S3 E10: And Many More

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Dr. Gatz. John, what are you doing here? I just got reinstated last night. That's great. Maybe you'll keep the job for more than a few weeks this time. Listen. A couple months ago, when we last spoke, I didn't really get the chance to ask if everything was okay between us. Or at least civil. We didn't really leave things on... What do you want, John? I can be civil with you if you're just honest with me. And you never are. So, what is it you want? Nothing. I'm not here to... John...

I'm not registered in the system yet. I was wondering if maybe you could pull some hospital records for me. And there it is. What files? Hospital records for patients with storm shock symptoms. From like 1989 and onward. All of them? Yeah. It doesn't matter how many there are. And what are you working on that you need these for? Just comparing some information. Hmm. Anyone in particular? Today's your birthday, isn't it? Happy birthday. Thanks. presents How I Die.

Patient file after patient file. So many people were hit with storm shock. It's unbelievable. And it had a pretty high mortality rate, too. I'm counting... maybe 30 or so people who came in with symptoms that actually lived. Jeez. Crowley?

Dr. Spacer, I wasn't aware you were back. Hi, Dr. Clark. I just got back yesterday. Ah, well, I hope you don't mind if I use your lab one last time? Of course. Yeah. Is it a case? Not officially, no. A patient of mine from the trauma bay. He unfortunately passed on the table, and I'm conducting an autopsy to see if there's anything I missed. Just you?

Were you expecting someone else? Uh, no. I meant like no one else from surgery wants to know. I really don't want to take up any more of your time, Dr. Spacer. I can handle the autopsy. Of course, sure. I'll just be in my office. Let me know if you need anything or... I think I've got the lay of the land here. Thank you. Actually, I'm going to grab a drink from the lounge. Can I get you a coffee or anything?

Uh, tea would be great, if you don't mind. Sure. Any particular kind? Earl Grey, if they have it. You got it. Hello? Anyone here from surgery? Uh, excuse me. Yes? Were you just in surgery? I was, with my daughter. How's she doing? Oh, I'm sorry. I think I'm looking for someone else. Wait, what? Sorry about that. What the fuck?

Admission, patient was immediately rushed to critical care, then surgery with myself, Dr. Miller, Dr. Hamid, and surgical nursing staff. Here's your tea, Dr. Clark. Thank you. Oh, uh, gloves. It'll be right here for you. Thank you. Patient presented with broken pelvic bone, shattered femur, and erratic heart rate upon initial admission. Well, what the hell happened to him? Not sure.

He was homeless. Someone found him on the side of the road and called 911. Ah. Yeah. Do you have a name? Does he even have insurance? We don't. He'd be a John Doe. No one ordered this autopsy then, did they? I'd like to know what happened. He deserves that at least. Sorry to hold you up. Dr. Clark, do you mind if I assist? You don't have something more pressing? Not until I hear from Crowley. Otherwise, it's just paperwork and whatever autopsies come from upstairs. Huh. Paperwork. Yeah.

Another set of hands couldn't hurt. Addendum to the autopsy notes. Dr. Spacer will be assisting going forward. It's been a long time since I've done an autopsy like this. Didn't you have colleagues assist at Hopkins? Oh, yeah. I meant, like, it's been a long year. I can only imagine. What have you got so far? Not much.

You heard what he came in with? Broken femur, pelvic bone, erratic heart rate. Right. He was unconscious initially, entering shock. So whatever happened to him was recent. Most definitely. But even with his injuries, he shouldn't have died during surgery. You slowed his heart rate quickly enough? Correct. He was given a dose of morphine and IV.

dr gatz admitted him ordering an mri x-ray and ct before he came to me scans revealed the aforementioned breaks and bone shards present in the lower thigh muscles that would need to be removed We took him into surgery with a fairly straightforward plan. After his heart rate was normalized, he was given a stronger anesthetic to begin surgery. I don't see any track marks. Neither did I. That's why I made the call for anesthesia.

But since he was homeless, he could have been on drugs. His blood test revealed nothing in the past 24 hours. Not knowing his medical history could have been a risk with anesthesia. Correct. It was a judgment call. And now you're worried that anesthesia killed him? It's a possibility. Are you covering your ass for an M&M? There won't be a morbidity and mortality conference for a homeless patient. The hospital admins couldn't care less.

And with no family to be concerned. So the autopsy is purely to know... Where I made the mistake. Shit. I can continue this without you if it's a frustrating case. I mean, it is a frustrating situation, regardless. Aren't you frustrated? Yes. Very. All the more reason to do it, then. Agreed. Thank you.

Look, Dr. Clark, you don't need to keep being so cordial with me. I was a dick to you the first couple times we met. You were under a lot of stress. I don't need excuses made for me either. There aren't any. And I acknowledge that now. Seems Dr. Kim has helped, huh? Sorry. I shouldn't have said that. Let's get back to the autopsy, if we can. Your lead. Because of the surgery, he's already partially prepped for conducting the internal exam. That was for the autopsy notes.

You and Dr. Kim were close right? I'd really rather not talk about them. You were right though. Before it got ugly the one thing I learned from therapy with Kim was to be accountable for the things I do. And say. And that's why I don't need you making excuses for me. I'm an ass, lashing out. You didn't deserve that. Would you mind holding that side of the retractors? I've got to crack open his chest cavity.

Now it's a party. Beginning internal exam by expanding the ribs? Jeez, that is a lot of internal bleeding. His BP dropped radically in the OR. I thought I nicked an artery. But you didn't. I didn't. It was the first thing I checked. Nothing in the legs or pelvis was nicked. So I started opening his chest when his heart stopped. And I first saw the blood. Damn. It had to be another major artery. I've got something. A torn jugular vein. It's...

