Rhode Island. I did
not autopsy that person, but what was released on the
news was also sort of like a chronic abuse. And
I wonder if there was a malnutrition component to it
or a starvation you know, where she was kidnapped and
(08:46):
held hostage and abused in many ways. And so and
I also don't want to make it just a gender
like the female gender. There it's well known that men
or males, you know, people who identify as male can
be affected by eating disorders or they could potentially kidnapped
(09:09):
and also held hostage. So I mean, unfortunately, the stories
that I know of just happened to be in women.
But I don't want that to be to you know,
paint the wrong picture that the awareness everywhere.
Speaker 1 (09:24):
Well you know we've seen pictures even in wartime, I
mean starving people, men in concentration camps. I mean exactly
that standard. Yeah, right, But I know, for me, the
first time I ever heard anything about anorexia, I'd never
heard of it, didn't know anything about it was Karen Carpenter, Yes, yes,
(09:46):
And I mean I was a huge fan, you know,
and she was so popular, She was so popular and
so gifted.
Speaker 2 (09:53):
And I mean she had I mean, if you think
about it, in the circles that she traveled, I mean
there was people would probably cater to her any whim.
If she wanted to eat something flown across the world,
she could get it, you know what I mean. It
wasn't that it was a lack of food, but the
psychological it's a manifestation of how severe the psychological disease is.
You know, now, like when we think about either self
(10:17):
induced starvation aka anorexia, bolima, eating disorders or I mean,
in some ways you see starvation as the end result
of a complication, like let's say long standing dementia or cancer.
Even right, the cancer eats away at the body. I
mean when people people I hate to say don't die
(10:37):
necessarily have cancer or dementia. It's a complication. But oftentimes
you'll hear at the end of life, elderly people stop
eating and drinking, right, and then they waste away.
Speaker 3 (10:47):
So all of.
Speaker 2 (10:48):
These things that are happening is that you know, the
body is shutting down again. The rate at which they
get there, the severity, it can all differ. But we
you know, we regard regardless of what we're dieting and
what we're doing. If you think about it, I can
eat a cheeseburger tonight, that's terrible for me, then I
can turn around eat a salad like. Our body regulates
(11:08):
all that, right, the amount of salt we eat, the
amount of sugar, whether we have five thousand calories on
Thanksgiving like, and then we eat a lot less the
next day because we don't feel good. Whatever it is,
there's a very tight regulation, right. And then to the
body is built to retain that equilibrium, right, because everything
(11:29):
works within a very narrow range, and that's how our
body is built, and everything's connected.
Speaker 3 (11:34):
So as soon as we start pushing.
Speaker 2 (11:36):
Away from giving the body the energy, the water, the
electrolytes it needs, that's when things are going to shut down.
So specifically what happens is, you know when we go
to starvation. I mean, especially if you have stuff, you know,
pictures like unfortunately concentration camps or I mean you've seen
(11:57):
African countries that go through famine, right, all of those
are very uh what I would say, prototypical pictures of
what the bodies look like.
Speaker 3 (12:05):
They just look like skin and bones.
Speaker 2 (12:07):
You know, and the body ultimately has to eat away
at muscle and fat stores to try to survive. Right,
So everything is being broken down. So even people who
are you know when they get anorexic if you think
about it, or they lose so much body weight to
try to compensate anorexia being one pathway if you will,
(12:29):
you know, the body starts breaking down energy stores. Now
energy stores there are sort of smaller ones in the
liver and muscle, which are just what we use for
short term energy, like glucose like and but that's what
gets us through exercise, even a marathon or something like that. Right,
but days out, weeks out, months out, that's no longer present.
Speaker 1 (12:50):
Dodge, let me ask you this. In those famine countries,
why are the children's bellies poked out like they're stuffed?
Speaker 3 (12:59):
Sure, so if I.
Speaker 2 (13:00):
Could just keep going and then we'll get to the kids.
Speaker 3 (13:02):
Sorry, yes, because it looks like you're.
Speaker 2 (13:11):
Like you have a fat belly, right, almost like that
those toddler bellies, you know what I mean. So what
happens is it's actually this weird presentation of starvation. So
once we go down to like we can't we don't
have any more sugars to break down in our body,
we then go down to breaking down fat and then muscle. Okay,
(13:31):
and people don't see muscle as a form of energy.
But when everything is gone, you know, we think about
first sugars.
Speaker 3 (13:38):
Then fats, then muscle.
