Podcast Summary: The Knife – "What Remains"

Release Date: November 6, 2025
Hosts: Hannah Smith & Patia Eaton
Guest: Dr. Paul Uribe (Forensic Pathologist)

Overview

This episode of The Knife: A True Crime Podcast dives into the complex and tragic story of Michael Cochran's death in Beckley, West Virginia. Through a meticulous blend of narrative and expert forensic insight, hosts Hannah Smith and Patia Eaton explore the ripple effects of crime on a family and a small community. The focus is the second investigation into Michael's suspicious death following his wife Natalie Cochran’s conviction for a multimillion-dollar Ponzi scheme. The episode features an in-depth interview with Dr. Paul Uribe, the forensic pathologist who performed a second autopsy for Natalie’s murder trial, revealing how circumstantial evidence and pathology intersected to bring justice.

Episode Structure

• Background and Timeline of Cochran Case (02:41–14:10)
• Interview with Dr. Paul Uribe: Forensic Pathology & Evidence (16:29–52:32)
  • Initial investigation & autopsy
  • Insulin as the murder weapon and medical context
  • Challenges in the forensic process
  • Impact of circumstantial evidence in court
  • Reflections on the case’s significance
• Verdict and Aftermath (49:42–52:32)

Key Discussion Points and Insights

1. The Case & Context (02:41–14:10)

• Natalie and Michael Cochran:
  Childhood sweethearts in Beckley, WV, who appeared to have a stable family with two children and strong local ties. Natalie, a pharmacist, later left her career to start two companies (TSG and TMG) with Michael—both ultimately revealed to be fronts for a Ponzi scheme defrauding friends, family, and other investors of over $2 million.

• Michael’s Unwitting Involvement:
  Text messages and behaviors show Michael had no awareness of the fraud, thinking the businesses were legitimate and expecting large government pay-outs, leading to stress over unpaid debts.

  "Michael was being extremely generous, thinking that... their companies were... thriving financially, because that's what Natalie had told him."
  — Hannah Smith (07:03)

• Timeline to Death:
  As the Ponzi scheme unraveled, Michael became increasingly worried and stressed. He discovered inconsistencies in Natalie’s accounts but was repeatedly assured by her that millions were imminent. His sudden, inexplicable illness and death in February 2019 (age 38) raised suspicions, especially as Natalie delayed seeking medical care and fabricated his seizure history.

2. Introduction to Dr. Paul Uribe & Forensic Pathology (16:29–18:23)

• Dr. Uribe’s credentials and role as a sought-after forensic pathologist, specializing in unnatural deaths and insulin-related homicide cases—leading to his recruitment in the Cochran investigation after his work on another notorious West Virginia case.

  "...we study death and see what we can learn from it. And we do that, namely by performing autopsies."
  — Dr. Paul Uribe (17:41)

3. Medical Investigation & Challenges (18:23–41:55)

• First Autopsy (7 months postmortem):

  • State autopsy failed to find clear cause; insufficient remains and limited analysis for insulin or injection evidence.
  • The challenge of detecting postmortem insulin was emphasized due to natural decomposition and the fact that insulin levels vary widely in life and degrade after death.

  "When you have a 38 year old male on hospice for reasons that aren't really clear... that's a legitimate reason for a younger person to be on hospice. But he didn't really have a great diagnosis."
  — Dr. Paul Uribe (19:49)

• Suspicious Circumstances Around Death:

  • Natalie left Michael unconscious for hours, sent photos to friends, delayed emergency care, and tried to put him on hospice immediately—raising alarm.
  • Michael’s blood glucose in the ER was <30 mg/dL (normal is 80–100), inconsistent with his health and unexplainable by infection or trauma.

  "[Natalie] took pictures of his unconscious body and sent it to friends and family, which is sort of bizarre and strange, very weird."
  — Dr. Paul Uribe (24:43)

  “His blood glucose was under 30... anything below 60, in an otherwise healthy person, there's usually something going on.”
  — Dr. Paul Uribe (24:43)

4. Second Autopsy & Forensic Hurdles (33:11–38:13)

• Second Exhumation (over four years later):

  • Dr. Uribe sought injection sites and tissue samples, but decomposition (adipocere) left virtually nothing viable for testing.
  • Family fully supported exhumation, seeking closure and justice.

