Loading summary
Transcript5 lines
- [00:00]
A
This is an I heart podcast, guaranteed human.
- [00:05]
B
Today's episode discusses the death of individuals. If this sort of thing upsets you, this is once again not the episode for you. May I suggest you watch a movie? Maybe something like dawn of the Dead. Welcome to Mayhem in the Morning with your host. Dr. Kendall crowns. Today's episode, coffin birth. Today I'm going to be discussing decompositional gas formation, the odor it creates, also known as the smell of death, and artifacts associated with it found at autopsy, including the rare event known as postmortem fetal extrusion, also known as coffin birth. So let's get started. When an individual dies, the body begins to decompose and it follows several stages until it finally turns to dust. A part of this decomposition process is the development of dozens of different types of gases. During the early stages of decomposition, once there is no more oxygen circulating in the blood, the cells begin the process of autolysis, which means they digest themselves and eventually rupture, releasing a nutrient rich fluid. After enough of the fluid becomes available, the decomposition process, known as putrefaction, begins. When people think of decomposed bodies, this is what they're usually thinking of. Putrefaction is when the body starts becoming green, begins to bloat or swell up, and the skin begins to slip off. The process of putrefaction is caused when the body is broken down by bacteria, as well as fungi and some viruses, but mostly bacteria. The main one involved naturally lives inside of us. They are sitting there right now in you while you're listening to this show, waiting, waiting for their opportunity to digest you. These bacteria are held in check by the immune system until the individual dies, after which the immune system shuts down and the bacteria start digesting the body, traveling through the blood vessels and lymphatics, consuming the tissues as they go. The main source of the bacteria involved in this process is from the intestinal tract, where There are over 38 trillion symbiotic bacteria in the average human body. One of the main gut bacteria are the ones belonging to the class Clostridia. These bacteria are anaerobes, meaning they don't rely on oxygen to function and generate energy through the process of fermentation. And when they are hard at work breaking down the body, they produce the decompositional gases. There are dozens of different gases released during putrefaction, but there are at least 10 primary ones that are associated with the smell of decomposition. And these are as cadaverine, putresine, scatol, indole, hydrogen sulfide, methanethiol, methane, dimethyldisulfide, dimethyltrisulfide, and ammonia. Each one of these gases adds a unique smell to decomposition. So let's go through each one, starting with hydrogen sulfide and methane. These two both have the same smell, which is reported to be a swampy, rotten egg smell. Next is cadaverine and putrescine. They have the smell of rotting fish, and at high enough levels, can actually be toxic to breathe. Scatol has the odor of feces. Indole smells like mothballs. Methanethiol smells like rotten cabbage. Dimethyldisulfide and dimethyltrisulfide smell like foul garlic and are also an attractant for flies. And finally, ammonia is described as having the smell of stale urine, sweat, or pungent rotting fish. As you can tell, decomposition gases are a variable potpourri of awful smells. And it depends on the environment and how the body is decomposed for to determine how truly bad the body will smell. My first exposure to a decomposed body was during my medical school rotation at the Sedgwick County Medical Examiner's Office in Wichita, Kansas. I had been there probably about a week or so when a case came in. It was a typical story of an elderly male with no family. He had not been seen for weeks. Mail in newspapers were piling up, and the neighbors had been noticing a foul smell coming from his house. Sadly, there was no paperboy paying attention to the fact that his lights were always on and his windows were full of flies. Eventually, a neighbor had become concerned that nobody had seen him, and they called police. When police arrived, they found the decedent's house locked and secured. They had to kick in the front door to gain entry, and when they entered the house, they were struck by an intense, foul smell of decomposition. One of the officers reportedly threw up instantly. They found the decedent dead in bed, covers pulled up. It looked like he had just been sleeping. But of course, now he was in a moderate state of decomposition, which meant he was bloated and green with skin slippage and flying maggot activity about his body. The body was brought to the medical examiner's office, and when I arrived at the morgue that day, the forensic death investigators told me about the case, and they told me the chief medical examiner wanted to know when I arrived because she wanted to be the one who. Who showed me the case, because it was the first decomposed body I would have ever experienced. And after all, that is an important milestone in a medical examiner's career. When the chief found me, she took me into the Decomposition Infectious disease Morgue it was a morgue that was separate from the rest of the building. It had its own special air handling system to filter out the foul smells and infectious diseases and keep them from circulating in the building or outside. When we walked into the morgue, most of the lights were turned off, except for the lights directly over the body. They illuminated the decedent in the darkness, making for a very dramatic display. The body bag was already opened and the decedent was clothed in a formally white tank top that was now