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Old 09-02-2016, 03:05 AM
choie choie is offline
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Help me solve the real-life mystery about my late brother-in-law (apologies for novella-like length)

Post-writing preamble: After all this, I realize this is really mostly me just blogging about this whole awful, tragic mess, and what it's done to my beloved sister, and me too since I'm also grieving for both of them. Forgive me for going endlessly on. I just can't tell you how bereft and shocked we all are, and I guess I just needed to vent.

There is one legit medical/autopsy-related question at the very bottom, if you wanna skip ahead.
========

Please help me unravel a conundrum that is causing my sister even more pain in addition to the almost unbearable anguish of her husband's sudden death ten days ago.

Early on August 22, my sister Carla's husband, Mike (48), died unexpectedly. He hadn't been ill (as far as Carla knows); the police and M.E. found nothing to indicate this wasn't natural causes, most likely a heart attack. The night before, Carla and Mike had been to Mike's class reunion party. Carla had left earlyish (well, 11PM); Mike had stayed to clean up and wind down w/stragglers.

BACKGROUND:

Mike had a history of a single heart attack 20+ years ago when he was a chef/restaurant owner and stressed as hell. (Much like most chefs.) He had a cocaine addiction at roughly the same time; hasn't used since (again, as far as Carla knows). Also, he was a diabetic, although it was pretty controlled. His last visit w/a doctor was a year ago July, when he'd had a kidney issue and herniated disc; otherwise he was fine.

One other big health thing, which only Carla knew about--she told me only last week: In his early 30s, Mike had non-Hodgkins Lymphoma. Something he apparently kept completely secret from his family (don't ask, but in short, they're assholes) and the majority of his friends, the reason probably being that he didn't want to worry them, and also didn't want their fear to add to his own. So, both self-protective and protecting others. Was treated, went into remission, end of story.

Maybe.

THE MYSTERY(/IES)

Now we get to the weird things that are troubling us, Carla especially. Oh, and just to start off with, the autopsy came back inconclusive, toxicology report pending. We won't know anything for 4 to 6 weeks, God help us.

CLUE 1. The day after Mike died, one of his friends who had also been to the party, called Carla and said that at about 3AM, he (the friend) had been about to leave the 'afterparty,' so to speak, when Mike had said, "You sure you want to go? There are party favors..." Carla didn't understand the reference (she is not exactly hip to the drug scene, to put it mildly), after which the friend explained that he assumed that meant, well, drugs, in particular coke. Friend claimed he'd said nah, it was too late, and left Mike w/the rest of the few left at the venue.

This took Carla aback (MAJOR understatement) because as far as she knew, Mike no longer used.

Before everyone leaps to the assumption that Carla was just blind as a bat and any husband/spouse/partner can easily pull the wool over another person's eyes, I should mention that Mike/Carla live in a studio apartment, both work from home many days of the week, they spent almost all free time together, and in his attitude/behavior there was never never never any indication that Mike was using anything.

I also spent time w/Mike--he and I were good friends (I live in the same building they do), and he never had a problem with my stopping by spur-of-the-moment just to say hi or hang out. The reason I mention this is that it's not as if he was behaving secretively, as if he had anything to hide.

Mike was a workaholic who did tech support for restaurants, and he was extremely well thought of by his clients, who knew they could count on him like clockwork. Also, Mike was just so... God, how can I sum this up?

He was quite simply one of the most straightforward and true-to-his-word people I've ever known. I don't trust people easily, but he made me feel completely comfortable. He treated me as a sister and friend. Most of all, he made Carla happy and quite clearly adored her. For all these reasons and more, I didn't just love him, I admired him greatly.

I'm not saying this admiration would be diminished if I found out he'd used coke; an addiction is an addiction. I would be saddened that his illness had made him hide something from Carla and, possibly, contributed to this tragic death.

CLUE 2. Right after the funeral, as Carla was accepting the condolences of attendees, one of Mike's not-very-close business contacts said to her in hushed tones, "So this was related to his cancer coming back?"

Rewind to several paragraphs above. Mike had kept this cancer-from-years-ago hella secret from just about everyone, even his dearest friends. Carla said (in a nice way), WTF are you talking about, and also, no.

Tactless Business Contact: "Oh, well, two months ago he was looking tired and I asked him what was wrong and he said his cancer had returned, but this time he didn't want to go through chemo, he was treating it 'homeopathically.'"

Um, so... Carla had no fucking idea about this. She feels as she's been living with someone she didn't know. Except she knew him, she saw him day in, day out. She saw no sign whatsoever of illness.

Yes, sometimes he was tired, but not out of the ordinary considering he biked around NYC constantly in the hot summer to do his tech support stuff. Also, Mike didn't believe in woo homeopathic shit. He was logical and cynical and mocked woo pretty mercilessly.

Also also, even if Mike were to believe in homeopathic shit because he was now desperate, Carla would've known if he had changed his diet or was adding some supplements like... I dunno, bat guano or whatever the hell homeopaths use. He hadn't lost weight--maybe a couple of pounds, which seem in line with his bike riding--and just didn't act like someone whose cancer had returned and it was preying on him, but was hiding it from his fucking wife.

Literally five days before his death, he and Carla went up to Boston for a two-mile walking tour, and they were together constantly. He was fitter than she was!

They were planning on buying a house this year. In a recent conversation with me, Mike expressed a lot of optimism--and it didn't seem forced, I swear--about how well his business was growing, and he was enjoying the summer and just generally his usual engaged, funny, idiosyncratic self.

Oh. I should mention that after this conversation with the Tactless Business Contact, Carla contacted his doctor (the one he'd liked from last year, when he'd had the kidney ailment) to see if he'd visited her re: any cancer diagnosis. Doc said no, she was shocked to learn he'd died, and also said that even if the cancer had returned, it would be extremely unlikely to have caused a sudden death like this.

(I'm just spitballing but this seems right to me. I mean, if it had been that fast-spreading to have been the likely cause of death, wouldn't the autopsy have found evidence of it in his organs, e.g. the liver or wherever non-Hodgkins Lymphoma usually spreads?)

CLUE 3. Now it's time to do the awful stuff relating to financial details. Mike didn't leave a will and so there's no real question that everything goes to Carla. But his business needs to be dealt with since he has clients and so on, so Carla had to get into his computer, which of course was password-protected (he carries the laptop everywhere so privacy is understandable) and, also of course, Carla didn't know the password.

Actually, a couple of days after he died, I posted about this computer problem (among other financial issues). Luckily getting inside turned out to be easier to get into than we'd feared, as it seems to have been just a basic screensaver password rather than some major privacy software.

So tonight Carla was able to get into the computer, by now less interested in the business data (at least tonight) and more interested in Mike's email and browsing history. In particular she was looking for something related to cancer or... well, anything. But there was nothing unusual at all. Except...

Back in June (which would've been around the same time that Tactless Business Contact had supposedly had the conversation w/Mike), Mike had done a lookup on longterm disability insurance.

Also in June, Carla found one email to a friend--who's on disability for drug addiction--saying something like, "Carla and I are looking into our longterm disability insurance options. What company did you go with?"

This is the first outright untruth Carla has discovered. Mike had never spoken about disability insurance w/Carla.