Speaker 2 (13:39):
Okay, we don't want to break down muscle because that's
a weakening. But what happens is at some point something's
got to give, right, the body is gonna self digest itself,
trying to keep itself alive, and then you get all
these weird manifestations, meaning the heart gets weaker, the lungs
get weak, or your immune system gets weaker where you
(14:02):
can be very susceptible to infections, and this weird sort
of bloating that you see. Okay, the starvation body habits,
especially in those kids, like when you know, you see
toddlers with bellies where their abdominal walls are weak and
they have these big toddler bellies sticking out. Well.
Speaker 3 (14:20):
In starvation, what happens is.
Speaker 2 (14:23):
Those abdominal muscles get weak because they get eaten away.
There's you know, the body's trying to hold onto any
fluid possible.
Speaker 3 (14:32):
Okay, and then you get.
Speaker 2 (14:35):
This nutritional wasting with severe protein deficiency. Now this is
a big word, but I had to look it up
in preparation. Quashy core all right, Uh no, it's quashio
core that is like severe protein deficiency associated with starvation.
So it really is disrupting your metabolism, like the body
(14:58):
slows down to basically like trying to regulate temperature and
expend as little energy as possible to function. Do you
understand this is not any kind of extra energy being expended,
So this koashier core is a it's like a type
of malnutrition, and you get like fluid and air building
(15:19):
up in the abdomen, you get that bloating. But the
rest of them, if you think about those pictures, you
get very gaunt faces, like there's no cheek fat, their
temples are sunken in because the temples have muscle, like
the rest of it's just wasted.
Speaker 3 (15:34):
So it's this very i would.
Speaker 2 (15:36):
Say, characteristic presentation. And then what the other thing you
see is that sometimes the body will grow very fine
hairs called lunugo.
Speaker 3 (15:50):
It's almost like baby hair.
Speaker 2 (15:53):
Some of you know, I have naked cats and then
sphinx cats and in the winter they get these like
almost like velvet type growth on their body because their
bodies are adapting to the colder environment. And that's literally
like analogous to what happens in the human body when
it's so cold and there's no fat and muscle to regulate,
that's when you know the body that's a very end stage,
(16:17):
like a very severe sign of starvation.
Speaker 1 (16:23):
Other than starvation, let's talk about radiation. So the radiation damage,
I think most people would think, like Aaron Brockovic, like
over time, like how long is this going to take?
Speaker 3 (16:35):
Well, that's harder for me to say.
Speaker 2 (16:37):
I think the big thing you have to talk think
about is, you know, because it's a dose dependent and
how much radiation you're getting exposed to, Like, so is
it environmental radiation? Like you know, you think about like chernobyl,
like no one can go in there right after that
that area is not safe. But they're supposedly like chernobyl
(16:59):
cats or something thing that are radioactive.
Speaker 3 (17:04):
And you know, so.
Speaker 2 (17:07):
You have to think about how much is in the environment,
and then you know, what is your proximity?
Speaker 3 (17:16):
Does that make sense?
Speaker 2 (17:17):
Like how close you are to it now? And is
it in the soil? Is it getting in your food?
Is it in the water? You know, And that's the
kind of if I recall correctly, she was Aaron Brockovich
was concerned about like contaminated water. But if you think
about it, like you can have you can live near
a nuclear plant, you can live you know, there's all
these things we don't know of about, you know, whether
(17:41):
businesses are leaching chemicals or you know, into the environment.
When we work with radiation. When I've worked with radiation
both in a hospital in the emy setting, So usually
what happens is radiation can be used as cancer treatment, right,
And I have a friend's son who's actually getting pediatric cancer,
who's getting radiation quite a bit of it, and they're
(18:01):
monitoring him, and you know, he has to worry about
exposing the family, right if in a house. So then
what happens Sometimes I get patients who pass away but
they have received radiation beads for prostate cancer or colon
cancer or whatnot, and they will set off the.
Speaker 3 (18:24):
Detector for radiation.
Speaker 2 (18:25):
We scan them, you know, so because we would have
to let that deteriorate before we can safely do an autopsy,
you know.
Speaker 3 (18:33):
And so this goes back.
Speaker 2 (18:34):
To our exposures are work risks, right, So sometimes we
have to delay the autopsy until the Geiger counter reads zero.
Speaker 3 (18:45):
And so everything is slow.
Speaker 2 (18:47):
But there can't I mean, I think when you have
radiation exposure. I would think it's years of exposure to
cause enough DNA damage to then result in cancer. You understand,
because it's at the DNA level that this mutation's happening.