stained dark green with decomposition fluid and red shorts. The clothing was stretched to the limit by the bloated, decomposed body. His skin was an odd bright green to dark black green. There were areas of skin slippage and a fluid exuded from his mouth and nose. Flies and maggots were swarming about his body. It was truly something that I had never seen before. The chief medical examiner turned to me and she said, take a deep breath and tell me what you smell. I breathed in deeply, but all I could smell was wet, stale saltines and blueberries. I told her what I could smell and she looked at me and she said, what? No, you smell the smell of money. Because this smell, the smell of decomposition, is what separates the true forensic pathologist from everyone else. And that smell will forever keep us employed because very few can stand it. That was a very true statement. Over the years, I've seen many a medical professional gag and vomit from a malodorous smell. When I was in residency, the chief resident who became a gastrointestinal pathologist had to show me how to do an autopsy in the morgue. And in the very next morgue, they were working on a decompositional case. And throughout the entire dissection, he gagged and almost vomited and finally told me to just finish the case up because he had to go because he couldn't take the smell anymore. I noticed this amongst my peers. The ones that didn't want to be forensic pathologists, never wanted to be around when there was a decomposed body. And like I said, it never bothered me. I was truly where I wanted to be. For me, though, it is an odd smell. Sometimes stale saltines and blueberries, occasionally a damp dirt smell like that of my grandmother's root cellar. And sometimes the bodies smell like yeasty bread. I have always known that I don't process smells like the rest of the population. Some smells I can pick up, like the intense smell of cinnamon, and others I can't process at all, like the smell of urine. I just don't smell it. Was it something I was born with, or is it the result of multiple concussions that I have suffered throughout my childhood? Who knows, but it definitely makes me well suited for the smelly world of forensics.
- [08:50]
A
Crime Stories is so proud to be supported by Grand Canyon University, an affordable, private, nonprofit Christian university based in beautiful Phoenix, Arizona. GCU doesn't settle for the status quo, they shatter it at gcu. Academically rigorous, industry driven programs are built to move at the speed of relevance with practical skills, career readiness, and opportunity for every learner. And GCU believes education should not be a privilege, but an affordable path forward for all. In fact, they've kept tuition at the same rate on their traditional campus for the past 17 years and they're continuing that into the 2026-2027 academic year. Grounded in Christian faith, GCU works to empower the next generation to lead with integrity, serve with purpose, and help transform their communities, building a future that matters. GCU is Purpose Driven Education. Take action. Find your purpose at GCU, private Christian, affordable nonprofit. Visit gcu.edu to learn more.
- [10:10]
B
All new drinks are now at McDonald's with refreshers like the Strawberry Watermelon Refresher and the Mango Pineapple Refresher with Popping Boba to crafted sodas like the Sprite Berry Blast with berry flavors and cold foam. Who knew ice cold drinks could be so fire six? All new drinks are here now at McDonald's. Refreshers contain caffeine Unlike me, there are many a creature that are able to process the smell of decomposition quite well and are very attracted to the dead decaying body. These creatures help expedite the decomposition process by consuming the body, and among them are coyotes, rats, vultures, and flies. Flies are a constant companion of the dead, and in every morgue that I have worked in they are always there. The main flies we deal with are blow flies, flesh flies, and house flies. They arrive within minutes after death, laying their eggs around the orifices, eyes and hair. The eggs hatch in as little as 8 to 24 hours after being laid, producing maggots, and when the maggots come out, they instantly begin to consume the tissues. Maggots are soft, legless worms that are white to yellow in coloration. They range in size from a grain of rice to almost an inch, depending on their age. They can be moving individually about the body or in giant swarms of hundreds in a particular location. They can be very active, writhing around on the surface of the body or under the epidermis, giving the skin an undulating appearance. And larger groups of maggots, known as maggot masses, can create intense heat because of their muscular movement and high speed metabolism. They can create temperatures that are up to 54 degrees Fahrenheit, higher than the surrounding air temperature. And you can actually see steam rising from the bodies in the cooler. Occasionally, they can also create a frothy foam in chest cavities or on the skin surface from their feeding frenzies. At autopsy, you have to scrape them off to evaluate the body. They will get on you and crawl around. I have never been bitten by one, but I have always had on my ppe. They are just an occupational hazard. They'll be on your sleeves, your gloves sometimes, or even on your shoes. And you just have to brush them off and keep working. There was one time one got on my pen and I wasn't paying attention and it crawled into the tip and clogged it. So I just threw that pin away and got a new one. Who wants to dig the maggot out of a pen? Some of the maggots jump and get onto the floor. And no matter what you do after an autopsy, there's always maggots around for the rest of the day, crawling on the floor in the sink. And sometimes