Important to note: this conversation ended with the friend's response of... well I don't remember the company. It doesn't appear that Mike ever applied or researched this further; there are no mailed documents or emails or other sites in his browser history since that date whatsoever.

One final thing: It was also around this time that Mike, for the first time in seven years, contacted his estranged father and tried to arrange a visit. The dad wasn't well so they never ended up connecting, which is really sad. Although I'm glad Mike seemed to have found some rapprochement with the guy, even if he was a shitty father.

And that, my friends, is what we have thus far.

=====================================================

So. What the actual fuck?

As you can probably guess, by now poor Carla is really rattled and feeling all sorts of self-recriminations, because she's grieving and thus her emotions are all over the place and guilt is taking the center stage right now. She's afraid he didn't trust her with the truth about either returning to coke use, or his cancer returning.

Here are my own thoughts, in order of likelihood (IMHO):

A. Mike was feeling run-down in June, maybe under the weather. Maybe it reminded him of the symptoms of his original bout with cancer. In some weird moment of vulnerability, he told the Tactless Business Contact that he believed his cancer had returned. He didn't go to a doctor (there are no bills, he's on Carla's health insurance, and the doctor he liked a lot knew nothing) but was catastrophizing.

He might have been afraid to go to the doc to confirm this--not terribly unusual--yet acted accordingly. Hence the brief disability insurance lookup, hence the getting-in-touch-with-asshat-dad, and hence the moment of vulnerability in which he mentioned to Tactless Business Contact his concern, probably assuming it wouldn't get back to Carla or anyone else he knew/cared about. He probably wasn't ready to tell her of his fears, not wanting to worry her yet.

Then, since there's literally nothing else in the subsequent two months since to indicate he was sick or that he'd confirmed a diagnosis, maybe he started to feel better, realized he'd blown the whole thing out of proportion, and so there was no need in his mind to tell Carla anything.

Conclusion: Death was from a heart attack, because he was a 49-year-old diabetic ex-drug user who continually overworked himself. For whatever reason, it wasn't conclusive in the autopsy. (I admit I don't understand why a heart attack wouldn't be easy to confirm, so maybe this is wrong.)

B. All of the above, plus on the night of the party, he was hanging out with the same people with whom he'd originally had some drug-using past. Because he was feeling good, or maybe because he was feeling tired, he did some coke. Not an overdose, but enough to cause problems for his heart.

Conclusion: Death was from a heart attack, precipitated by drug use, and also possibly age, diabetes, overwork.

C. Same as B, except he did have cancer, presumably non-aggressive. He didn't tell Carla because he was working up the courage, but he didn't have time when the heart attack hit him.

Conclusion: Death was from a heart attack, precipitated by drug use, also weakened system, age, diabetes, overwork.

(What nags at me is that it just seems so out of character for him not to get his ducks in a row. Mike was always extremely concerned about making sure Carla was happy and protected, so how could he fall down on the job here? Why didn't he go for the disability insurance? Why is there literally no documentary evidence that he'd gone to any doctor or clinic or witch doctor or whatever the hell would've diagnosed him?)

D. Mike was a Colombian drug lord who was searching disability insurance because he was gonna put a hit on Carla to hobble her in some way and get that sweet, sweet insurance payoff.

Conclusion: Death was from a Bulgarian umbrella tip using an untraceable poison.

Frankly I find D nearly as likely as any suggestion that Mike was using drugs on the regs, so to speak. If he does, he was a masterful hider of it. Their studio is about 20x27. One bathroom, shared medicine cabinet. If he had any addiction that I saw, it was his addiction to frickin' bike accessories. (He had three bicycles, including a folding one, and he just loved shopping for various doodads to help him carry around his various computer tech for his support calls.)

But seriously. WHAT IS GOING ON?

I'll end this crazy Encyclopedia Brown mystery (adult version) with a repetition of my unswerving love for Mike. I am as straightedge and teetolating as a person can be, at least if you ignore the benzos I'm prescribed for panic disorder. (Which, in fairness, could get me some good money on the street!)

Nevertheless, if cocaine or some other substance was involved in his death, I will think of Mike simply as my wonderful, loving, adorable, empathetic, fiercely political, protective, funny-as-hell brother (I really think of him more as a brother/friend than just a brother-in-law) who made a dumbass mistake.

People make dumbass mistakes all the time that, by sheer luck, don't cause their deaths. In this case, maybe Mike's luck failed. Either way he was a fucking fantastic human being and I bless the day he entered Carla's life and enriched our entire family.

Also, my poor, big-hearted sister is in agony. Carla is knocked for a loop and full of all sorts of self-recriminations, because she's grieving and thus her emotions are all over the place and guilt is taking the center stage right now. She's afraid he didn't trust her with the truth about either returning to coke use, or his cancer returning. And so it's her fault. Also it's her fault if he was pushing himself too hard. And on and on and on.

For putting her through this albeit inadvertently, I guess I am upset with Mike. But I know his love for her was such that he'd be furious enough at himself for hurting her--more furious than the rest of us put together.

If anyone has any ideas or theories, please go on.

I guess if there's one tangible question someone might be able to ask, it'd be this medical/forensic question: Is it possible for someone to die of a heart attack or other natural cause, e.g., aneurism/stroke/pulmonary embolism/blood clot/whatever, but not have it be easily identifiable in an initial physical autopsy?

Again, I guess this was part question, part mystery, and a bigger part venting and my needing to just write about this.

Sorry. And also, help.
  #2  
Old 09-02-2016, 03:18 AM
Nava Nava is offline
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Is it possible for someone to die of a heart attack or other natural cause, e.g., aneurism/stroke/pulmonary embolism/blood clot/whatever, but not have it be easily identifiable in an initial physical autopsy?
IANAD, but based on conversations with too many of them (relatives, friends), yes, it is perfectly possible. Both a "massive heart attack" and a "heart attack" can kill you: the difference is that the first one is pretty evidently the CoD whereas the second... wellllll, yeah, this could have been the cause but well, I'm not going to bet my diploma on it, ok?

My father had cancer. He also had an inoperable aneurysm (inoperable because of the cancer). And he was on morphine. Ultimate CoD? A combination of the above. Root CoD? The cancer. If an autopsy found the aneurysm burst, that would be relabeled as the ultimate CoD, but if it didn't, then no relabeling.

Last edited by Nava; 09-02-2016 at 03:20 AM.
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Old 09-02-2016, 05:09 AM
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John Mace John Mace is online now
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I can't comment about the other stuff, but the thing about coke is...

1. It's a regular part of the scene at many restaurants. Since Mike was working more or less in that business, there's a good chance he had easy access.

2. Some people are absolutely Jekyll/Hyde when it comes to coke. I've never seen a personality chance so dramatic among some people. It's like they are a completely different person when they do coke. And it usually ain't pretty. Someone can be the nicest guy in the world, and then just insufferable whenever coke is around. Maybe it's part of the whole "addict" thing.

3. Workaholic? What helps you do that? You get 3 guesses and the first two don't count.

4. A lot of coke is laced with speed, which isn't going to be good for someone with heart issues. The coke is bad enough alone, but with speed?

5. Something very similar happened among my friends a few years back. One of them died suddenly after a night of partying. No one said anything to his wife, but we all knew there was a lot of coke going around that night.

