04x03 - Broken Lives
Posted: 02/26/24 12:55
[music playing]
NARRATOR Police make a grisly discovery
when they pull the body of a bound and gagged
woman from her shallow grave.
Her tissues are very soft.
She's got greenish discoloration.
NARRATOR Her grieving mother is desperate for answers.
You want some type of justice.
Nobody has the right to do that to a family, nobody.
NARRATOR Can Dr. G prove that this young woman was m*rder*d
and help put a suspected k*ller behind bars?
If you can't put the pieces together
that say, this is a homicide, you know, he may go free.
NARRATOR Then a mentally ill man is
found dead in a halfway house.
He's got blood coming from his nose and his mouth.
NARRATOR And Dr. G uncovers a possible motive for m*rder.
They saw him on Monday.
They gave him his allowance.
And then they don't see him again.
Did somebody try to rob him?
NARRATOR Altered lives, baffling medical mysteries,
shocking revelations, these are the everyday cases of Dr. G,
medical examiner.
As chief medical examiner for the district nine morgue
in Orlando, Florida, Dr. Jan Garavaglia
must solve mysteries every day.
But sometimes, her job takes her beyond the realm
of simple medical diagnosis.
In some cases, Dr. G is called upon
to use her expertise to help the deceased themselves,
to speak for those voiceless victims,
and to see that justice is served.
It's my job to find the answers.
It's my job to hopefully come up with a cause of death.
NARRATOR Dr. G was called upon to play this crucial role
in when she served as medical examiner
at the Duval County medical examiner's office
in Jacksonville, Florida.
On this balmy Thursday morning in March,
Dr. G receives word that the police are bringing in a box
containing a disturbing cargo.
They think they're seeing what could
be a decomposed person in the box,
but they weren't % sure.
NARRATOR But the contents of the box
are not nearly as unsettling as the story of its discovery.
The day before the delivery to the morgue,
a man shows up at the Jacksonville sheriff's office.
He claims that two months earlier, a friend of his,
Kenneth Garrity, enlisted his help
in burying a box in the woods.
Garrity told him that the box contained his dead dog.
So he went with Kenneth out to a wooded area
and they buried this box that had this dog in it.
A few weeks later, the man starts
hearing reports of a missing person in the area,
a -year-old woman.
When he learns that the missing woman is
none other than Garrity's girlfriend,
he begins to fear the worst.
He started putting two and two together and saying,
you know, I buried a box with a supposed dog in it
about the time she went missing.
Then this fellow took the police to where he buried this box.
And they started digging it up.
I started digging, and I got down probably six or eight
inches and I hit a wooden box.
Oh, yeah, I can see it.
Look at that. Is that your box?
That's the box.
When I opened the lid of it up,
you can definitely tell it was a human
not a dog that was in the box.
Well, at that point, it became a homicide case
or a death of suspicious means.
NARRATOR Detective Bradley rushes
the box and its macabre contents to the medical examiner's
office.
He is counting on Dr. G to tell him
if this is indeed the body of the missing
woman Michelle Robertson.
And if so, how did she die?
According to her family, Michelle Robertson
was a vivacious -year-old with an insatiable zest for life.
Michelle was a very outgoing child, very small,
very petite, but very outgoing.
And a lot of fun.
You know, she really brought the fun into any kind of situation.
SHIRLEY GARNTO Always happy.
Thank you, grandma.
SHIRLEY GARNTO Had the best smile.
She was very good older sister,
very good, very kind person.
NARRATOR When Michelle fails to acknowledge her sister's
birthday on January th, her family
immediately suspects that something is desperately wrong.
THERESA KLEIN Soon as my birthday arrived and there was
no phone call, there no gift or card,
I said, there is something wrong with Michelle.
[ … ]
She is either she's gone, something has happened to her.
SHIRLEY GARNTO I started calling
their apartment and nobody answered, nobody
answered, nobody answered.
I was pretty sure that there was something really, really wrong.
NARRATOR As the days go by and Michelle fails to reappear,
her distraught family begins to fear that Michelle
is never coming home.
And they suspect that her boyfriend
Kenneth Garrity may have played a role in her disappearance.
I had told Michelle that I didn't trust him.
I think he was a bully.
He had a strange personality as far as getting mad easily.
NARRATOR Now with the excavation
of the mysterious box and its grisly contents,
Michelle's family and investigators
are anxious to know if Michelle has finally been found.
And if so, was she the victim of a homicide?
This case was somewhat of a big deal.
Everybody wanted to know, is it her?
Is it not her?
NARRATOR It is now up to Dr. G to find the answers in what
will prove to be one of the most disturbing cases of her career.
The box was delivered to my office intact.
The lid was still on it but a little bit ajar.
The box is about three feet long,
three feet deep, but narrow, about and / feet wide.
And then we open the box up.
NARRATOR A quick glance inside confirms the worst.
When you look inside, it does look like there
is a human body in there.
My immediate reaction is kind of your adrenaline goes.
And you're thinking, boy, this is going to be a lot of work,
but let's get into it.
NARRATOR Dr. G can tell right away that it's a woman,
but her identity and cause of death are a complete mystery.
To avoid destroying any potential evidence,
Dr. G and her assistant carefully
remove the sides of the makeshift coffin,
fully revealing the body for the first time.
She is bent at the waist and her knees
are brought up towards her head to fit into that small box.
She's very petite.
You can't see much of her because she's wrapped
in a yellow blanket and then an electric cord
was wrapped with four loops around the body.
NARRATOR But the shocking treatment of the body
does not end there.
We have one piece of evidence that's glaring right at me.
She's got this packing tape over her mouth, her nose, her eyes,
even goes over her ears.
She couldn't breathe through that.
NARRATOR Despite the horrifying implications of this discovery,
Dr. G is determined to stay focused and objective.
At this point, you don't react to any
of the emotion of the case.
I know that she must be the loved one, the daughter,
the sister of somebody.
But my job is to find the answers.
NARRATOR Dr. G surveys the body for clues
to the victim's identity.
Unfortunately, the body's state of decomposition
is too advanced for visual identification
or a fingerprint analysis.
She does, however, determine that the victim's appearance is
consistent with a female in her mid s with wavy brown hair,
weighing less than pounds, and under five feet tall.
Although this physical description
matches that of Michelle Robertson, for Dr. G,
it is not enough.
You know, I wanted a scientific ironclad
identification.
NARRATOR And she knows just where to look for it.
I look in her mouth.
She does look like she has some dental repair.
So we know that there must be a dentist.
NARRATOR People are often identified
by comparing their teeth to personal dental records.
We'll start with the most obvious.
We'll look at the teeth.
We'll look for the fillings.
We'll look at the restorations.
If that's not available, then we have
to use more subtle techniques looking at sinuses, looking
at angle of the mandible.
We want something unique to that individual,
whether it's a filling, a piece of bone, a root fragment.
NARRATOR For this critical task,
Dr. G enlists the help of a forensic dentist
who compares Michelle's dental records to the victim's teeth.
Within minutes, they have their answer.
JAN GARAVAGLIA Sure enough, he was
able to give a positive identification
that her dental records match this body.
So it's clearly Michelle.
NARRATOR Detective Bradley now has the heart wrenching task
of informing Michelle's mother that her daughter has
been found dead.
I already knew.
I already knew.
[ … ]
I knew that if she was in any kind of trouble,
she would have called me.
It was very, very devastating.
But, at the same time, we'd finally known.
We'd finally known.
NARRATOR Michelle's grieving family now
believes that Michelle was m*rder*d
by the very man who buried her body,
her boyfriend Kenneth Garrity.
I felt he was unstable.
He tried to keep her isolated and didn't
want her to have friends, didn't want
her to receive phone calls.
What's going on?
Didn't want her to be as close to us as we were.
NARRATOR You need to listen to me when I'm talking to you.
She would say to him, I will leave you.