And then it has to happen, and the body has
(19:08):
to fail at getting rid of those pre cancerous cells,
do you understand, So it has to be multiple hits,
and then your body usually has a sort of monitoring system,
if you will, you know, trying to keep the house
clean and get rid of cancer cells. But sometimes that fails,
and then that one cell becomes the trigger for a
(19:30):
cancer's growth. Right, it evades the body systems and starts
taking over. But I suspect that is years to happen,
and I wouldn't say that it's one hundred percent of
people that are exposed to radiation are going to get cancer.
Speaker 3 (19:47):
Do you understand that?
Speaker 2 (19:48):
Like, I think there's incidences of higher like types of
cancer in certain areas. Like they think, what was that
thing in Boston or Boston area they were talking about
a few nurses that had there was a cluster of
nurses or something that had cancer.
Speaker 3 (20:05):
But I don't think there's a.
Speaker 2 (20:08):
I don't know that case I'm not involved in it,
so I could be misquoting it. But I don't think
there's been a direct cause and effect, you know. I
think there's a suspicion. And the cluster of nurses was
or hospital workers was very concerning, you know. And so
if you see that in kids, or or if you
see it you know there's a cluster of kids in
a certain area or a certain type of disease that
(20:31):
shows up, you know, that's when you think about environment
such as radiation or chemicals that are dumped, you know,
unknowingly in the area, toxins that then go to cause cancer.
Speaker 1 (20:43):
Well, the last thing I want to ask you about
this kind of comes to my mind every time I
think of a slow, crazy death. There was a guy
in Atlanta that got stabbed in the head with a
pretty significant butcher knife, and he's sitting up, he's talking
to the medical folks, he's talking to law enforcement, and
(21:04):
the result was if we leave it in, he's going
to die. If we remove it, he's going to die.
And it was just strange for me watching this man
sit there talking, you know, perfectly able to communicate and
move about, knowing he was on limited time.
Speaker 2 (21:23):
Well, That's so interesting because I had a very similar case,
unfortunately end in depth because it was an autopsy, but
similar stabbed in the head, sliced in the head the
side of the head where there was a huge gaping
wound and really bleeding to death from it. This guy
was able to drive around for quite a bit, not
(21:44):
just and he didn't go to the hospital unfortunately, and
so it became this. They could have stopped the bleeding
and sutured the wound and treated him, you know what
I mean, But it just didn't happen, and then he died,
and I'm like, oh my god. And you know, the
amount of blood loss was all throughout the car and
his clothing.
Speaker 3 (22:03):
It was voluminous, and we're like, my god.
Speaker 2 (22:05):
When I say that scalp wounds can bleed, this was
like the extreme manifestation of it because it was one slice,
you know, an argument gone wrong, and then now this
kid is dead, you know, so that is not I mean,
that could be hours, you know before someone like that dies.
If it's a simple what I would say, like your
(22:28):
case had a little bit more penetration into the brain
or the skull, but this one was absolutely uninjured. Skull
just completely slice the scalp diagonally and the muscle.
Speaker 3 (22:39):
And it's crazy.
Speaker 2 (22:41):
Because you know, the attorney generals were very distraught, like
how are we going to prove this is a murder
because he drove around for a while, you know, and
and it is like if not for that wound, would
he have died? You know, That's really what you have
to think. And I don't actually remember how that case went,
so you know, it's not a bias. It was just
(23:01):
something I handled years ago. But you have to remember
whether it's hours delayed or days, weeks, even years, right,
Like sometimes we have people who have an injury, then
become paralyzed, then die of a complication that's like a
medical complication, right, kind of like bleeding to death if
you will, right, and then it's still a homicide. Now
(23:25):
that's not again, right, we are always going back. That's
a manner of death. That doesn't imply what will happen
in the court system. You know whether there'll be charges
or not, but or what the charges will be. But seriously,
like if you think about it, if someone dies, if
someone gets shot in the back and then five, ten, fifteen,
twenty years later they die of I don't know an
(23:47):
infection because they're paralyzed, but the paralysis was due to
the gunshot wound.
Speaker 3 (23:53):
It all goes back. Yep.
Speaker 1 (23:54):
We had those cases too, absolutely, yeah.
Speaker 2 (23:57):
And it's interesting, like I remember there's some cases where
and unfortunately those people are passing away, But there were
war veterans, you know, where someone got shot in the
war and then they were paralyzed and lived throughout and
then passed away at the veterans home, and then we're like,
oh my god, like they were shot at wartimes, so
(24:18):
like we had to we don't know all the intricacies
of the event even you know, you're like nineteen whatever, right,
like you might put Vietnam, or you might put abroad
like because people don't know necessarily, and his family's deceased, whatever.