N.b: I'm not passing any moral judgment on the use of cocaine. Far from it. Just adding my 2 cents.
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Old 09-02-2016, 06:43 AM
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I haven't touched coke in twenty years, but if I, with a previous cancer diagnosis, believed I'd lost my remission, I'd totally give my nose a workout. "Party favors" indeed!

I'm sorry for your loss. Maybe the tox panel will tie things together for you.
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Old 09-02-2016, 12:02 PM
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I am so sorry that you and your sister are dealing with this. My father had diabetes, and while his was uncontrolled for many years, he was told at the time of diagnosis that he would likely have a heart attack within the year. He did, and the only symptom ahead of time was that he felt nauseated. I don't even remember if they did an autopsy - he was alone at home, so i know they investigated - something - but it was pretty much a clear cut heart attack, and we were told that immediately.

As kayaker said above, if I thought cancer had made a comeback, I would probably do something a bit reckless as well. Not necessarily on the regular, but I could easily see myself going "What the hell, why not?" when presented with party favors.

If I were you, my mind would be swirling. there are just too many weird things - like the business associate who said he was treating his cancer with homeopathic remedies. I would guess that something was misunderstood there by the associate.

My guess? He felt crappy, feared his cancer was back, threw caution to the wind, had a bit of coke, which strained his (already) strained heart. The disability query was right around the time he was fearing cancer, but he didn't want to worry Carla. In other words, scenario A or B.

Again, i am so sorry you and your sister are dealing with this.
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Old 09-02-2016, 12:46 PM
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Did I miss where it talked about an autopsy? What did the toxicology say?
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Old 09-02-2016, 12:52 PM
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Did I miss where it talked about an autopsy? What did the toxicology say?
From OP:
Quote:
Oh, and just to start off with, the autopsy came back inconclusive, toxicology report pending. We won't know anything for 4 to 6 weeks.
Also, I wonder if they have histopathology from the autopsy pending as well....
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Old 09-02-2016, 01:09 PM
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beowulff beowulff is online now
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I am not:
a) A Pathologist.
b) A Cardiologist
c) Omniscient

Given that, my guess is sudden death due to latent heart muscle damage causing heart rhythm irregularities. If there was damage to the Sinus Node, or some of the muscle surrounding it, that could result in fatal A-Fib.

I don't think that any of that would show up on an autopsy, but like I said, I'm not a pathologist.

And, this event could have been precipitated by drug use.
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Old 09-02-2016, 01:51 PM
choie choie is offline
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Thank you all very much for your responses and sympathy. It really is hard enough to deal with the loss without all these questions arising from it.

I was wondering if Mike might have had a "to hell with it" thought vis-à-vis drug use--assuming he still thought he had cancer, although given his complete lack of any subsequent research or behavior changes, it's hard to fathom he'd been diagnosed (but then, thank God, I've never had a terminal illness, just a relatively brief scare once that turned out harmless).

Carla is now determined to think that he was hiding cancer from her. Of course, some of the symptoms Carla is now remembering--he woke up with night sweats a few times, which is a symptom of lymphoma--are also symptoms of andropause, not to mention just eating spicy food, which is definitely something Mike enjoyed. Maybe that's why Mike leapt to the conclusion that his cancer had returned.

As for the tox report, raventhief is correct of course. It'll take at least another month, most likely. This really astonished me and was pretty educational, if nothing else. Law and Order makes it sound as if it's as easy to get such reports as quickly as blood/urine drug tests one does for work or in an ER.

A-Fib... that's an interesting hypothesis, beowulff. I had briefly looked up reasons for sudden death and that, or the other type, ventrical fibrillation / ventrical tachycardia, was one of them. But I figured it would have shown up.

The worst part of this is watching my sister go through such cycles of regret and now bitterness. She's questioning whether she even knew Mike at all. Which as an (admittedly not entirely objective) observer, I think that's utterly, completely untrue; yes, he may have lied to his friend about the disability thing, and yes, he may have omitted telling Carla his fears especially if they subsided; and, also, there's the (possible) coke use. But as much of an anti-drug snob as I am (and Carla makes me look like a total libertine in that area), I don't think that ultimately changes the most important aspects of Mike as a person, and that's how he treated others. His generosity, his compassion, his sweetness, his playfulness, his joy in his marriage (which Carla too is questioning, because "why would he use drugs if she made him happy?"), his work ethic, and just... his Mikeness.

He had a shitty childhood and had depression issues. But I and both my sisters also battle depression. That doesn't mean other people don't make us happy at times. I think Carla made Mike as happy as he could be, as comfortable with himself and free to be his true self (whimsical, outspoken, intellectual) as he ever felt. Isn't that the most one can do for someone else?

I know her anger and this questioning is part of the grieving process, especially with such complications. It's just extraordinarily agonizing to watch. And I find myself strangely protective of Mike, his advocate during all this, in a way. Don't get me wrong, if we learn something like... I dunno, he'd had an affair or was secretly selling drugs out of their apartment and lying to all of us... I'll be angry and outraged as well. But if he did all that he leads* the most astonishingly ingenious double-life I've ever seen.

Many thanks for the ideas & commiseration so far, guys. Seriously, it's good to talk about it.


* Damn it. I meant led. Still hurts to say that.

Last edited by choie; 09-02-2016 at 01:55 PM.
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Old 09-02-2016, 02:22 PM
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Loach Loach is offline
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From OP:


Also, I wonder if they have histopathology from the autopsy pending as well....
Ok thanks it was a long OP and I was on my phone and didn't want to reread for what I missed. If he did take coke with a previous heart attack he was playing Russian Roulette. Len Bias died that way and he was a world class athlete. After dealing with many death investigations given the information here I would say it will most likely come back positive for cocaine and cause of death will be heart attack due to cocaine use. There is a possibility that it was just a heart attack that couldn't be prevented.
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Old 09-02-2016, 02:37 PM
choie choie is offline
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Ok thanks it was a long OP and I was on my phone and didn't want to reread for what I missed. If he did take coke with a previous heart attack he was playing Russian Roulette. Len Bias died that way and he was a world class athlete. After dealing with many death investigations given the information here I would say it will most likely come back positive for cocaine and cause of death will be heart attack due to cocaine use. There is a possibility that it was just a heart attack that couldn't be prevented.
First--it's totally understandable that you'd've missed something in the Moby Dick that was my OP! Frankly I'm surprised anyone got that far. (Or isn't accusing me of some coke-fueled manic writing spree!)

Your suggestions wouldn't surprise me at all. Sadly. If I may ask a few more questions... knowing in advance that no one here is "my" pathologist or doctor and you'd all be stabbing in the dark...

1) Would death from a heart attack brought on by cocaine use take a couple of hours to occur? There appears to be some time between Mike's time at the party and then his subsequent death, anywhere from 90 minutes to three hours. For some reason I have it in my mind that the coke would've had a much quicker negative effect, but then again, I know next to nothing about this stuff.

2) Kind of a repeat question from the end of the OP, but: If it was a heart attack, due to anything, would that still be marked down as an 'inconclusive' finding? I understand looking further for a why, hence the necessity for toxicology reports, but surely heart damage is relatively apparent to a pathologist, no?