they make interesting trails in the blood in decompositional fluid that almost looks artistic as they search for a new food source. Occasionally, the maggot activity is so severe, they've consumed all the organs and there's really nothing to find at autopsy. And when you don't catch these maggots or get rid of them, they grow into flies. And they are all over the morgue in Cook County. The flies were so bad that they had fly strips hanging from the ceiling to catch the wayward flies. They did work, but unfortunately they hung just low enough that I could run into them. And occasionally I would get stuck on one of the fly strips with my scrub cap. I would have to pry this fly strip off my head and then continue working. It was always frustrating when that would happen. So flies, they just add to the decomposition experience and make it just a little bit more miserable. The decomposition gases cause the body to swell or bloat, which we'll go into more of that in a little bit. But the body's like a balloon, and when you have to cut into it, it suddenly deflates, releasing its smelly contents into the morgue. It will fill the entire room with the decomposition odor, and you have to spend the rest of your day working in the smell. The other problem is it can make the whole building smell. Typically, most offices have a decomposition in infectious disease morgue that has a different air handling system, so the smell doesn't get all through the building. In Cook county, if you didn't do the case in the decomposition morgue, it would make the whole building smell. The problem was the decomposition morgue was difficult to work in. It had poor lighting, and it meant working in two separate areas, which would then need to be cleaned by the autopsy technicians. And they were never a big fan of this. Having a decomposition case was always something you wanted to avoid. But if you did have one and you autopsied it in the main morgue, the smell started circulating about the office, and it would cause the chief medical examiner come down to figure out who was doing a decomposition case outside of the decomposition morgue. If he caught you doing this, he would get very angry and tell you never to do it again, and you would have fear that you would possibly get written up. So even if it was a pain and the autopsy technicians would complain, you would just go work in the decomposition morgue, because ultimately, you wanted to keep your job. One of the doctors hated to work in the decomposition morgue. He figured out a workaround. What he did was, before the decomposition case was started, he covered the large intake vents that were in the morgue with. With thin pieces of cardboard that he had cut specifically for this task. Before the case would start, he would pull the pieces of cardboard out from his secret hiding space, place them on the intake fence. Once they were covered, they would make a bit of a whistling noise, and he would start the case. The air would be foul and stagnant in the room that he was working in. And if you were in that room, you just had to deal with it, too. He would always do his decomposition cases last. Once he was done, the autopsy technicians would clean up the station and sew the body back together and wheel it back into the cooler. He would gather his notes and head to his office. And right before he left the morgue, he would pull the pieces of cardboard off. There'd be a loud whoosh as all the stagnant air would be sucked into the intake vents and pulled out of the room and then circulated suddenly about the building. If you were in your office and not on the morgue on one of these days, you would be sitting there doing your paperwork, when suddenly there would be an overwhelming, intense decomposition smell filling your office and filling the entire building as well. And as soon as this would happen, it was like clockwork. The chief medical examiner would come out of his office and head directly to the morgue to figure out who was doing this. And when he would come down looking for who was doing a decomposition case in the main morgue, he would only find an empty clean room. This went on for a little while, and then one day, the doctor who had perfected this technique Was working in the decomposition morgue just like the rest of us. I guess it only took a little while for the chief medical examiner to figure out what he was doing and caught the perpetrator and redirected him. Even when you're working in the decomposition warg, the smell will still get about the building, just not as intense. It's a common occurrence, and the secretarial records and administration staff Always has to deal with it, Especially in the summer when decomposition cases are at their highest. We had a phrase in Travis county in Texas, which was, in the summer, the grass gets yellow and the bodies get green. It's an occupational hazard that I'm sure some of the staff didn't realize that they would have to deal with when they signed on to work at the office. And no matter how many candles and air fresheners you use, it still permeates the air. It permeates your clothes and your hair and does not go away. You have to wash your clothes and take a shower to finally be rid of the smell. Due to my unique smelling ability, I often don't notice that I have an odor After I do a decomposition case. I typically wear scrubs that I only wear in the morgue and change into my going home scrubs when I'm done. So at least that part of me doesn't smell when I get home. Beth, on the other hand, who has an incredible sense of smell. The second I walked through the door to our house, she could tell no matter where she was that I had been around a decomposed body. And she would instantly tell me, oh, you need to go take a shower before you go any further. And after