But if you think about it, it could be decades later,
you know. So it could be not going to the
(24:39):
hospital because you're bleeding from a moon, I'll be fine
to all the way to decades later having a complication
that doesn't seem.
Speaker 3 (24:48):
Like a trauma complication, but it is.
Speaker 2 (24:51):
And so that is oftentimes some of the hardest cases
to explain in court as well, because people don't see
the connection.
Speaker 1 (25:00):
Right, he shot him five years ago, when you're charging
him with murders today, right, and.
Speaker 2 (25:05):
Then there may have already been assault with the deadly
weapon or you know what I mean, they may have
already been charges, so they're like, why are we punishing
this twice?
Speaker 3 (25:13):
Or you know, but then they up charge it.
Speaker 2 (25:14):
Right, there's a you know, so that's really where it's
finessing the legal you know, aspects of it and then
showing that, oh, look, this is still if not for
this one event, right five years ago, ten years ago,
a week ago, hours ago, whatever it is, he would
have been he or she would have been in the
(25:35):
same healthy state. And in the interim they didn't bounce
back to that healthy state.
Speaker 3 (25:41):
Right, there's nothing.
Speaker 2 (25:42):
That's if they go they get injured, and like if
I break a leg, I don't know in a fight,
but my leg heels fine and I'm running and acting
and then something happens to me and I die of
an infection in the same leg. That's not related because
I was able to get healthy again. Right, But really
understanding that it's always downhill, even if the slope is
(26:02):
very very shallow, takes years, you know, you can still
get to the end and have to connect the dots
back up to the initial event. That's a delayed death,
I mean, the ultimate delay.
Speaker 1 (26:14):
I've heard people say death by a thousand cuts, but
you know that was a torture practice. I'm not sure
I'm pronouncing it right, but ling cha lin Kai, I'm
not sure I pronounce it, but it was straight up real.
I mean, it was a torture mechanism for sure, right.
Speaker 2 (26:33):
And you know the other thing is when we have
we're talking sort of going into manner of death, but
when we look at injuries and bleeding out or whatnot,
they all contribute, right, and then you have some that
are more serious than others, but they can all I mean,
you can have superficial what seems to be non lethal
wounds when I say superficial that cause bleeding, but if
(26:56):
you have enough of them, like a thousand, they're going
to cause enough wait, blood loss, excuse me, and so
then you die from that mechanism, you know, And these
are really this is why I like to say, you know,
I like to teach, but it's not black and white
like TV. You know, this is where the nuance of
death certification. I mean, when someone dies twenty thirty years later.
(27:19):
Think about it. We have to review as many medical
records as possible to then connect those dots. I think
I just reviewed a case in private practice and I
told them please, it was two or three thousand pages
of records and I was like, oh my or eight
thousand it was something insane. And I was like, I can't, Like,
we really need to narrow this down. I just don't
(27:42):
have the time or you know, and you know, things
can be repetitive, and it was such a long process,
and you know, it was very tedious, and I don't
like billing for needless work, you know. So I was like,
if we can rehone hone down on what's important, then
I can and you know, do it. And I think
that thousands of pages, that's five or eight thousand something
(28:04):
insane was brought down to like eight hundred pages, like,
you know, a tenth of it. So that makes more sense.
But think about the voluminous details that happen in that
time frame, right when we're talking about years and this
person was in the nursing home needing exquisite care. That
it then gets really complicated to really prove it. You
(28:28):
know that there isn't an intervening event, you know, and
that's where defense lawyers are going to come in and say, hey,
you know, they had a stroke or they had something
completely unrelated.
Speaker 3 (28:37):
Why are you saying it's the gunshot? Right?
Speaker 2 (28:39):
They're just getting old and they had a natural medical event,
and it's you.
Speaker 3 (28:43):
Know, that's really where it becomes you know, difficult.
Speaker 2 (28:47):
You really have to sort out the facts, you know,
the timing, the extent, the location, whatever. Absolutely, you can't
just start charging people without being sure that the events
are in men.
Speaker 1 (28:58):
Well, doctor, appreciate it. I tell you, next time I
hear somebody say, well, I hope they have a slow,
painful death, you know what, I hope you know what
you're talking about because it is horrifying.
Speaker 2 (29:11):
Well yeah, and even our eye drop keis right, that
wasn't that wasn't an instant death, right, think about I mean.
Speaker 3 (29:19):
Different, Yeah, that's right, that's right.
Speaker 1 (29:25):
Well, I appreciate you so much and we will talk again.
Speaker 3 (29:28):
Money, Yes, take care of them, thank you, ma'am. Right,
Host
Sheryl McCollum
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