3) I can't help harping on the cancer thing, mainly because that's what's eating away--ugh, horrible unintentional pun there--at my sister. Would a forensic pathologist bother to note, or would s/he even find, a lymphoma if it wasn't either the immediate or proximate cause of death (esp. if it hadn't spread to major organs)? Reason I ask is that I don't think my sister mentioned the possibility that the cancer had returned to the M.E. (although she had mentioned that he'd had a history of it fifteen years ago). So if the pathologist wasn't looking for it and it wasn't necessarily related to the cause of death, would it come up?

Thanks so much, Loach.

Last edited by choie; 09-02-2016 at 02:40 PM.
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Old 09-02-2016, 02:47 PM
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I have nothing to add to the medical stuff, so just a few words about the death of a spouse.

You find out weird shit sometimes. Some of it feels like huge things there's no way you missed, and other things are really minor but they hit you hard. The thing is that we find out things about our spouses all the time that we didn't know, but since we can ask about them or they just blend into the warp and weft of our days, they don't really stick in our memories. The death puts a tear right through the weave and removes the opportunity to clear up those little weird loose ends, so they become big sad mysteries.

And we tie them together in ways we wouldn't if we learned about them in real time. It's like the difference between living your life and reading a mystery novel. In the novel, you know everything is relevant so you pay attention, where in life so much happens that we don't take particular note of.

So, I would just say to be cautious about thinking too much about his life as a series of plot points. It's incredibly hard to do, so don't think I'm just thinking you can wave your hand and suddenly it's not a problem. But do try to keep it in mind that events get distorted by later events.

I'm sorry you and your sister are going through this terrible time.
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Old 09-02-2016, 03:09 PM
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Lots of people do coke on occasion recreationally without being addicted to it, especially if they have been drinking and if he was drinking till 3AM his system was already under stress from the alcohol intake. As another poster said coke has killed young athletes in their prime dead. A diabetic, ex heart attack, work stressed, maybe cancer having 49 year old who had been drinking all night and then snorting coke recreationally dying suddenly is not a particularly big mystery. Honestly the drinking alone might have killed him with those prior health issues stacked up against him.

Last edited by astro; 09-02-2016 at 03:12 PM.
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Old 09-02-2016, 03:16 PM
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Article


Cocaine is 'the perfect heart attack drug' - even if you only use it only a few times a year
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Old 09-02-2016, 05:05 PM
Tom Tildrum Tom Tildrum is offline
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Lots of people do coke on occasion recreationally without being addicted to it, especially if they have been drinking and if he was drinking till 3AM his system was already under stress from the alcohol intake. As another poster said coke has killed young athletes in their prime dead. A diabetic, ex heart attack, work stressed, maybe cancer having 49 year old who had been drinking all night and then snorting coke recreationally dying suddenly is not a particularly big mystery. Honestly the drinking alone might have killed him with those prior health issues stacked up against him.
Remember too that he was at a class reunion. He may have seen people that he used to do drugs with, and the nostalgia could have contributed to falling back into old ways, if only for that one night.
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Old 09-02-2016, 06:31 PM
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Some chemotherapy drugs also cause heart damage; I have a distant relative who had to have a heart transplant due to doxorubicin-induced cardiomyopathy. Maybe it caught up with him this way?
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Old 09-02-2016, 08:29 PM
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First, I'm so very sorry for your family's loss. What a horrible and unexpected blow.

Some addicts can hide usage really, really well. I lived with a Vicodin/speed user (Vic was daily; speed was more occasional) for four years before realizing what was going on -- and we also lived in a small space and spent a great deal of time together. Given this experience, I might recognize someone else using now, but maybe not and I don't know if a coke user would be able to so effectively hide use.

My sister's 20-year-old fiancee had a mild heart disorder he had been diagnosed with as a child and dropped dead 5 minutes after he tried coke the first time.

I hope that whatever the outcome is, definitive or vague, your family can find some peace.
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Old 09-02-2016, 09:01 PM
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RivkahChaya RivkahChaya is offline
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Did Mike take any heart medications? I know of someone who wasn't supposed to drink alcohol because it could interfere with her heart medications, but chose to drink anyway, and literally dropped dead. I wasn't there to witness it, but she reportedly passed out mid-conversation, and in spite of CPR, was dead by the time the ambulance got there. It wasn't the first time she'd ever had a drink, it was just the first time she'd had a cardiac event while drinking, and the meds weren't able to do their job because they were suppressed by the alcohol, if I understand the scenario correctly.

She was in her mid-20s.

I don't know if she took anything else that night, but I know who she was with, so I doubt it-- it wasn't the sort of crowd to even have pot much less coke or LSD or anything.

Diabetics can have blood sugar events from alcohol. I'm not personally clear on exactly what all the finer points are, just that you have to know how to count the alcohol as a total sugar, and check your blood sugar, something people who get really toasted may fail to do. I have no idea what death from a blood sugar event looks like, though, and I also don't know how or whether there would be any blood sugar testing after death as part of the autopsy.

I guess that just muddies the water more, but all I'm trying to say is that there are probably a host of ways circumstances could have converged to cause Mike's death without his needing to do coke or have metastatic cancer.

Wait for the final autopsy results.
  #19  
Old 09-02-2016, 09:21 PM
psychobunny psychobunny is offline
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I would put my money on A or B. Just remember that the term "heart attack" is an an imprecise term. There are several reasons that somebody can have a sudden death from heart causes but let's break them down into 2 basic categories:

1) Blockage of a coronary artery leading to decreased blood flow to the heart.
-This can be because of closing off of an already narrowed artery because of atherosclerotic disease or can occur in an artery that is relatively open but has an unstable plaque that ruptures suddenly, or from sudden spasm in an artery that is otherwise clear.
-Autopsy in this case may show the blocked artery but won't necessarily show the heart damage because there isn't time for an inflammatory response or for muscle damage to manifest. The autopsy may show the blockage in an artery but will show nothing in the case of spasm.
-He had a history of a prior heart attack so may have had blocked arteries and had diabetes which predisposes to atherosclerosis.
-Previous chemotherapy and radiation can damage the blood vessels and the heart leading to predisposition to disease.
-Cocaine can cause coronary spasm.

2) He may have had a heart rhythm problem (most likely ventricular fibrillation) leading to sudden death since if the heart is not pumping effectively, blood cannot reach vital organs.
-Autopsy usually won't show anything since again, there is no time for inflammation to occur and there are no structural abnormalities.
-Prior heart damage (from a heart attack, radiation, or chemotherapy) can predispose to arrythmias.
-Cocaine can predispose to arrythmias

FWIW- in my state, the ME would refuse this case (trust me I've tried to get an autopsy on similar patients and been turned down). The thinking is that somebody with diabetes and a prior heart attack in their 20s, as well as treatment for lymphoma is at such high risk for a cardiac event that there is no point in investigating further and that an autopsy would likely not be useful since it would likely be inconclusive.

The only additional question I would have is the cocaine, and the toxicology should answer that.