And he would always say, no, you'll never leave me.
You'll never leave me.
NARRATOR But suspicions are not enough.
With only circumstantial evidence against Garrity,
this entire case hinges on whether Dr. G
can find proof of m*rder.
JAN GARAVAGLIA It's a bad thing to bury somebody
who dies in your house.
That sounds bad.
But there's not much crime to that.
There is a much more punishable crime
to k*ll somebody who's alive.
NARRATOR But in her quest to prove how Michelle
Robertson died, Dr. G faces a formidable adversary,
mother nature.
The natural forces of decomposition
have left their grim mark on Michelle's body--
Her tissues are very soft.
She's got greenish discoloration.
NARRATOR --destroying the very evidence Dr. G relies on.
Will she be able to find enough clues to help
solve this mysterious death?
Or is it already too late?
I'm hoping, at this point, that there's
clear cut evidence.
Sometimes you can't tell for sure.
NARRATOR Dr. G is carefully inspecting the body
of -year-old Michelle Robertson
for clues that might point to a cause of death.
Michelle's family and investigators
suspect that Michelle was brutally
m*rder*d at the hands of her own boyfriend, Kenneth Garrity.
You want some type of justice.
You want some kind of penalty.
Nobody has the right to do that to a family, nobody.
I already have that tape that was on her face.
That could be a cause of death in and of itself.
But we're looking for other things.
NARRATOR But there's a problem.
Autopsying a decomposed body presents enormous challenges.
When you have a decomposed body
and the tissues are showing some discoloration
and the tissues are softened, it's
much harder to find trauma.
NARRATOR But as she continues her examination,
Dr. G finds Michelle's body to be surprisingly intact.
Ironically, the reason for this lies in the callous way
her body was disposed of.
Being buried helps in this case
because you're going to decompose slower.
It's a little cooler in the dirt.
You're protected from the elements.
NARRATOR But despite the relative good condition
of the body, Dr. G finds no evidence of external wounds.
As Dr. G continues her examination,
Detective Bradley learns another disturbing detail
about Kenneth Garrity, that he had a history of v*olence.
Six months before Michelle's disappearance,
he had beaten her severely causing multiple contusions.
We'd found out that she had been assaulted by Kenneth
Garrity and put in a hospital.
So I guess you'd have to say he's a violent person.
Domestic v*olence isn't just about anger.
It's about control, and it's about power.
And he was trying to have control and power over her.
That's what domestic v*olence is about.
NARRATOR This latest discovery fuels
the investigators' suspicions.
But so far, their case is purely circumstantial.
In order to arrest Garrity, they are counting on Dr. G
to prove that this is a homicide.
So far, the external exam has turned up nothing.
JAN GARAVAGLIA I don't see any major trauma on her.
So I'm very suspicious that she either has a blow to her head
or she's got strangulation or she has both.
NARRATOR Dr. G's next step is to check
for signs of strangulation.
JAN GARAVAGLIA One of the things
I look for is subtle signs of trauma on her neck.
It could even be just fingernail marks, could be just
some bruising.
NARRATOR But the initial inspection yields no clues.
JAN GARAVAGLIA Because of the greenish discoloration,
[ … ]
the skin slippage, I don't see a lot of external trauma
on the neck.
NARRATOR Undaunted, Dr. G looks for another telltale sign
of strangulation.
Then we'll look for the petechiae, the little burst
blood vessels in those thin membranes
in the inside of your eye.
Those blood vessels can burst very easily
with increased pressures put on your neck from strangulation.
NARRATOR But once again, Dr. G comes up empty handed.
When I looked on this case, she didn't have any.
Now she is awfully decomposed.
So I may be missing those, but I don't see any.
NARRATOR This finding, or lack of one,
makes it impossible for Dr. G to make
a conclusion about whether or not Michelle was strangled.
I can't rule out strangulation.
But I don't have anything to rule it in yet.
So already, I look like I'm in a hole here.
NARRATOR But Dr. G still has one
last place left to look for signs of foul play,
Michelle's head.
And when she does, she makes a chilling discovery.
JAN GARAVAGLIA One thing I find is that there's some evidence
of her being beaten.
She's got a bruise or contusion on her forehead,
and she's got a contusion or a bruise on the left side
of her head, and a broken nose.
NARRATOR But these bruises, while horrifying,
are in themselves inconclusive.
JAN GARAVAGLIA We need to see, did these cause her death
or are these just a sign of her being beaten prior to her
being k*lled?
NARRATOR Will Michelle's body give up its secrets?
Only the internal exam will tell.
If you can't put the pieces together that say, this
is a homicide, he may go free.
NARRATOR Dr. G is examining the body
of -year-old Michelle Robertson, recently excavated
from her shallow grave.
But so far, she hasn't been able to determine
the cause of death, much less a means of homicide.
I need to see what I can find on this body and say,
these are the facts that I can say happened,
and these are the things I can say didn't happen.
NARRATOR Dr. G makes the standard Y incision,
cutting from shoulder to sternum to fully
reveal the internal organs.
She then studies the body looking for any signs
of physical trauma.
We look for any rib fractures that would suggest being beaten
or stomped.
We don't see anything along that line.
NARRATOR The next step is to follow
a clue from the external exam.
JAN GARAVAGLIA I really want to evaluate those contusions
or bruises on the head.
I don't know yet if that blunt trauma to the head k*lled her.
NARRATOR Now it's time to take a closer look.
Using an oscillating saw, a morgue technician
cuts through the skull.
Dr. G then steps in and removes the skullcap.
I look inside, but I don't see any evidence of hemorrhage.
NARRATOR This is a serious blow to the case.
The absence of blood means that Dr.
G cannot make an accurate determination about
the severity of Michelle's head trauma due to the decomposition
of her brain.
Whether there's internal trauma or not,
I just can't say.
I don't see any evidence of it.
NARRATOR It appears that the case has reached a dead end.
With no way to tell if her head injury k*lled Michelle,
Dr. G is still without a cause of death,
and her options are running out.
Only one stone remains unturned.
While she didn't see any signs of strangulation
during the external exam, she knows that evidence could have
been erased by decomposition.
To completely rule out strangulation,
Dr. G must now look for evidence internally.
Definitive proof may lie with a small bone
of the neck called the hyoid.
The hyoid bone is kind of a U-shaped
bone that sits in the upper portion of your neck.
NARRATOR The hyoid bone is the only bone in the body not
connected to any other bone.
Its main function is to help support the tongue.
The tiny hyoid bone is protected by thick layers of muscle
and the mandible, making it nearly impossible to break,
except when extreme pressure is applied to the neck.
There are very few ways to break that bone
without strangulation.
NARRATOR Dr. G begins the painstaking
dissection of Michelle's neck.
And before long, she has her answer.
I do the layer Y dissection.
I see that hyoid bone, and there's hemorrhage around it
and there's a fracture of the hyoid bone.
NARRATOR This discovery can mean only one thing.
[ … ]
She was strangled.
NARRATOR But Dr. G is not quite ready to declare strangulation
the cause of death.
The broken hyoid bone, that indicates, at least,
that there is a strangulation.
Now does that indicate she died from strangulation?
Possibly not.
NARRATOR There is no doubt that Michelle was strangled.
But this alone might not have been enough to k*ll her.
What it is is you're cutting off the blood supply
to your brain, and you're cutting off
the drainage from your brain.
So basically, you're not getting oxygen, and you pass out.
The problem is, even after you pass out,
there has to be some pressure maintained
because studies have shown that you can wake back up.
NARRATOR Dr. G suspects this is exactly what happened
in this case, which would explain the tape found
on Michelle's face.
She's probably coming out of her strangulation
making gurgling noises, so he suffocates her
by putting the tape over her mouth and nose
to make sure she died.
NARRATOR Dr. G finally has the forensic evidence
needed to make the case against Kenneth Garrity.