  "There was significant decomposition... It was largely skeletonized remains... But... you don't know if you don't look."
  — Dr. Paul Uribe (37:20)

• No Direct Forensic 'Smoking Gun':

  • No insulin or injection-site evidence could be recovered from either autopsy.
  • All samples from the first autopsy had long since been destroyed.
  • The case thus relied on medical history, clinical facts, and circumstantial evidence.

5. Piecing Together the Circumstantial Evidence (38:13–49:42)

• Insulin as the Weapon:

  • The suspicion of insulin poisoning first arose when Natalie herself brought up insulin during a police interview, which investigators hadn't considered.
  • A vial of insulin (from a diabetic neighbor, under false pretenses) was found in the Cochrans’ fridge, with a single puncture and partly used, months after Michael’s death.
  • Natalie lied about medical needs (breast cancer treatment) and had no legitimate reason to possess insulin.

  "In the refrigerator, ironically, under a candy bar, they found a vial of insulin. With one hole punched in the top of it... it was not a full bottle."
  — Dr. Paul Uribe (42:24)

• Rule-Out of Alternative Explanations:

  • Michael was not a bodybuilder using insulin for performance enhancement; supplements he took were not steroids or insulin.
  • Compared to the Rita Mays case (where tissue evidence existed), Cochran’s prosecution relied entirely on inference.

• Power of Circumstantial Evidence:

  "Circumstantial evidence can be just as powerful as objective autopsy evidence if it's in the right context. And in this particular case, there was literally mountains of circumstantial evidence. Like, literally so many things that didn't make sense."
  — Dr. Paul Uribe (50:16)

  "It was my opinion that there was nothing else that could have killed him. There is no other explanation that makes even a shred of sense in this case."
  — Dr. Paul Uribe (49:41)

Notable Quotes & Memorable Moments

• On the Importance of Considering the Whole Story:

  "The autopsy is just one part of it. We also have postmortem samples... But you have to look at the big picture."
  — Dr. Paul Uribe (31:13)

• On Natalie’s Behavior:

  "[Natalie's] reaction... is like, 'Let's just leave him there.' It's like, wait, no, that's not a normal reaction."
  — Dr. Paul Uribe (50:16)

• On the Jury's Verdict:

  "They found her guilty."
  — Dr. Paul Uribe (49:53)
  "She was found guilty of first degree murder for the murder of her husband, Michael Cochran, and she was sentenced to life in prison without parole."
  — Taisha Eaton (49:57)

• On Family Closure:

  "Once again, it's not gonna bring Michael back, but at least it provides some type of closure."
  — Dr. Paul Uribe (52:06)

Timestamps for Important Segments

• Background & Timeline of the Crime: 02:41–14:10
• Forensic Pathology 101 & Dr. Uribe’s Background: 16:29–18:23
• Details on the First and Second Autopsy:
  • First Autopsy: 18:23–24:43
  • Second Autopsy: 33:11–38:13
• Medical Suspicion & Circumstantial Case Development: 24:43–41:55
• Insulin Evidence & Investigation: 41:55–46:56
• Legal Outcome & Reflections: 49:42–52:32

Conclusion

"What Remains" presents a deeply human story about the limits and potential of forensic science in the criminal justice system. Through the tragedy of Michael Cochran and the tenacity of investigators and family, Hannah and Patia demonstrate how truth can be pieced together without physical evidence, thanks to skilled forensic analysis and careful attention to circumstantial details. Dr. Paul Uribe’s expertise and candid explanations make the complexities of the case approachable, while the hosts’ empathetic storytelling brings listeners behind the headlines to the heart of a family's search for justice.

For story submissions, listeners are encouraged to email The Knife at thenifexactlyrightmedia.com or follow them on Instagram @theknifepodcast or Bluesky @theknifepodcast.bsky.social.