Lymphoma should show up on an autopsy. I can't imagine that they wouldn't look at the lymph nodes and if it was obvious enough for him to actually get a diagnosis, it should be obvious enough for the ME to see it. Perhaps the friend misunderstood and he was merely worried about cancer coming back with the weight loss.
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Old 09-02-2016, 10:00 PM
nearwildheaven nearwildheaven is offline
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Please keep us posted on what you find out.
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Old 09-02-2016, 10:35 PM
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So sorry about what happened and I can well imagine how hard it is to "just wait for the results". I hope you get a very clear answer in the end and I also hope that your sister can somehow realize the truth of what jsgoddess had to say about what happens when you lose a spouse. I'm glad your sister has you to help her through this; it sounds like you have a good grasp on what sort of person Mike really was. Good luck to both of you during this terrible time.
  #22  
Old 09-02-2016, 10:51 PM
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Helena330 Helena330 is offline
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I'm so very sorry. What agony you both must be in.

I just wanted to address the night sweats. He was diabetic, and night sweats can be caused by hypoglycemia at night if he was taking medication.

  #23  
Old 09-02-2016, 11:12 PM
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eschereal eschereal is online now
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Originally Posted by Tom Tildrum View Post
Remember too that he was at a class reunion. He may have seen people that he used to do drugs with, and the nostalgia could have contributed to falling back into old ways, if only for that one night.
This would be my theory, adding that, IME, it is deceptively easy to do too much coke – in fact, I recall the coke all but begging me to do more, and it can be hard to tell when you get to "too much".
  #24  
Old 09-02-2016, 11:30 PM
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TruCelt TruCelt is offline
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I can't help with the medical questions, but perhaps I can help with understanding some of the possibilities.

First, the hiding illness. I'm not suggesting he was ill, but if he was, and he hid it, that's really not so strange. We all think that if we find out we're dying, we'll immediately make a long bucket list and then run around like crazy people trying to do everything before we go.

But it's happened to me twice, at different stages of life, that doctors led me to believe my time was short. (Spoiler: I made it.) And both times I had no interest at all in rushing out to do things. The most precious thing imaginable to me was a normal day. I wanted as many normal days as I could get before I had to go. So I hid it from everybody, and made excuses for my lethargy, and tried for as long as possible to just *be.*

So maybe he had a similar reaction.

Also, I've got some experience with addicts. People can stay sober for 40 years and then suddenly go back out. They go back out when they are stressed, or when their lives have become dull and routine. They go back out to celebrate a great joy, or to numb themselves from grief. They go back out when they just plain want to, and when they absolutely don't want to.

And very, very often, people who have given up drugs, but not alcohol, will get drunk, and do something stupid, and then wind up dead from the drugs. The alcohol wears away their inhibitions, but it's not quite the high they really want, and then Boom! The lightening strike of coincidental availability finally occurs, and they are gone. Just like that.

There's a saying in AA that while you are sober your disease progresses nonetheless. I have quite a few anecdotal confirmations on this point. One man went back out on the night of his 42nd AA anniversary. Within two days his wife had to bail him out of jail, and in two more days he was dead.

I think some of it is that they try to use exactly as "hard" as they did at the time that they quit, but their bodies have lost that tolerance. Another part is that, having given up their sober life, there's a feeling of inevitability - moderation will avail them nothing, so they just slam it.

It's entirely possible that he wasn't sick after all, and he didn't do any drugs. Maybe it was just his time. It happens.

Try to help your sister stop asking,and just accept that it has happened, and why doesn't really matter. She needs to be reassured that the face he presented to her was genuine. If he hid something, it was because he loved his life with her and didn't want it to change. Dwelling on suppositions and allowing one's mind to constantly grind away trying to figure out something when there isn't enough information to go on is a sure route to insanity and misery.

Her brain will pick itself to death over this if she lets it. She must make a conscious decision to re-train her thoughts elsewhere. And encourage her to cherish her memories, and give herself permission to just sit and sift through them. Keeping memories fresh at a time like this is very important. It may bring on the tears,but tears are a tool that she needs to use right now. Don't be afraid of them.

I hope some of this is helpful. And I hope you'll ignore any part of it that isn't.

I'm sorry for your loss.
  #25  
Old 09-03-2016, 01:51 AM
choie choie is offline
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This will be short (for me) because Carla's over now sleeping on the other half of my bed (staying in her apartment's too painful right now, so this is her haven I guess) and I'm afraid she'll wake up and spot me posting, and I, um, haven't told her I wrote about this.

I'm so grateful for your immensely helpful, supportive and informative posts--whether with medical info, drug knowledge, or (all too sadly) experience of your own grief.

I'll write more tomorrow to respond to your comments properly, but I couldn't let the night pass without a proper acknowledgement. I'm continually touched and surprised by how thoughtful strangers can be. And now I'm teary so I'd better go.

Thank you.
  #26  
Old 09-03-2016, 11:10 AM
mischievous mischievous is offline
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choie, I think you're over-interpreting. As jsgoddess mentioned, there are a thousand weird things that all of us do every day that would look like clues to our secret identities if we died suddenly, but are really just random passing thoughts. You're trying to put them all together and torturing yourself in the meantime. Could this his life have been a cancer- and drug- filled sham? Sure, but more likely:

1) His tactless business associate knows bupkis and is either confusing him with someone else or simply wrong. I had a secretary once who was convinced I had life-threatening asthma and every time I was late or called out sick, she would worry that I was in the ER for my non-existent asthma. Nothing I could say would convince her otherwise. I can totally picture her coming up to my parents after a fatal burning car wreck and saying "did she wreck because of her asthma?"

2) At some point, someone mentioned disability insurance to him, and being the upstanding protective husband he is, he thought "hey, health problems happen and I ride a bike all over town and I could get into an accident - I should look into that". Either he mentioned it to Carla as a passing thought, and she has since forgotten, or he presented it as a joint decision to his friend because he was intending to get insurance for both of himself and Carla. Then he forgot all about it.

3) He was at a party, having a good time. He knows coke is available, because coke is always available in a restaurant, and he mentions it to a friend who seems to be winding down/tiring out. He may or may not have had any intention of doing some himself.

4) He had a terrible, tragic heart attack. Since he was living a full life, he left a lot of loose ends.



Seriously, go through your own browsing history/sent email files as if you were a forensic detective and tell me you wouldn't be convinced that you have a secret life running guns for the KGB.
  #27  
Old 09-03-2016, 11:57 AM
joyfool joyfool is offline
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Right off the bat, I'd like to say that I'm so sorry, choie. Mike sounded like he was a wonderful person. I hope that you and Carla can find some closure soon.

As to the mystery, I agree with mischievous's sentiment....... I think that these are just random pieces of a much larger puzzle that may or may not (actually, probably don't) mean anything. And he might've been afraid at one point that the cancer was returning, and that spurred him to talk about it some / check into things, yet once he began feeling better again, just kind of developed a wait and see attitude about it. I mean, at any given moment, I have about a million irons in the fire. You have no idea how many of those get tossed by the wayside, if I remember them at all.

I also think that if there was cocain (and if that source is to be trusted), it really could've been a one-off due to the circumstances or he might've occasionally partook every once in a blue moon just because. Then like others said, add in that to other past (and current) health issues, and the results can be fatal. So, yeah. I think even though looking through the lens of daily activity, all this seems out of place for a fit fellow, but overall, maybe not as mysterious as first glance.

I hope you both get all the answers you need. Hang in there.
  #28  
Old 09-03-2016, 12:58 PM
Count Blucher Count Blucher is offline
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I'm so sorry about your loss, Choie.