The cause of death is going to be strangulation
with suffocation from the tape and then
contributing soft tissue injuries to the head.
It's a classic case of domestic v*olence, and it's tragic.
NARRATOR After an hour long examination,
Dr. G is now able to report her findings to investigators.
It's Sunday, January th, and Michelle and Garrity
are spending the day together at home.
Suddenly, something triggers Garrity's rage
and he lashes out.
JAN GARAVAGLIA There's a fight.
There's blows to the face, blows to the head
to the point where he breaks her nose, probably stuns her.
NARRATOR Garrity then grabs hold of Michelle by the neck
and begins to strangle her.
His grip is so strong that he breaks Michelle's hyoid bone
and cuts off blood flow in and out of her brain.
Michelle's brain quickly becomes starved for oxygen,
and she most likely loses consciousness.
But she probably then starts to gurgle.
And he realizes she's not quite dead,
so he puts the tape over her mouth and nose and eyes
so she can't breathe.
There is no way she's coming out of that strangulation.
NARRATOR Within a few agonizing minutes, Michelle is dead.
Then in a cold-blooded effort to dispose of his girlfriend's
body, Garrity places Michelle in a box
and buries her with the help of his unsuspecting friend.
There she remains in her shallow grave
until she is discovered by police two months later.
It just amazes me that there are people
that can do this to anybody.
NARRATOR Thanks to Dr. G, investigators finally
have enough hard evidence to arrest
Kenneth Garrity for m*rder.
Once we made the arrest, he confessed.
So that was just the final nail in the coffin.
NARRATOR On May , , Garrity is convicted
of second degree m*rder.
Although he receives a year sentence,
he serves only years and is released on April , .
No one else is charged with any crime in connection
with Michelle Robertson's death.
Michelle's mother is grateful to Dr. G for bringing
her the comfort of the truth.
If it wasn't for her, we would have never known
what caused Michelle's death.
She has children of her own.
So she knows what we're going through.
NARRATOR But Dr. G believes that Michele's death
holds a valuable message for the living.
About % of all our homicides are
some type of domestic v*olence.
And I think the bottom line here is if there's
any evidence of v*olence and you're afraid,
I would suggest leaving quickly.
I know that's very hard.
Call the national hotline for domestic v*olence
and see what your options are, make
a plan that you could leave quickly
if things get out of hand.
NARRATOR In Dr. G's next case, the body
of a mentally ill transient is found in a halfway house.
It doesn't take a genius to figure out he's dead
because he's already starting to decompose.
NARRATOR And Doctor G's first priority
is to figure out if this man was the victim of foul play.
He was last seen by the caregiver who had actually
just given him his allowance.
Did he get in a fight?
Did somebody try to rob him?
NARRATOR District nine is a busy urban morgue
in downtown Orlando, Florida, a city known for its theme
parks and resorts.
But in the morgue's jurisdiction of Orange and Osceola Counties,"], index ,…}
[ … ]
an estimated , people live on the streets
or in group shelters.
When they die, their bodies usually
end up in Dr. G's hands.
Having transients come through is a common thing.
NARRATOR And their bodies often remain unclaimed.
I have a lot of empathy for people who died suddenly
and nobody cares about them.
I have to care about them.
NARRATOR Such is the case of -year-old Alex Wilcott.
Well, today, we have a middle-aged man that was
found dead in a halfway house.
NARRATOR Dr. G's investigator's report on the homeless man
reads like so many cases she's seen in the past,
no job, no friends, no family.
He'd been living at St. Paul's Residence, a halfway house
for the homeless in Edgewood, Florida,
for about a year and a half and spent most of his time
alone in his room.
So it comes as no surprise when Alex doesn't
come down for dinner one night.
But the next morning, when Alex fails to show for breakfast,
a fellow resident goes to his room to wake him.
Alex, you OK?
NARRATOR But Alex isn't sleeping.
Alex.
Then one of the roomies comes in and sees him in his bed--
Hey!
JAN GARAVAGLIA --dead.
NARRATOR A St. Paul's administrator immediately calls
the authorities, who arrive on the scene with Dean Smith,
Dr. G's medical investigator.
We entered the subject's private room, found
him lying in bed on his back.
He was covered with a blanket.
His head was kind of tilted to the right.
He'd probably been dead or hours.
NARRATOR Dean immediately begins interviewing residents
and staff at St. Paul's, who reveal
that Alex had been estranged from his family for some time.
We found out that he's pretty much for the past years
lived a pretty much nomadic life.
We know he's single.
He's never been married, doesn't have any children.
NARRATOR And according to those at the halfway house that knew
him, Alex was often irritable and suffered
from periodic mood swings.
While these few facts provide some insight into Alex's life,
they don't shed any light on how he died.
There's just a lot of pieces of the puzzle
that I don't know yet.
I just told Dean that we need some more information.
NARRATOR While Dean Smith works to uncover more details
about Alex, Dr. G begins her own search
for clues in the autopsy.
OK, let's flip that leg.
NARRATOR She begins by looking for a cause of death
that she's seen all too often with transients, m*rder.
JAN GARAVAGLIA Having transients come through who
are m*rder*d is a common thing.
I mean, it's certainly something we see several times
every year.
Whenever you have communal living with a bunch of men,
some of them are very transient, some of them
have psychological problems, you always worry about trauma.
NARRATOR And despite the limited background information
available on Alex, the investigator's report
does indicate that he was last seen
alive two days earlier when a caregiver gave him
his weekly allowance of $.
There you go.
NARRATOR Is it possible that someone
k*lled Alex for his allowance?
Did somebody take his $, beat him up and take his $,
suffocate him or do something to him?
NARRATOR To a drug addict, $ can represent
two bindles of heroin or up to four rocks of crack
cocaine, a significant fix.
We certainly are going to have to rule out
foul play right off the bat.
NARRATOR Dr. G starts the autopsy by checking Alex's body
for any bruises or contusions consistent with an as*ault.
And she finds her first clue on Alex's face.
JAN GARAVAGLIA He's got blood coming
from his nose and his mouth.
Is it decomposition or is it from some type of trauma?
NARRATOR Attempting to isolate the source of the blood,
Dr. G meticulously examines Alex's head and face.
Feeling the facial bones, nasal bones,
looking in the mouth, I don't see any direct trauma.
So it could still be coming up from his GI track
or coughing up.
NARRATOR But despite these findings,
years of experience tells Dr. G that it's way
too soon to rule out foul play.
There are many people that I've
opened that I've been surprised at finding internal trauma
when I don't see anything external.
NARRATOR Sure enough, when Dr. G examines Alex's brain,
she discovers an intriguing abnormality.
[ … ]
He's got adhesions of the surface of his brain.
NARRATOR And she wonders if this
could be his hidden k*ller.
Dr. G is about to open Alex Wilcott's body
and look inside for answers.
We need his history.
We can find a lot when we go in there,
but I don't like surprises.
NARRATOR If Alex was the victim of a violent as*ault,
Dr. G would expect to find evidence of trauma to his head.
He could have a subdural hematoma
or blood over his brain.
NARRATOR So that's where Dr. G begins the internal exam.
Morgue technicians carefully saw through Alex's cranium.
But right away, the cranial exam proves
problematic for Dr. G. That's because Alex's
brain is starting to decompose.
Now in a normal body, I would cup the brain in my hand
and remove it.
You cannot do that with a decomposed body.
You get one look at the brain.
I hope that his brain is still preserved
enough that I'm going to be able to see
if he does have any trauma.
NARRATOR Dr. G quickly scans Alex's brain
and immediately spots something unusual.
He's got adhesions of the surface of his brain
to the dura, which indicates that he did have
some old trauma to that brain.
NARRATOR Head trauma, but old head trauma.
Despite the start of decomposition of Alex's brain,
Dr. G is nevertheless able to make one other key finding.