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Was there maybe a traveling bone fragment? No, we would have seen it on the x-ray. Hmm, are those the scans? The damage goes for a few inches up the vein. He stood no chance. Which means you didn't make a mistake. It means we missed something internally. I'm seeing something on this x-ray. Where? Near the neck. Here.

We ruled that it's a small crack from whatever happened to him, not something life-threatening. What if it wasn't a crack? What if it was an object? In his neck? There were no penetration marks, no blood. Could have been there from before. Check inside him. Anything? I don't know what I'm looking for. What is that? A pen. A surgical pen? That's what it looks like.

Hmm. Let me put it under the microscope. It's got to have a serial number. A surgical pin in his neck. And there's the serial. It was legit. Let me... It was obscured inside the bone during the x-ray, but the MRI was done afterward. Giant magnet machines plus surgical pins equals bad. The MRI must have moved the pin. It completely shredded his neck veins.

I got a match on the number. You did? It was registered to an Xavier Wallace during a collarbone break in 2002. He was from here. Military vet. And he came back to live on the streets. To be all alone with no one. Without knowledge of the pen. Don't. He was unconscious with no ID. No medical history.

There was no way to know he had that surgery or that he still had the pin inside him with how the x-ray looked. He needed an MRI after the accident. It wasn't anyone's fault, especially not yours in the OR. I disagree, Dr. Spacer. We all failed him. At every step of the way. After serving our country, the state, the government failed him.

Then our own city for leaving one of our own out on the street failed him. And then Dr. Gatz and I were just the last straw. This man died because no one could be bothered to give a...

A flying fuck about him. There is no one that should feel better about his death. Do you take every death this hard? Thank you for your help, Dr. Spacer. I wasn't being facetious. I was really asking. I couldn't do what you're doing, Nathan. I became a pathologist partly because I couldn't deal with the stress of being in an OR.

or making those life-changing decisions. I can't have that kind of responsibility over someone else. I would take it this hard every time, and I'm afraid of that, and afraid of what that would do to someone. How do you deal? Silence. Sorry. No, that's how I deal with it. Silence. From the time I leave the hospital until I open my car door at home, I sit in silence. No music. No podcast playing on the drive. Just silent reflecting.

This one hits especially hard. The thought of him being out there with no one, it reminds me of how I felt when I moved here. It's probably how you felt as well. Is that why you tried to be so nice to me? I still think about them all, though. Patients from med school all the way until now. Twelve people have died on my table. Most weren't avoidable. But they still eat at me, and I find myself sitting in my driveway for longer and longer every time it happens. Car off, sitting in the cold.

I used to live close to the hospital. After I moved here, I thought it would be convenient. And then I reached my third patient who died on the table and I sat in my driveway until the next morning. Just staring into space. I moved further away after that. The furthest house I could find. So I could drive in silence. Pretty soon I'll be commuting from a different state. Did his patient record list next of kin? It did. Could you write down the name and number for me?

I'm going to give them a call. Yeah, of course. Do you want me to process the body for you? That would be... Thank you. Nathan? Yes? After work, would you like to grab a drink? Ah, no, thank you, Dr. Spacer. I didn't mean like a... I meant as colleagues. Instead of being alone. I know what you meant. And I appreciate the offer, but no thank you. Thanks for the assist, Dr. Spacer. Glad to have you back.

Hey Crowley, it's John. Look, I know you said I should keep out and I do plan to, but before our meeting I was looking into something and I think you should know about it. Before you get mad about the... Full disclosure and whatever, this is just conjecture. It's just a pattern that I noticed and something I was looking into. I have a bunch of files on victims from the 1989 effects of Storm Shock.

Patient files. Jake Drazer, Frank Reynolds, Bianca, Becca, they're all on the list as patients of the hospital who lived after the effects. And I got to thinking, if the killers were replicating the effects of storm shock, they must have somehow been involved. Maybe they were a victim themselves who lived and they were trying to kill others or something. I'm not sure. You know the serial killer mind better. But either way, the list of people might be a good starting point. Oh, and by the way...

Did you know Officer Hart was on the list? I'm not sure if that's a breach of confidentiality, but he had symptoms in 1989. Not that he's the killer at all, just thought it was interesting. Anyway, if you want the files, just stop by or call me back and I can come drop them off. And Celeste, I'll bother you about how your case is going. See you around. Bye.

How I Died is an Audio Media original production, created and written by Vince Dejani, directed by Chroma Sikora, and mixed by Eric Howell. This episode was edited by Chris Harris-Beachy, with sound design by Eric Emma. Our theme song was created by Silent Mike. Starring me as John Spacer, Shayna Waring as Sheriff Crowley, Luis Bermudez as Eric Mendez, Vin Vox as Dr. Kim, and Caitlin Roberts as Amelia.

This episode guest starred Albie Robles as Dr. Clark and someone as Joy. If you're enjoying the show, please head over to your favorite podcast app and give us a rating and a review. It really helps us out a ton and we definitely appreciate it. Thank you so much for listening. And until next time, try not to do it. Hear the most popular fiction podcast of all time.

which the New York Times described as what might occur if David Lynch was a producer at your local radio station. Welcome to Night Vale is a twice-monthly update from a small desert town where the paranormal is real. Every conspiracy theory is true. We all have to get on with our lives anyway. Welcome to Night Vale is available wherever you get your podcasts.

All right, girls, this is the place. We'll get everything loaded over to the boat, and we'll lock up the truck. Don't leave anything behind. Wait, is that it? That's where we're going? Yeah, that's it. Seal Skin Rock. Wow. Return to the mysteries in Don't Mind, Seal Skin Rock. Subscribe now to catch the premiere, and we'll see you on The Rock.