I can only suggest that getting through the 4-6 weeks until you know... prepare for the worst result, but hope for the best.
Questions can rip you apart if you let them... so don't let them.

Also, if it was coke, nobody needs to know. The man died from a heart attack in his fifties and a lot of guys have died the same way.
  #29  
Old 09-03-2016, 02:05 PM
Mikkel Mikkel is offline
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I have read and reread the post and I think some people should shut their slandering mouths.
First of all there is no evidence that his cancer came back. I may or may not keep it secret from my family at first, if/when I get that problem, but certainly not from my doctor.
Even if I should decide that chemo isn't worth it again, there are so many other concerns.

Secondly, even if he tried to get a drug using friend to stay a little longer by telling about the favors, he would not necessarily partake of those favors himself.

I don't think there need to be any other reasons for the tragedy than high pressure lifestyle, diabetes, perhaps overeating and staying up late. I guess that's what the verdict will be.
I'm sorry you are going through this.
  #30  
Old 09-03-2016, 10:25 PM
choie choie is offline
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Me again. God, I am so physically and psychically tired. I'm embarrassed to be relieved that Carla is spending today with one of her oldest friends upstate. I need a bit of respite. Then again, I have the luxury of getting a respite; Carla doesn't. So I'm feeling like a terrible sister. The depth of her grief scares me at times and I'm ultimately useless. (Ugh but that's another topic, sorry, I don't mean to talk about my own issues.)

Anyway. I'm saying thank you so often that some may think it has no more meaning, but it really and truly does. I continually find myself surprised by such kindness, as I never expect it. So I hope you know my gratitude is absolutely sincere and deeply felt.

jsgoddess, I remember your losing your husband recently... perhaps in the past couple of years? (OMG I just checked... 2009. Still not ages ago, but I can't believe I misjudged so poorly. Where did the time go?) And faithfool, you as well... just last year, IIRC. Both of you are so sweet to respond; your words are very meaningful and I will absolutely be sharing them with Carla.

It's so true, certain events/statements stand out more because of all the questions Carla has (which sure ain't helped by the obliging bystanders who keep sharing this unhelpful trivia to her). But they're not an accurate reflection of the totality of their relationship. As TruCelt so astutely observes, even if Mike hid stuff, it was because he loved her. A couple of random details doesn't indicate a pattern, not when you consider the entire five years of their relationship.

But that's something she will hopefully accept over time. We'll just have to take one day at a time. Tonight is just two weeks since that damn reunion. That's nothing. Right now I'm just endlessly having to reassure her of things that to me seem unquestionable but with a sudden loss, the questions are almost inevitable:

Did Mike know she loved him? Did she take him for granted? Was he disappointed by her, was she a terrible wife because she sometimes had bad moods, was his death her fault for not getting him to slow down?

And so on. It's painful to hear her doubting herself but that's grief for you. I remember going through similar (but not on the same level) regrets/guilt after my mom died when I was 19. That's not even including the whole side issues of cancer/drugs that she's adding to her burden.

Thanks also to all those who've noted that heart issues (especially given his age, diabetes and past history) are hardly surprising, and that if--if--there was drug use that night, it's even more of a time bomb. That article, I think linked by astro, was enlightening regarding how coke use affects people even 48 hours the actual intake. That answers at least one of those three medical questions I had.

I totally agree that there are very good possibilities in both the notion that Tom Tildrum mentions--that being with his old friends could have been a reason for him to slide back into a one-time nostalgic drug-use event--as well as the idea that I've also considered, brought up by mischievous, that just because Mike referred to "party favors" to his friend doesn't mean that Mike was partaking in them.

Either way, it really doesn't signify. The worst and only really important part of any of this is that he's gone. It seems extremely likely it was heart-related. Otherwise, short of something bizarre like poison, either self-administered or someone of murderous intent (and please please be aware I am only using as a 'for instance,' not a real theory!!), do the details really matter?

I don't even know if he was drinking that night. Funny, I don't remember ever seeing him drink. Not that this means anything, I'm not much of a social animal so I rarely went out with him somewhere where there was alcohol, but I don't think he drank anything other than wine, and not to excess. But again, it was a party, and one full of old friends with whom he shared a certain rowdy past. So who knows. And, again, who cares. We'll find out from the toxicology report and aside from possibly edifying us as to cause (not all autopsies actually do find a conclusive cause of death) and thus answering at least that question, that's really it.

Jennshark, you bring up a good point; addicts are certainly good at hiding their usage. I think pill use would've been easier to hide than coke. But that wasn't his thing. Last year during his herniated disc recovery, his doc prescribed him some Oxycontin, but he stopped taking them after two days because he didn't like the way they made him feel, and also didn't want to rely on them. Stubborn dude. (That was the only medication he's taken in a long time, to those who asked: no heart-related or diabetes meds.)

(Also, Jennshark, that is horrible about your sister's fiancé! Terrible. Your poor sister!)

To psychobunny... wow. What a fantastically informative post! You've pretty much answered the rest of the medical questions I had. I hope this doesn't sound cold (especially given my initial paragraph above) but I found the details fascinating simply as an author who focuses on mysteries.

Re the autopsy rationale: I checked and in NYS, apparently, autopsies are mandatory when the person isn't in a hospital, has no doctor in attendance, and is in "apparent good health." (This disregards obvious other reasons like murder or possible suicide.)

I suppose that last one--"apparent good health"--is debatable given his past history (and current diabetes), but maybe that wasn't enough to satisfy the ME on site.

Quote:
Perhaps the friend misunderstood and he was merely worried about cancer coming back with the weight loss.
Yes! That's precisely what I said to Carla! At this point who the hell knows. Well, I guess we'll know whenever we get the final report. In October. (Oy.)

I'm soooo going to emphasize stuff that faithfool, mischievous, jsgoddess, kayT, TruCelt (how awesome that you're better and defied your doctors' prognoses!!) and so many of you said.

The issue that needs to be emphasized over and over to my brokenhearted sister. The reality of Mike's behavior, personality and meaningful relationships is what matters most. Not the possibility of some omission/deception, and that's really all it is, there's literally no evidence whatsoever except that single email re: the disability and that could indeed mean nothing.

TruCelt's final paragraphs really get to the heart of it:

Quote:
Try to help your sister stop asking,and just accept that it has happened, and why doesn't really matter. She needs to be reassured that the face he presented to her was genuine. If he hid something, it was because he loved his life with her and didn't want it to change. Dwelling on suppositions and allowing one's mind to constantly grind away trying to figure out something when there isn't enough information to go on is a sure route to insanity and misery.

Her brain will pick itself to death over this if she lets it. She must make a conscious decision to re-train her thoughts elsewhere. And encourage her to cherish her memories, and give herself permission to just sit and sift through them. Keeping memories fresh at a time like this is very important. It may bring on the tears,but tears are a tool that she needs to use right now. Don't be afraid of them.
I am doing all I can to remind her, and share my own fond and funny memories of Mike, and all the incalculable little ways he brightened our lives--the little handmade signs or doodles he put on their front door to make her laugh when she got home from work, his singing to her, the TED talks or obscure documentaries he'd show her, his irreverent "Jesus Is Coming! Look Busy!" t-shirt--and the bigger things: his warmth toward me, their shared passion for justice, his integrity, and the fact that his love was absolutely unconditional.