There is a no fresh hemorrhage either in the scalp
or in the brain.
There's no skull fracture.
That's easy enough to see.
So we don't have any fresh trauma to his brain.
NARRATOR No recent injury, no indication of foul play.
It's looking less likely that Alex was m*rder*d.
But Dr. G won't know for sure until she
performs the internal exam.
Hopefully, we'll have the answer very quickly.
You make your Y incision and look for hemorrhages,
see if he's had any blows to the chest,
and look and see if there's any free fluid in those regions,
see if there's any free blood in the belly.
NARRATOR But after a thorough examination,
she can detect no signs of hemorrhaging,
no pooled blood, and no signs of bruising of any kind.
It's a finding that leads Dr. G to her first conclusion
in the case.
When the head is clear, the chest is clear,
and the belly is clear, you know,
there's really not much chance that trauma
has k*lled him because we don't see any trauma.
NARRATOR Medical investigator Dean Smith
returns to the morgue with tragic new information
about Alex Wilcott.
When I heard that, I thought, what a sad life.
NARRATOR But will it lead her to his elusive cause of death?
Dr. G's next step is to remove Alex
Wilcott's organs, one by one.
So far, she has found no overt signs of trauma
to explain the -year-old transient's sudden death.
JAN GARAVAGLIA Okey dokey, I expect everything to be normal.
I don't see-- certainly don't see any trauma.
NARRATOR Then, just as the team is running out of leads,
medical investigator Dean Smith returns to the morgue
with new information about Alex that he obtained
from a childhood friend.
We got some fairly sad information
about this poor fellow.
NARRATOR Dean learns that Alex was hit by a motorcycle when
he was eight.
He was pretty much in a coma for about days
in the hospital, had some severe head injuries after that.
NARRATOR Two years later, he suffered
a second head trauma when he plummeted
from a neighbor's tree.
These accidents explain the old head trauma Dr.
G detected in the cranial exam.
She also learns that these injuries caused him to develop
a debilitating mental illness, one that
would alter his life forever.
Supposedly, he's been diagnosed with schizophrenia.
There is a lot of controversy about what
environmental factors might be involved
in causing schizophrenia.
Some studies have shown that people with a history of head
trauma are two to three times as likely to develop
schizophrenia later in life.
NARRATOR Schizophrenia is a neurological brain disorder
that causes paranoia, delusions, frightening behavior,
and disorganized thoughts.
And this new finding could take the investigation
in a completely different direction.
This new information adds some maybe
things I'm going to concentrate a little bit more on.
NARRATOR She must now consider how
Alex's mental illness may have played a role in his death.
[ … ]
There is a subset of people with schizophrenia
that do die suddenly.
So that just adds a little bit of more question.
NARRATOR Schizophrenics often die
prematurely from untreated natural disease or illness.
Schizophrenics are not going to be
as attuned to their bodies.
So we see more advanced diseases in them sometimes.
NARRATOR Dr. G now wonders if Alex developed
a serious medical condition that went untreated
and eventually k*lled him.
That's what I often see in schizophrenics.
They'll have this bad disease going on and no complaints.
NARRATOR Her next step is to examine Alex's heart and lungs.
So I might as well look at the lungs.
NARRATOR These vital organs may hold
the answer to this mystery.
As Dr. G removes the lungs, she immediately
notices something troubling.
I weigh the lungs, and both lungs are very heavy.
The heavy lungs are due to fluid buildup.
Oh my gosh, that left lung is just full of fluid.
NARRATOR A phenomenon medically referred to as edema.
So we have very heavy lungs.
Well, what does that tell me?
Well, people who have heart disease
will have very heavy lungs.
Their heart's just not pumping well enough
and the fluids get backed up into the lungs.
I'm really curious about the heart.
Well, let's do this heart.
This is where the money is.
NARRATOR And when she examines the heart,
she finds another clue.
Wow.
Look at this.
It really looks like he's starting to have
some dilatation to his heart.
NARRATOR Dr. G quickly determines
that Alex's heart is enlarged and the wall is thickened.
His heart's really thickened here,
like ., . in that vicinity.
NARRATOR This is often a result of chronic high blood pressure."], index ,…}
If your blood pressure is high,
your heart has to pump that much harder
to get it out against those pressures.
NARRATOR This extra work can cause the heart muscle
to thicken, just as a muscle thickens
in response to weight lifting.
As that heart gets thicker, it's more prone to arrhythmias,
and it's more prone to fail.
NARRATOR But as she continues to examine his damaged heart,
Dr. G finds another important clue.
When I do the coronary arteries,
it was another little surprise.
He also had some atherosclerosis.
NARRATOR Atherosclerosis is a buildup
of plaque in the heart's arteries
that supply blood to the heart muscle.
Severe atherosclerosis can block the flow of blood to the heart."], index ,…}
But surprisingly, that's not the case with Alex.
Atherosclerosis or narrowing of the blood vessels
was not that severe.
He only had about a % narrowing.
NARRATOR While the atherosclerosis in Alex's
arteries was not severe enough to k*ll him,
Dr. G quickly realizes that it paved the way for a more
serious problem to develop.
Voila, little thrombosis.
I do see a clot adhere to the atherosclerosis.
And I thought, hmm, could that be real?
Blood clot right inside the coronary artery.
NARRATOR A blood clot, or thrombus, can form as a result
of atherosclerotic plaque.
It can become deadly when it stops blood flow
to the heart muscle altogether.
For Dr. G, this clot is the final piece of the puzzle.
He already has a sick heart from the high blood pressure,
and it looks like then he gets a thrombus on top of that.
NARRATOR After an hour long examination,
Dr. G is finally ready to contact
Alex's estranged family to let them know what happened to him.
-year-old Alex Wilcott has been plagued
by a life of misfortune.
After two serious childhood head injuries damage his brain,
he is eventually diagnosed with schizophrenia.
He doesn't appear to be treated because we
don't have any medication.
NARRATOR Alex's debilitating mental disorder
contributes to an isolated nomadic existence.
JAN GARAVAGLIA He's been in and out of mental hospitals
and in and out of halfway houses.
NARRATOR These factors also most likely lead
to Alex disregarding his health altogether, resulting in a case
of chronic high blood pressure.
People who live in halfway houses and live nomadic lives
don't always get the best medical attention.
It's not something you routinely do is
go check your blood pressure.
NARRATOR Untreated, Alex's chronic high blood pressure
[ … ]
ravages his heart.
His heart, over years, had pumped against the high blood
pressure.
The heart got thicker.
And over time, and we're talking years,
the heart starts to fail.
NARRATOR The stress of this extra work on Alex's heart
eventually causes it to fail and also puts him
at risk for atherosclerosis.
Then he develops a small blood clot that further
compromises the weakened organ.
Now as his heart struggles to pump enough blood out,
his lungs back up with fluid.
He would have a little bit of cough.
Maybe he'd have thought that was maybe the flu coming on,
little shortness of breath.
Maybe that's he went to bed.
NARRATOR Over the next several hours, as Alex sleeps,
his overtaxed heart fights to continue beating.
But eventually, his heart gives out.
He most likely died in his sleep.
NARRATOR Unlike many of the transient cases in Dr. G's
morgue, Alex Wilcott wasn't m*rder*d,
and he did not overdose on dr*gs or alcohol.
He died a natural, quiet death.
JAN GARAVAGLIA Dying in a halfway house all alone,
I mean, it really makes you think what a sad, sad life
some people have.
NARRATOR In the end, Alex's untimely death ironically
may have stemmed from two tragic head injuries
he sustained as a child.
This trauma might have led him to develop
a debilitating mental illness, which in turn caused
him to neglect his health.
This poor guy's got no luck either in his youth, all
these horrible accidents that occur to him,
down to dying in a halfway house all alone.
Whenever I do an autopsy, you really do
get a window in people's lives.