all these years that we've been married, I know the routine. So instead of her telling me to go shower, I just assume I smell when I get home and I instantly go take a shower. People often ask me, how do I deal with the smell. I have heard others say, breathe through your mouth, but then some say, then you can taste it. The main piece of advice that I've heard that I also share with other people Is that it's just best to breathe normally and focus on what needs to be done. And eventually you'll become nose blind to it, but you can't leave the room because if you do, your nose resets and then you have to start the whole process over again. It stinks, but if you can smell it, you can power through it eventually. But even some medical examiners struggle with the smell throughout their career. One that I worked with in Cook county, had been working for over 20 years and had done thousands of autopsies. But he always gagged with the bad decomposed cases, which made him an easy target for individuals seeking revenge with case assignments. When he would get one of these cases, he would diligently work on it, gagging every five minutes or so. But he never complained, and he always got it done. And he was incredibly thorough. As I said earlier, decomposition gases cause the body to swell or bloat. The body swells up like a balloon. The skin stretches and becomes tight. The gases can get between the epidermis and dermis and create blisters. These large blisters then can fill with decompositional fluid and they burst with minimal movement and getting fluid all over the place, if you're not paying attention. Also with this separation of the epidermis and dermis, it can result in skin slippage, which means the outer epidermal layer slips off the body. And one interesting thing is that the hands and feet slip off in a glove like distribution. As I have said on a previous episode, you can take the skin of the hands, place it on your own skin, and then get fingerprints from it. It's always a little odd wearing someone else's skin to accomplish this task, but it's just part of the job. Another thing that happens with skin slippage is tattoos can become more brightly colored and more visible because the tattoo ink is actually on the dermal layer. So when the skin slips off, the dermis, which is still there, retains the tattoo ink, and you can get a very good picture of it for documentation purposes. The swelling of the skin distorts the facial features and makes the individual difficult to identify. With standard forms of identification, like a driver's license, passport, or other id. So other means of identification are needed to be used. In the severely decomposed cases, such as dental records, radiographic studies, or even DNA testing, the pressure from the gas can actually cause the body to rupture. Typically, this is seen along weakened areas of skin, like a previous surgical incision or a healing scar. In these areas, the body will split open, simulating an injury. One case that I had was an individual who was intoxicated and he was walking around the house naked, which a lot of people Do. Shockingly enough, when he collapsed and fell on multiple liquor bottles, shattering them. Some of the glass shards stabbed into his abdomen, penetrating his liver and his intestines. He got up and then collapsed, falling backward on a mattress that was on the floor and bled to death. He was not found for nearly a week, and by the time he was found, he was moderately decomposed. His skin was bright green. His body was swollen with decomposition gases. His abdomen had three large, gaping, parallel incised wounds that stretched from the bottom of his chest to just above his genitals. It like someone had gutted him. When evaluating these parallel incised wounds, I noticed they appeared to be bloodless and there was no underlying associated injuries of the organs. Upon further examination, they appeared to be old areas of scarring from previous surgeries that had ruptured because of the swelling from the decompositional gases. I did find two small stab wounds from the glass that had hemorrhage associated with them and corresponding injuries in the organs, and also recovered the glass shards. And this explained his death. Cause of death, sharp force injuries, manner of death, accident. But initially it looked like he had gruesome sharp horse injuries consisting of large incised wounds splitting open his body. And that would have been a much different type of case. The other thing that the pressure causes is purging of decompositional fluids out of the orifices, meaning the mouth, vaginal canal and rectum. These are often confused as evidence of sexual assault. And there have been more than one case in my career in which there was a concern of this. In one particular case, it was that of an elderly woman who was fully clothed in pajamas and underwear. She was found in a locked and secured residence, dead in bed. The investigating officers were concerned because she had what they thought was blood coming from her mouth and there was blood on her underwear. They insisted a complete sexual assault kit be done at autopsy. She had no external evidence of injury. She was markedly swollen and she was obviously purging fluids from her mouth, vagina and anus. I tried to explain this to the officers, but they were insistent that they wanted to rule out a sexual assault. I did the sexual assault kit as they requested and it was submitted to the crime lab and nothing was found. They did an intense investigation and found there was no nefarious activities associated with her death. She had not been involved in gang related activities, nor was she a cartel member. There was no large insurance policy out on her. She was just an old lady who had no family and died and decomposed. She