The only thing I want to correct is just the tiniest thing, from mischievous"

Quote:
Originally Posted by mischievous View Post
choie, I think you're over-interpreting. As jsgoddess mentioned, there are a thousand weird things that all of us do every day that would look like clues to our secret identities if we died suddenly, but are really just random passing thoughts. You're trying to put them all together and torturing yourself in the meantime.
(Just snipping the rest for brevity HA HA HA yeah, like I know about brevity!)

I actually agree with your (and faithfool's) hypotheses completely, mischievous--if I've given the impression that I'm the one who's over-interpreting or torturing myself, I've done a bad job of expressing myself. I'm only writing this, and offering these questions, because Carla is torturing herself. What I think is the most likely scenario is that he probably felt bad at some point in June, maybe went through some private angst about it including contacting his dad etc., but felt better and realized nothing was wrong. And he died of some heart-related event that was unexpected but not hugely surprising given his history. End of story. (That was option "A" in my dissertation-length OP... which you and every other sane person can be forgiven for not reading!)

My delving deeper here is my attempt to combat Carla's wildly desperate questions and doubts, looking for you guys to provide new arguments (thanks to the SDMB group zeitgeist's better knowledge and objectivity) that I can use in my weary efforts to bring Carla some peace.

Quote:
Seriously, go through your own browsing history/sent email files as if you were a forensic detective and tell me you wouldn't be convinced that you have a secret life running guns for the KGB.
LOL, tell me about it: I've been reading Caleb Carr's The Alienist, and thanks to that and this thread, my web history consists mostly of gruesome serial killer data and stuff about cocaine use and heart-related deaths. God only knows what people would think.

(Admittedly, being an author is a convenient excuse for a lot of dubious search histories.)

It's also so true that people should shut their stupid mouths! I haven't even mentioned Mike's ex-wife who with saccharine sweetness implied she could tell Carla all about Mike (despite not having dealt with him in a decade at least, and btw, this was at the funeral), or another ex-colleague (like the ex-wife, someone who didn't know him except during his troubled years) who called him "difficult"--again, at the damn funeral--and on and on. WTF, who raised these people? How do you decide to say things that will only make the widow feel worse?

All right, just heart from Carla that she's on her way back. Thanks yet again to everyone, even if I didn't mention you... Mikkel, eschereal, Helena330, Count Blucher and everyone else... you guys are wonderful and I can't get over what a fantastic community this can be, not to mention a resource for info. I will indeed keep you updated.

Last edited by choie; 09-03-2016 at 10:26 PM.
  #31  
Old 09-03-2016, 11:18 PM
Spice Weasel Spice Weasel is offline
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I have no real authority on this subject because the only death experience I've really had is my uncle dying of a heroin overdose when he was 30 (I was 25, we were quite close in age.) Death is a somewhat alien concept to me, and I am so very sorry you and your sister are enduring this level of pain. You are NOT failing her as a sister, on the contrary, your willingness to hurt for her and along with her is going to make a difference. I wouldn't feel the need to hide your hurt from her either. By hurting with her, you are validating her pain. When my uncle died the hardest part was seeing his mother (my grandmother) suffer and be helpless to do anything about it. All I could do was just hurt with her. I don't know if that's the best approach but it seemed to work for us.

One of the big questions that plagued our family was whether it was accidental overdose or suicide as he had just been released from the hospital for a depressive episode and had fought with his sister that night before taking off and getting high. I never actually liked him that much, because he wasn't a very considerate person, but I remember finding his journal while cleaning out his room, and it was full of this very self-hateful stuff, the level of self-loathing he had toward himself was nothing he ever showed to any of us. As someone who had gone through depressive episodes and suicidal ideation myself I immediately felt like if only I had known, I could have talked to him, could have prevented it. It's nonsense of course. It's human nature for us to do that to ourselves in the wake of grief, but it's also a futile exercise that just piles guilt on top of misery and is not very helpful for moving forward.

Quote:
Originally Posted by choie View Post
Either way, it really doesn't signify. The worst and only really important part of any of this is that he's gone... do the details really matter?
What you're saying in this bit I quoted seems to be the crux of it. I read your entire OP the other day and my immediate instinct was that it all seems like a (perhaps necessary) distraction from the reality that this person you loved and admired is gone. Knowing the details of his death can't change any of that. I don't think there is any real mystery about the kind of man he was, and details don't take away from the quality of person he was or what he meant to your sister and to you.

I really wish I had the wisdom of experience to share on a deeper level, but please know you and your sister and in my thoughts, and we are always here to listen when you need to vent. You were right to step away for a bit to rest for yourself - you can't be much of a support if you aren't taking care of yourself. You are doing a wonderful job loving her and I hope your love will offer some measure of solace through this difficult time.
  #32  
Old 09-03-2016, 11:21 PM
Spice Weasel Spice Weasel is offline
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Originally Posted by choie View Post
(Admittedly, being an author is a convenient excuse for a lot of dubious search histories.)
I'm a writer too! One recent google search was ''What's the fastest way to kill someone with a knife?"

I have to wonder if occasionally the FBI comes knocking for weird google searches and then the person under suspicion says, ''Well, I'm a writer,'' and the FBI says, ''Oh, yeah, we get that a lot. Carry on."

Last edited by Spice Weasel; 09-03-2016 at 11:21 PM.
  #33  
Old 09-03-2016, 11:26 PM
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Originally Posted by choie View Post
jsgoddess, I remember your losing your husband recently... perhaps in the past couple of years? (OMG I just checked... 2009. Still not ages ago, but I can't believe I misjudged so poorly. Where did the time go?) And faithfool, you as well... just last year, IIRC. Both of you are so sweet to respond; your words are very meaningful and I will absolutely be sharing them with Carla.
2009 was both yesterday and a lifetime ago. I can't remember exactly what it was, but I remember reading something and commenting to my husband that I couldn't imagine what the person had gone through... and what she had gone through was something I had gone through, too. I just sometimes don't associate my life with me!

As a person who leaned heavily on family to get me through those first months, thank you for being there for Carla. Do take time for yourself, too, though, and don't think you can't have limits and boundaries for your time. Yes, so much easier said than done.
  #34  
Old 09-04-2016, 12:26 AM
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I do think it's natural to look for patterns previously unseen and wonder at the underlying causes...even if sometimes it's just bad fucking luck that something happened the way that it did when it did... Our hearts want patterns.

I recently lost a high school friend of mine- he, too, was diabetic, though Type I and he had controlled his disease admirably for decades. Yet somehow his disease gained the upper hand one night and he slipped into a diabetic seizure. He was 43. I try to keep reminding myself of his good qualities, because he was human and had bad qualities too, and those keep rising to the surface. And part of me is angry at him for letting this happen. God knows he didn't want it to, but I have had numerous friends ask me if it was suicide. It wasn't. Sometimes bad shit happens at the worst possible time, and for no damn (discernible) reason.

Embrace and accept the grief. Work through it. Allow the brain to engage, but don't let the heart fall by the wayside. Let yourself remember his faults, but never forget his virtues.