This poor kid's life was unlucky from the beginning to the end.
NARRATOR Police make a grisly discovery
when they pull the body of a bound and gagged
woman from her shallow grave.
Her tissues are very soft.
She's got greenish discoloration.
NARRATOR Her grieving mother is desperate for answers.
You want some type of justice.
Nobody has the right to do that to a family, nobody.
NARRATOR Can Dr. G prove that this young woman was m*rder*d
and help put a suspected k*ller behind bars?
If you can't put the pieces together
that say, this is a homicide, you know, he may go free.
NARRATOR Then a mentally ill man is
found dead in a halfway house.
He's got blood coming from his nose and his mouth.
NARRATOR And Dr. G uncovers a possible motive for m*rder.
They saw him on Monday.
They gave him his allowance.
And then they don't see him again.
Did somebody try to rob him?
NARRATOR Altered lives, baffling medical mysteries,
shocking revelations, these are the everyday cases of Dr. G,
medical examiner.
As chief medical examiner for the district nine morgue
in Orlando, Florida, Dr. Jan Garavaglia
must solve mysteries every day.
But sometimes, her job takes her beyond the realm
of simple medical diagnosis.
In some cases, Dr. G is called upon
to use her expertise to help the deceased themselves,
to speak for those voiceless victims,
and to see that justice is served.
It's my job to find the answers.
It's my job to hopefully come up with a cause of death.
NARRATOR Dr. G was called upon to play this crucial role
in when she served as medical examiner
at the Duval County medical examiner's office
in Jacksonville, Florida.
On this balmy Thursday morning in March,
Dr. G receives word that the police are bringing in a box
containing a disturbing cargo.
They think they're seeing what could
be a decomposed person in the box,
but they weren't % sure.
NARRATOR But the contents of the box
are not nearly as unsettling as the story of its discovery.
The day before the delivery to the morgue,
a man shows up at the Jacksonville sheriff's office.
He claims that two months earlier, a friend of his,
Kenneth Garrity, enlisted his help
in burying a box in the woods.
Garrity told him that the box contained his dead dog.
So he went with Kenneth out to a wooded area
and they buried this box that had this dog in it.
A few weeks later, the man starts
hearing reports of a missing person in the area,
a -year-old woman.
When he learns that the missing woman is
none other than Garrity's girlfriend,
he begins to fear the worst.
He started putting two and two together and saying,
you know, I buried a box with a supposed dog in it
about the time she went missing.
Then this fellow took the police to where he buried this box.
And they started digging it up.
I started digging, and I got down probably six or eight
inches and I hit a wooden box.
Oh, yeah, I can see it.
Look at that. Is that your box?
That's the box.
When I opened the lid of it up,
you can definitely tell it was a human
not a dog that was in the box.
Well, at that point, it became a homicide case
or a death of suspicious means.
NARRATOR Detective Bradley rushes
the box and its macabre contents to the medical examiner's
office.
He is counting on Dr. G to tell him
if this is indeed the body of the missing
woman Michelle Robertson.
And if so, how did she die?
According to her family, Michelle Robertson
was a vivacious -year-old with an insatiable zest for life.
Michelle was a very outgoing child, very small,
very petite, but very outgoing.
And a lot of fun.
You know, she really brought the fun into any kind of situation.
SHIRLEY GARNTO Always happy.
Thank you, grandma.
SHIRLEY GARNTO Had the best smile.
She was very good older sister,
very good, very kind person.
NARRATOR When Michelle fails to acknowledge her sister's
birthday on January th, her family
immediately suspects that something is desperately wrong.
THERESA KLEIN Soon as my birthday arrived and there was
no phone call, there no gift or card,
I said, there is something wrong with Michelle.
[ … ]
She is either she's gone, something has happened to her.
SHIRLEY GARNTO I started calling
their apartment and nobody answered, nobody
answered, nobody answered.
I was pretty sure that there was something really, really wrong.
NARRATOR As the days go by and Michelle fails to reappear,
her distraught family begins to fear that Michelle
is never coming home.
And they suspect that her boyfriend
Kenneth Garrity may have played a role in her disappearance.
I had told Michelle that I didn't trust him.
I think he was a bully.
He had a strange personality as far as getting mad easily.
NARRATOR Now with the excavation
of the mysterious box and its grisly contents,
Michelle's family and investigators
are anxious to know if Michelle has finally been found.
And if so, was she the victim of a homicide?
This case was somewhat of a big deal.
Everybody wanted to know, is it her?
Is it not her?
NARRATOR It is now up to Dr. G to find the answers in what
will prove to be one of the most disturbing cases of her career.
The box was delivered to my office intact.
The lid was still on it but a little bit ajar.
The box is about three feet long,
three feet deep, but narrow, about and / feet wide.
And then we open the box up.
NARRATOR A quick glance inside confirms the worst.
When you look inside, it does look like there
is a human body in there.
My immediate reaction is kind of your adrenaline goes.
And you're thinking, boy, this is going to be a lot of work,
but let's get into it.
NARRATOR Dr. G can tell right away that it's a woman,
but her identity and cause of death are a complete mystery.
To avoid destroying any potential evidence,
Dr. G and her assistant carefully
remove the sides of the makeshift coffin,
fully revealing the body for the first time.
She is bent at the waist and her knees
are brought up towards her head to fit into that small box.
She's very petite.
You can't see much of her because she's wrapped
in a yellow blanket and then an electric cord
was wrapped with four loops around the body.
NARRATOR But the shocking treatment of the body
does not end there.
We have one piece of evidence that's glaring right at me.
She's got this packing tape over her mouth, her nose, her eyes,
even goes over her ears.
She couldn't breathe through that.
NARRATOR Despite the horrifying implications of this discovery,
Dr. G is determined to stay focused and objective.
At this point, you don't react to any
of the emotion of the case.
I know that she must be the loved one, the daughter,
the sister of somebody.
But my job is to find the answers.
NARRATOR Dr. G surveys the body for clues
to the victim's identity.
Unfortunately, the body's state of decomposition
is too advanced for visual identification
or a fingerprint analysis.
She does, however, determine that the victim's appearance is
consistent with a female in her mid s with wavy brown hair,
weighing less than pounds, and under five feet tall.
Although this physical description
matches that of Michelle Robertson, for Dr. G,
it is not enough.
You know, I wanted a scientific ironclad
identification.
NARRATOR And she knows just where to look for it.
I look in her mouth.
She does look like she has some dental repair.
So we know that there must be a dentist.
NARRATOR People are often identified
by comparing their teeth to personal dental records.
We'll start with the most obvious.
We'll look at the teeth.
We'll look for the fillings.
We'll look at the restorations.
If that's not available, then we have
to use more subtle techniques looking at sinuses, looking
at angle of the mandible.
We want something unique to that individual,
whether it's a filling, a piece of bone, a root fragment.
NARRATOR For this critical task,
Dr. G enlists the help of a forensic dentist
who compares Michelle's dental records to the victim's teeth.
Within minutes, they have their answer.
JAN GARAVAGLIA Sure enough, he was
able to give a positive identification
that her dental records match this body.
So it's clearly Michelle.
NARRATOR Detective Bradley now has the heart wrenching task
of informing Michelle's mother that her daughter has
been found dead.
I already knew.
I already knew.
[ … ]
I knew that if she was in any kind of trouble,
she would have called me.
It was very, very devastating.
But, at the same time, we'd finally known.
We'd finally known.
NARRATOR Michelle's grieving family now
believes that Michelle was m*rder*d
by the very man who buried her body,
her boyfriend Kenneth Garrity.
I felt he was unstable.
He tried to keep her isolated and didn't
want her to have friends, didn't want
her to receive phone calls.
What's going on?
Didn't want her to be as close to us as we were.
NARRATOR You need to listen to me when I'm talking to you.
She would say to him, I will leave you.
And he would always say, no, you'll never leave me.