was never sexually assaulted. It was Just purge fluid from decomposition that was forced out of her body because of the pressure from the gases. Another thing is the decomposition gases can be flammable. And one of the things that is often done to show this to fellows and medical students is a needle is placed in the swollen abdomen of the decedent. As the gases are released from the needle, it's lit up with a match or a lighter showing a bright blue flame coming from the gases released from the body. It's always a good parlor trick, but it's not something that I would recommend because I've always wondered what happens if the flame pulls into the body. That's a lot of gas. Would the body explode? But in the times I've seen this done, they usually pull the needle out quite quickly. So nothing like this has ever happened in my presence. Finally, one of the other things that very rarely occurs with decompositional gas pressure is what is known as postmortem fetal extrusion, also known as coffin birth. I have recently discussed this on the Nancy Grace show when we were reviewing the death of Shanann Watts. If you're not familiar with her death, she was pregnant and soon to have a son. Her husband, who was having an affair, evidently did not want another child and manually strangled her. He also killed their two small daughters. The daughters were shoved into oil storage tanks and Shanann was buried in a shallow grave. Her body was not found for three days. And when she was found, she was described to be in a state of mild to moderate decomposition consisting of generalized discoloration, which is the green coloration of the skin, skin slippage and bloating. Shanann was also noted to have a second trimester fetus and placenta found, and I quote, expelled from the gravid uterus. This is not the first time that I've discussed coffin birth on the Nancy Gray show. The other case that I have discussed on her show was that of Lacey Peterson. If you're not familiar with her, she was murdered by her husband back in 2004. She was pregnant and her husband was having an affair. Notice a trend here. He strangled her and then her body was weighed down and dumped in the San Francisco Bay. Much like Shanann, her unborn fetus was found separate from her body. It actually washed ashore and was found before what was left of Laci Peterson's remains at autopsy. Laci's uterus was described as enlarged and intact, and they could not find any evidence of a cesarean section, meaning that she had also had an instance of coffin birth. Coffin birth occurs because of the amount of pressure formed in the abdomen by the decompositional gases pushes down on the uterus and causes the baby to be expelled. The thing is though, the smaller the baby or fetus is, the more likely the entire fetus will be extruded. At 13 weeks, a fetus is about the size of a lemon, 27 weeks, about the size of a cauliflower, and by 40 weeks it's the size of a watermelon. And once it gets this big, it would become very difficult for just gas pressure to force it out. So depending on the size of the fetus, it may only be partially extruded from the mother's birth canal. Coffin birth has been documented for centuries. Though early accounts lack scientific precision. There has been several articles written on this subject, most notably the majority of them taking place in Germany for whatever reason. One article described a 34 year old woman who was eight months pregnant. She had died of a heroin overdose and when her body was discovered she was in a state of moderate decomposition. Her fetus was found partially extruded through the birth canal. It was an eight month gestation fetus. At this size, it's less likely for coffin birth to occur because to extrude a fetus of this size, more pressure is needed to expel it from the uterus. Postmortem fetal extrusion of a mature fetus can occur, but it requires a dilation of the internal os of the cervical canal prompted by antemortem uterine contractions in the sense of the first stage of labor. Things like infectious disease, eclampsia and drug abuse can simulate this first stage of labor, causing the internal os to soften and relax the birth canal. There is also a theory that post mortem uterine contractions occur by the onset of rigor mortis within the uterine musculature that then results in contraction of the uterus and can force a late trimester coffin birth to occur. The literature discusses that a coffin birth is something that must be determined by the medical examiner because you have to separate post mortem fetal extrusion from a possible live birth. And this can only be done by evaluating the fetus and checking to see if there is any sign of life. If you do find this, it would mean the mother was buried alive or there was an attempted abortion. It cannot just be assumed that it is a result of a coffin birth. So a full autopsy of mother and fetus, as well as a microscopic evaluation is necessary to make the final determination if it truly is a coffin birth. I have never seen a case of this, and I hope I never do. But because of the research I've done for the Nancy Gray show, at least I know what to look for. In closing, I would like to thank the members of Team Mayhem. These are the individuals that have gotten me through all the shows so far. And they are first, Max Loyden, who's the technical editor of audio production, and Katie Flatley, the digital producer extraordinaire. I'd also like to thank my wife, Beth, for helping me with multiple aspects of the show and the TikTok page. And finally, I'd like to thank Car55 for providing the music for the show. That brings us to the end of the episode. I hope you learned something, and I hope you were entertained. Until the next time.
- [31:35]
A
This is an I Heart podcast. Guaranteed human.