Aw hell, I'm drinking and feeling sad. I apologize for my rambling, sentimental thoughts.
  #35  
Old 10-01-2016, 12:58 AM
choie choie is offline
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Hi everyone. I thank you all once again for your help and words of comfort--sorry for this belated thanks to the last few folks to whom I didn't reply.

Over the past few weeks my poor sister has had a couple of extremely unfortunate discoveries about Mike's activities about 10 days before he died. Probably don't need to get into that. The reason I'm posting is that now with the return of the toxicology report (the medical examiner called just this evening), the main part of the mystery has been solved.

The M.E. did confirm that it was cocaine use that caused v-fib and what she said was almost certainly very fast death. Hopefully that's true and he wasn't in any pain. Physical pain, anyway. We don't know what pushed him off the wagon... or indeed when. She added that his heart had... uh, something that Carla doesn't remember, possibly beginning with "mitra" or "myocardio-" (she obviously wasn't paying close enough attention)... the point is, it's evidence of damage from cocaine use. (Anyone know what it could be? Possibly something to do with the mitral valve?)

In any event, that's not the end of the story--God forbid we should have some real closure. Another mystery to solve, because every fucking thing in this situation has to come with an added awful surprise. This cocaine revelation isn't as straightforward as it sounds. Because the M.E. said that he had "a large number" of empty packets (presumably for cocaine) in his stomach.

When Carla asked "why would he have these? What does this mean?" the doc told Carla that it's not uncommon for cocaine users to lick the packets and then swallow them to get all traces of the drug into their system. Which, okay, it makes some sense. But... in my subsequent Googling, I cannot find any reference to this practice on the part of individual drug users. The only references to swallowing cocaine packets are inevitably descriptions of mules/smuggling.

I just... I just can't. What. The. Fuck. Is. Going. ON?! Did we just enter an episode of Narcos?

Of all the many things that make no sense in this surreal nightmare we entered six weeks ago, this is the non-sensiest. So now this sweet guy who worked from home and was a highly respected tech dude, and never took days off except for weekend trips with Carla to Boston or Washington (and always by car, not any public transport)... this guy was a mule? I don't buy it.

So now, the latest question in this never-ending Lifetime movie saga is: does anyone know if what the M.E. said--about licking/swallowing packets--is actually a thing? Was it just that Mike had this really weird fucking habit of feeding his addiction? Or is the M.E. being kind and making up some story so Carla won't know Mike was....somehow... part of some drug smuggling operation?

(What makes me doubt the latter is... surely she would have to pass this info on to the police, wouldn't she? If she suspected something sinister like that? Wouldn't cops want to search Mike/Carla's apartment for more info if Mike was potentially involved in criminal activity like that?)

Needless to say, Carla was torn apart by the final report, even though she pretty much expected the death to have been drug-related. But now it's back to another round of self-reproach for not having realized he was using again, and for thinking she didn't make him happy enough, and... so on and so on.

I'm just so at a loss, and miserable for her. She's lost at least 15lbs in the past 5 weeks and, while she's been back at work for the past three weeks, is still a walking shadow of herself, not surprisingly. Meanwhile I've had a relapse of my panic attack symptoms (I'm having them every night now) and am, also not surprisingly, pretty damn depressed. Our whole family is stunned. Most of all, we just miss Mike terribly.

How can such a kind-hearted, loving, intelligent, endearing man have been so goddamned stupid?! I know that's addiction for you, but God, I am both heartbroken for and angry at him for doing this to himself.

Well. So that's the latest. I promised I'd fill you guys in on the details. I just had no idea this whole thing would be a ceaseless cycle of Russian nesting dolls, one after the other forever and ever amen.

Thanks for reading all this. I greatly appreciate your help so far.

P.S. forgot to mention: The M.E. said there was no sign of cancer, so at least that much is known.

Last edited by choie; 10-01-2016 at 01:02 AM.
  #36  
Old 10-01-2016, 01:26 AM
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eschereal eschereal is online now
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Thanks for the update. I feel for you, this must really hurt.

IME, "cocaine packets" are typically folded pieces of something like a square of magazine paper. A drug mule would not be swallowing packets, because they would not be water-tight (or stomach-acid-tight, as it were). Cocaine is quite expensive, so a user would want to get all of it. It sounds like Mike handed out the Coke to partiers and was gleaning the leftovers after doing a line or two himself, or was trying to recapture the rush (cocaine lasts about half an hour, after which you really feel like shit and need more coke to relieve that). On the one hand, it almost sounds like he was being suicidal, but on the other hand, coke really makes one want to do more coke.

So, no, he was probably not being a mule in the sense that you mean. But he might have been making connections in those cities, or maybe he was just using all the while and not wanting to get caught with it.
  #37  
Old 10-01-2016, 05:49 AM
choie choie is offline
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Thank you, eschereal, very much. Now I'm very glad I happened to ask Carla if the M.E. told her what the packets were made out of, because as it turns out, the answer is "no." Both of us had been assuming plastic/baggies (well, very little ones). But now that you mentioned paper, that led me to research and find more info about this practice, apparently called "parachuting" or snow bombing. I'd been using the term "packets" and that inevitably led me to the drug mule sites; going with "paper" helped me head in the right direction.

I had no idea this was a thing. I'm extremely daft and unknowledgeable when it comes to drugs--and my sister is even worse; she makes me look like Al Pacino in Scarface. But this helps make some sense of things. Even though it's still senseless.

My poor brother-in-law.

Thanks again, eschereal. Any more thoughts from anyone else will, of course, be greatly appreciated. In the meantime, stay tuned for a poll thread later on. These results now kinda require some decisions about whom, or whether, to share details with, and I'm curious to see what the teeming millions think.

Last edited by choie; 10-01-2016 at 05:50 AM.
  #38  
Old 10-01-2016, 07:46 AM
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Anecdotally, back in the day, I'd lick every bit of powder from my bindle, then eat it as a way of destroying the "evidence".
  #39  
Old 10-01-2016, 08:38 AM
joyfool joyfool is offline
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Dear heavens, choie, I'm so very sorry that you and your sister are having to face these revelations. I can't imagine just how tough it is and I pray that, with time, all this will fade away and everyone can go back to happy memories of Mike. God bless you for doing this legwork for her and making sense of such a tragedy. Hang in there. <3
  #40  
Old 10-01-2016, 10:48 AM
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Qadgop the Mercotan Qadgop the Mercotan is online now
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As a recovering addict and as a physician who treats a LOT of addicts, all I can say is that addict behavior can be very inexplicable. But what you describe certainly falls well within the range of bizarre behaviors I've seen addicts indulge in, when they're in the throes of their addictions.

So don't make yourselves crazy trying to understand; the addict him/herself can't really explain it, except to say that it seemed like a good idea at the time.

I hope you and your family find peace.
  #41  
Old 10-01-2016, 12:37 PM
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Quote:
Originally Posted by choie View Post
...his heart had... uh, something that Carla doesn't remember, possibly beginning with "mitra" or "myocardio-" (she obviously wasn't paying close enough attention)... the point is, it's evidence of damage from cocaine use. (Anyone know what it could be? Possibly something to do with the mitral valve?) ...
Cocaine-Related Cardiomyopathy most likely.

My condolences as well.
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