You'll never leave me.
NARRATOR But suspicions are not enough.
With only circumstantial evidence against Garrity,
this entire case hinges on whether Dr. G
can find proof of m*rder.
JAN GARAVAGLIA It's a bad thing to bury somebody
who dies in your house.
That sounds bad.
But there's not much crime to that.
There is a much more punishable crime
to k*ll somebody who's alive.
NARRATOR But in her quest to prove how Michelle
Robertson died, Dr. G faces a formidable adversary,
mother nature.
The natural forces of decomposition
have left their grim mark on Michelle's body--
Her tissues are very soft.
She's got greenish discoloration.
NARRATOR --destroying the very evidence Dr. G relies on.
Will she be able to find enough clues to help
solve this mysterious death?
Or is it already too late?
I'm hoping, at this point, that there's
clear cut evidence.
Sometimes you can't tell for sure.
NARRATOR Dr. G is carefully inspecting the body
of -year-old Michelle Robertson
for clues that might point to a cause of death.
Michelle's family and investigators
suspect that Michelle was brutally
m*rder*d at the hands of her own boyfriend, Kenneth Garrity.
You want some type of justice.
You want some kind of penalty.
Nobody has the right to do that to a family, nobody.
I already have that tape that was on her face.
That could be a cause of death in and of itself.
But we're looking for other things.
NARRATOR But there's a problem.
Autopsying a decomposed body presents enormous challenges.
When you have a decomposed body
and the tissues are showing some discoloration
and the tissues are softened, it's
much harder to find trauma.
NARRATOR But as she continues her examination,
Dr. G finds Michelle's body to be surprisingly intact.
Ironically, the reason for this lies in the callous way
her body was disposed of.
Being buried helps in this case
because you're going to decompose slower.
It's a little cooler in the dirt.
You're protected from the elements.
NARRATOR But despite the relative good condition
of the body, Dr. G finds no evidence of external wounds.
As Dr. G continues her examination,
Detective Bradley learns another disturbing detail
about Kenneth Garrity, that he had a history of v*olence.
Six months before Michelle's disappearance,
he had beaten her severely causing multiple contusions.
We'd found out that she had been assaulted by Kenneth
Garrity and put in a hospital.
So I guess you'd have to say he's a violent person.
Domestic v*olence isn't just about anger.
It's about control, and it's about power.
And he was trying to have control and power over her.
That's what domestic v*olence is about.
NARRATOR This latest discovery fuels
the investigators' suspicions.
But so far, their case is purely circumstantial.
In order to arrest Garrity, they are counting on Dr. G
to prove that this is a homicide.
So far, the external exam has turned up nothing.
JAN GARAVAGLIA I don't see any major trauma on her.
So I'm very suspicious that she either has a blow to her head
or she's got strangulation or she has both.
NARRATOR Dr. G's next step is to check
for signs of strangulation.
JAN GARAVAGLIA One of the things
I look for is subtle signs of trauma on her neck.
It could even be just fingernail marks, could be just
some bruising.
NARRATOR But the initial inspection yields no clues.
JAN GARAVAGLIA Because of the greenish discoloration,
[ … ]
the skin slippage, I don't see a lot of external trauma
on the neck.
NARRATOR Undaunted, Dr. G looks for another telltale sign
of strangulation.
Then we'll look for the petechiae, the little burst
blood vessels in those thin membranes
in the inside of your eye.
Those blood vessels can burst very easily
with increased pressures put on your neck from strangulation.
NARRATOR But once again, Dr. G comes up empty handed.
When I looked on this case, she didn't have any.
Now she is awfully decomposed.
So I may be missing those, but I don't see any.
NARRATOR This finding, or lack of one,
makes it impossible for Dr. G to make
a conclusion about whether or not Michelle was strangled.
I can't rule out strangulation.
But I don't have anything to rule it in yet.
So already, I look like I'm in a hole here.
NARRATOR But Dr. G still has one
last place left to look for signs of foul play,
Michelle's head.
And when she does, she makes a chilling discovery.
JAN GARAVAGLIA One thing I find is that there's some evidence
of her being beaten.
She's got a bruise or contusion on her forehead,
and she's got a contusion or a bruise on the left side
of her head, and a broken nose.
NARRATOR But these bruises, while horrifying,
are in themselves inconclusive.
JAN GARAVAGLIA We need to see, did these cause her death
or are these just a sign of her being beaten prior to her
being k*lled?
NARRATOR Will Michelle's body give up its secrets?
Only the internal exam will tell.
If you can't put the pieces together that say, this
is a homicide, he may go free.
NARRATOR Dr. G is examining the body
of -year-old Michelle Robertson, recently excavated
from her shallow grave.
But so far, she hasn't been able to determine
the cause of death, much less a means of homicide.
I need to see what I can find on this body and say,
these are the facts that I can say happened,
and these are the things I can say didn't happen.
NARRATOR Dr. G makes the standard Y incision,
cutting from shoulder to sternum to fully
reveal the internal organs.
She then studies the body looking for any signs
of physical trauma.
We look for any rib fractures that would suggest being beaten
or stomped.
We don't see anything along that line.
NARRATOR The next step is to follow
a clue from the external exam.
JAN GARAVAGLIA I really want to evaluate those contusions
or bruises on the head.
I don't know yet if that blunt trauma to the head k*lled her.
NARRATOR Now it's time to take a closer look.
Using an oscillating saw, a morgue technician
cuts through the skull.
Dr. G then steps in and removes the skullcap.
I look inside, but I don't see any evidence of hemorrhage.
NARRATOR This is a serious blow to the case.
The absence of blood means that Dr.
G cannot make an accurate determination about
the severity of Michelle's head trauma due to the decomposition
of her brain.
Whether there's internal trauma or not,
I just can't say.
I don't see any evidence of it.
NARRATOR It appears that the case has reached a dead end.
With no way to tell if her head injury k*lled Michelle,
Dr. G is still without a cause of death,
and her options are running out.
Only one stone remains unturned.
While she didn't see any signs of strangulation
during the external exam, she knows that evidence could have
been erased by decomposition.
To completely rule out strangulation,
Dr. G must now look for evidence internally.
Definitive proof may lie with a small bone
of the neck called the hyoid.
The hyoid bone is kind of a U-shaped
bone that sits in the upper portion of your neck.
NARRATOR The hyoid bone is the only bone in the body not
connected to any other bone.
Its main function is to help support the tongue.
The tiny hyoid bone is protected by thick layers of muscle
and the mandible, making it nearly impossible to break,
except when extreme pressure is applied to the neck.
There are very few ways to break that bone
without strangulation.
NARRATOR Dr. G begins the painstaking
dissection of Michelle's neck.
And before long, she has her answer.
I do the layer Y dissection.
I see that hyoid bone, and there's hemorrhage around it
and there's a fracture of the hyoid bone.
NARRATOR This discovery can mean only one thing.
[ … ]
She was strangled.
NARRATOR But Dr. G is not quite ready to declare strangulation
the cause of death.
The broken hyoid bone, that indicates, at least,
that there is a strangulation.
Now does that indicate she died from strangulation?
Possibly not.
NARRATOR There is no doubt that Michelle was strangled.
But this alone might not have been enough to k*ll her.
What it is is you're cutting off the blood supply
to your brain, and you're cutting off
the drainage from your brain.
So basically, you're not getting oxygen, and you pass out.
The problem is, even after you pass out,
there has to be some pressure maintained
because studies have shown that you can wake back up.
NARRATOR Dr. G suspects this is exactly what happened
in this case, which would explain the tape found
on Michelle's face.
She's probably coming out of her strangulation
making gurgling noises, so he suffocates her
by putting the tape over her mouth and nose
to make sure she died.
NARRATOR Dr. G finally has the forensic evidence
needed to make the case against Kenneth Garrity.
The cause of death is going to be strangulation
with suffocation from the tape and then
contributing soft tissue injuries to the head.
It's a classic case of domestic v*olence, and it's tragic.
NARRATOR After an hour long examination,
Dr. G is now able to report her findings to investigators.
It's Sunday, January th, and Michelle and Garrity
are spending the day together at home.
Suddenly, something triggers Garrity's rage
and he lashes out.
JAN GARAVAGLIA There's a fight.
There's blows to the face, blows to the head
to the point where he breaks her nose, probably stuns her.
NARRATOR Garrity then grabs hold of Michelle by the neck
and begins to strangle her.
His grip is so strong that he breaks Michelle's hyoid bone
and cuts off blood flow in and out of her brain.
Michelle's brain quickly becomes starved for oxygen,
and she most likely loses consciousness.
But she probably then starts to gurgle.
And he realizes she's not quite dead,
so he puts the tape over her mouth and nose and eyes
so she can't breathe.
There is no way she's coming out of that strangulation.
NARRATOR Within a few agonizing minutes, Michelle is dead.
Then in a cold-blooded effort to dispose of his girlfriend's
body, Garrity places Michelle in a box
and buries her with the help of his unsuspecting friend.
There she remains in her shallow grave
until she is discovered by police two months later.
It just amazes me that there are people
that can do this to anybody.
NARRATOR Thanks to Dr. G, investigators finally
have enough hard evidence to arrest
Kenneth Garrity for m*rder.
Once we made the arrest, he confessed.
So that was just the final nail in the coffin.
NARRATOR On May , , Garrity is convicted
of second degree m*rder.
Although he receives a year sentence,
he serves only years and is released on April , .
No one else is charged with any crime in connection
with Michelle Robertson's death.
Michelle's mother is grateful to Dr. G for bringing
her the comfort of the truth.
If it wasn't for her, we would have never known
what caused Michelle's death.
She has children of her own.
So she knows what we're going through.
NARRATOR But Dr. G believes that Michele's death
holds a valuable message for the living.
About % of all our homicides are
some type of domestic v*olence.
And I think the bottom line here is if there's
any evidence of v*olence and you're afraid,
I would suggest leaving quickly.
I know that's very hard.
Call the national hotline for domestic v*olence
and see what your options are, make
a plan that you could leave quickly
if things get out of hand.
NARRATOR In Dr. G's next case, the body
of a mentally ill transient is found in a halfway house.
It doesn't take a genius to figure out he's dead
because he's already starting to decompose.
NARRATOR And Doctor G's first priority
is to figure out if this man was the victim of foul play.
He was last seen by the caregiver who had actually
just given him his allowance.
Did he get in a fight?
Did somebody try to rob him?
NARRATOR District nine is a busy urban morgue
in downtown Orlando, Florida, a city known for its theme
parks and resorts.
But in the morgue's jurisdiction of Orange and Osceola Counties,"], index ,…}
[ … ]
an estimated , people live on the streets
or in group shelters.
When they die, their bodies usually
end up in Dr. G's hands.
Having transients come through is a common thing.
NARRATOR And their bodies often remain unclaimed.
I have a lot of empathy for people who died suddenly
and nobody cares about them.
I have to care about them.
NARRATOR Such is the case of -year-old Alex Wilcott.
Well, today, we have a middle-aged man that was
found dead in a halfway house.
NARRATOR Dr. G's investigator's report on the homeless man
reads like so many cases she's seen in the past,
no job, no friends, no family.
He'd been living at St. Paul's Residence, a halfway house
for the homeless in Edgewood, Florida,
for about a year and a half and spent most of his time
alone in his room.
So it comes as no surprise when Alex doesn't
come down for dinner one night.
But the next morning, when Alex fails to show for breakfast,
a fellow resident goes to his room to wake him.
Alex, you OK?
NARRATOR But Alex isn't sleeping.
Alex.
Then one of the roomies comes in and sees him in his bed--
Hey!
JAN GARAVAGLIA --dead.
NARRATOR A St. Paul's administrator immediately calls
the authorities, who arrive on the scene with Dean Smith,
Dr. G's medical investigator.
We entered the subject's private room, found
him lying in bed on his back.
He was covered with a blanket.
His head was kind of tilted to the right.
He'd probably been dead or hours.
NARRATOR Dean immediately begins interviewing residents
and staff at St. Paul's, who reveal
that Alex had been estranged from his family for some time.
We found out that he's pretty much for the past years
lived a pretty much nomadic life.
We know he's single.
He's never been married, doesn't have any children.
NARRATOR And according to those at the halfway house that knew
him, Alex was often irritable and suffered
from periodic mood swings.
While these few facts provide some insight into Alex's life,
they don't shed any light on how he died.
There's just a lot of pieces of the puzzle
that I don't know yet.
I just told Dean that we need some more information.
NARRATOR While Dean Smith works to uncover more details
about Alex, Dr. G begins her own search
for clues in the autopsy.
OK, let's flip that leg.
NARRATOR She begins by looking for a cause of death
that she's seen all too often with transients, m*rder.
JAN GARAVAGLIA Having transients come through who
are m*rder*d is a common thing.
I mean, it's certainly something we see several times
every year.
Whenever you have communal living with a bunch of men,
some of them are very transient, some of them
have psychological problems, you always worry about trauma.
NARRATOR And despite the limited background information
available on Alex, the investigator's report
does indicate that he was last seen
alive two days earlier when a caregiver gave him
his weekly allowance of $.
There you go.
NARRATOR Is it possible that someone
k*lled Alex for his allowance?
Did somebody take his $, beat him up and take his $,
suffocate him or do something to him?
NARRATOR To a drug addict, $ can represent
two bindles of heroin or up to four rocks of crack
cocaine, a significant fix.
We certainly are going to have to rule out
foul play right off the bat.
NARRATOR Dr. G starts the autopsy by checking Alex's body
for any bruises or contusions consistent with an as*ault.
And she finds her first clue on Alex's face.
JAN GARAVAGLIA He's got blood coming
from his nose and his mouth.
Is it decomposition or is it from some type of trauma?
NARRATOR Attempting to isolate the source of the blood,
Dr. G meticulously examines Alex's head and face.
Feeling the facial bones, nasal bones,
looking in the mouth, I don't see any direct trauma.
So it could still be coming up from his GI track
or coughing up.
NARRATOR But despite these findings,
years of experience tells Dr. G that it's way
too soon to rule out foul play.
There are many people that I've
opened that I've been surprised at finding internal trauma
when I don't see anything external.
NARRATOR Sure enough, when Dr. G examines Alex's brain,
she discovers an intriguing abnormality.
[ … ]
He's got adhesions of the surface of his brain.
NARRATOR And she wonders if this
could be his hidden k*ller.
Dr. G is about to open Alex Wilcott's body
and look inside for answers.
We need his history.
We can find a lot when we go in there,
but I don't like surprises.
NARRATOR If Alex was the victim of a violent as*ault,
Dr. G would expect to find evidence of trauma to his head.
He could have a subdural hematoma
or blood over his brain.
NARRATOR So that's where Dr. G begins the internal exam.
Morgue technicians carefully saw through Alex's cranium.
But right away, the cranial exam proves
problematic for Dr. G. That's because Alex's
brain is starting to decompose.
Now in a normal body, I would cup the brain in my hand
and remove it.
You cannot do that with a decomposed body.
You get one look at the brain.
I hope that his brain is still preserved
enough that I'm going to be able to see
if he does have any trauma.
NARRATOR Dr. G quickly scans Alex's brain
and immediately spots something unusual.
He's got adhesions of the surface of his brain
to the dura, which indicates that he did have
some old trauma to that brain.
NARRATOR Head trauma, but old head trauma.
Despite the start of decomposition of Alex's brain,
Dr. G is nevertheless able to make one other key finding.
There is a no fresh hemorrhage either in the scalp
or in the brain.
There's no skull fracture.
That's easy enough to see.
So we don't have any fresh trauma to his brain.
NARRATOR No recent injury, no indication of foul play.
It's looking less likely that Alex was m*rder*d.
But Dr. G won't know for sure until she
performs the internal exam.
Hopefully, we'll have the answer very quickly.
You make your Y incision and look for hemorrhages,
see if he's had any blows to the chest,
and look and see if there's any free fluid in those regions,
see if there's any free blood in the belly.
NARRATOR But after a thorough examination,
she can detect no signs of hemorrhaging,
no pooled blood, and no signs of bruising of any kind.
It's a finding that leads Dr. G to her first conclusion
in the case.
When the head is clear, the chest is clear,
and the belly is clear, you know,
there's really not much chance that trauma
has k*lled him because we don't see any trauma.
NARRATOR Medical investigator Dean Smith
returns to the morgue with tragic new information
about Alex Wilcott.
When I heard that, I thought, what a sad life.
NARRATOR But will it lead her to his elusive cause of death?
Dr. G's next step is to remove Alex
Wilcott's organs, one by one.
So far, she has found no overt signs of trauma
to explain the -year-old transient's sudden death.
JAN GARAVAGLIA Okey dokey, I expect everything to be normal.
I don't see-- certainly don't see any trauma.
NARRATOR Then, just as the team is running out of leads,
medical investigator Dean Smith returns to the morgue
with new information about Alex that he obtained
from a childhood friend.
We got some fairly sad information
about this poor fellow.
NARRATOR Dean learns that Alex was hit by a motorcycle when
he was eight.
He was pretty much in a coma for about days
in the hospital, had some severe head injuries after that.
NARRATOR Two years later, he suffered
a second head trauma when he plummeted
from a neighbor's tree.
These accidents explain the old head trauma Dr.
G detected in the cranial exam.
She also learns that these injuries caused him to develop
a debilitating mental illness, one that
would alter his life forever.
Supposedly, he's been diagnosed with schizophrenia.
There is a lot of controversy about what
environmental factors might be involved
in causing schizophrenia.
Some studies have shown that people with a history of head
trauma are two to three times as likely to develop
schizophrenia later in life.
NARRATOR Schizophrenia is a neurological brain disorder
that causes paranoia, delusions, frightening behavior,
and disorganized thoughts.
And this new finding could take the investigation
in a completely different direction.
This new information adds some maybe
things I'm going to concentrate a little bit more on.
NARRATOR She must now consider how
Alex's mental illness may have played a role in his death.
[ … ]
There is a subset of people with schizophrenia
that do die suddenly.
So that just adds a little bit of more question.
NARRATOR Schizophrenics often die
prematurely from untreated natural disease or illness.
Schizophrenics are not going to be
as attuned to their bodies.
So we see more advanced diseases in them sometimes.
NARRATOR Dr. G now wonders if Alex developed
a serious medical condition that went untreated
and eventually k*lled him.
That's what I often see in schizophrenics.
They'll have this bad disease going on and no complaints.
NARRATOR Her next step is to examine Alex's heart and lungs.
So I might as well look at the lungs.
NARRATOR These vital organs may hold
the answer to this mystery.
As Dr. G removes the lungs, she immediately
notices something troubling.
I weigh the lungs, and both lungs are very heavy.
The heavy lungs are due to fluid buildup.
Oh my gosh, that left lung is just full of fluid.
NARRATOR A phenomenon medically referred to as edema.
So we have very heavy lungs.
Well, what does that tell me?
Well, people who have heart disease
will have very heavy lungs.
Their heart's just not pumping well enough
and the fluids get backed up into the lungs.
I'm really curious about the heart.
Well, let's do this heart.
This is where the money is.
NARRATOR And when she examines the heart,
she finds another clue.
Wow.
Look at this.
It really looks like he's starting to have
some dilatation to his heart.
NARRATOR Dr. G quickly determines
that Alex's heart is enlarged and the wall is thickened.
His heart's really thickened here,
like ., . in that vicinity.
NARRATOR This is often a result of chronic high blood pressure."], index ,…}
If your blood pressure is high,
your heart has to pump that much harder
to get it out against those pressures.
NARRATOR This extra work can cause the heart muscle
to thicken, just as a muscle thickens
in response to weight lifting.
As that heart gets thicker, it's more prone to arrhythmias,
and it's more prone to fail.
NARRATOR But as she continues to examine his damaged heart,
Dr. G finds another important clue.
When I do the coronary arteries,
it was another little surprise.
He also had some atherosclerosis.
NARRATOR Atherosclerosis is a buildup
of plaque in the heart's arteries
that supply blood to the heart muscle.
Severe atherosclerosis can block the flow of blood to the heart."], index ,…}
But surprisingly, that's not the case with Alex.
Atherosclerosis or narrowing of the blood vessels
was not that severe.
He only had about a % narrowing.
NARRATOR While the atherosclerosis in Alex's
arteries was not severe enough to k*ll him,
Dr. G quickly realizes that it paved the way for a more
serious problem to develop.
Voila, little thrombosis.
I do see a clot adhere to the atherosclerosis.
And I thought, hmm, could that be real?
Blood clot right inside the coronary artery.
NARRATOR A blood clot, or thrombus, can form as a result
of atherosclerotic plaque.
It can become deadly when it stops blood flow
to the heart muscle altogether.
For Dr. G, this clot is the final piece of the puzzle.
He already has a sick heart from the high blood pressure,
and it looks like then he gets a thrombus on top of that.
NARRATOR After an hour long examination,
Dr. G is finally ready to contact
Alex's estranged family to let them know what happened to him.
-year-old Alex Wilcott has been plagued
by a life of misfortune.
After two serious childhood head injuries damage his brain,
he is eventually diagnosed with schizophrenia.
He doesn't appear to be treated because we
don't have any medication.
NARRATOR Alex's debilitating mental disorder
contributes to an isolated nomadic existence.
JAN GARAVAGLIA He's been in and out of mental hospitals
and in and out of halfway houses.
NARRATOR These factors also most likely lead
to Alex disregarding his health altogether, resulting in a case
of chronic high blood pressure.
People who live in halfway houses and live nomadic lives
don't always get the best medical attention.
It's not something you routinely do is
go check your blood pressure.
NARRATOR Untreated, Alex's chronic high blood pressure
[ … ]
ravages his heart.
His heart, over years, had pumped against the high blood
pressure.
The heart got thicker.
And over time, and we're talking years,
the heart starts to fail.
NARRATOR The stress of this extra work on Alex's heart
eventually causes it to fail and also puts him
at risk for atherosclerosis.
Then he develops a small blood clot that further
compromises the weakened organ.
Now as his heart struggles to pump enough blood out,
his lungs back up with fluid.
He would have a little bit of cough.
Maybe he'd have thought that was maybe the flu coming on,
little shortness of breath.
Maybe that's he went to bed.
NARRATOR Over the next several hours, as Alex sleeps,
his overtaxed heart fights to continue beating.
But eventually, his heart gives out.
He most likely died in his sleep.
NARRATOR Unlike many of the transient cases in Dr. G's
morgue, Alex Wilcott wasn't m*rder*d,
and he did not overdose on dr*gs or alcohol.
He died a natural, quiet death.
JAN GARAVAGLIA Dying in a halfway house all alone,
I mean, it really makes you think what a sad, sad life
some people have.
NARRATOR In the end, Alex's untimely death ironically
may have stemmed from two tragic head injuries
he sustained as a child.
This trauma might have led him to develop
a debilitating mental illness, which in turn caused
him to neglect his health.
This poor guy's got no luck either in his youth, all
these horrible accidents that occur to him,
down to dying in a halfway house all alone.
Whenever I do an autopsy, you really do
get a window in people's lives.
This poor kid's life was unlucky from the beginning to the end.