Season 1 Episode 12: The Cause of Death
I was prepared to invest
months and months in this, in sitting
here with the dappled sunlight…
wanting but unmoving.
Yet I need not wait so long.
- from the poem “we see what we want to…” written by me, k.b. marie
And this is the true story of “Who Killed My Mother?”
I can’t hear myself think with the pounding in my ears. Over my thunderous heartbeat, I said, “I’m sorry. What did you say the cause of death was?”
“The cause of death for your mother is acute fentanyl intoxication.”
“Acute fentanyl intoxication,” I repeat. “Fentanyl. I don’t—I don’t know what that is. How did she—”
I think I’ve heard the word fentanyl before. Somewhere. But I’ve never heard my mother mention it. And I wasn’t sure what it looked like or how one ingested it. But I understood, at least from context, that it was a drug.
“It’s an overdose,” she said patiently.
“I—” Questions float to the surface, emerging from the twisting confusion of my mind. “Does it say if there were marks on her body? Or how much of this drug was in her body or—”
She interrupted me. “Ma’am, I can’t tell you any of that. I can only read you the cause of death over the phone. If you need more information than that, you can go to our website and order the full report. Just fill out the form, enter your payment information, and your request will be fulfilled in a few days.”
“And once you get your report, read through it. If you still have questions, you can request to speak to the medical examiner who performed the autopsy. She’ll be happy to go over the report with you and explain her findings.”
“I definitely want to speak to the medical examiner,” I said. “Can I make that request now?”
“I’ll make note of it, but there is a part of the form where you must indicate your wish to speak to the medical examiner as well. So be sure to check that box when you fill out the form.”
“Is there anything else I can do for you today, ma’am?”
Anything else? I had a million other things I wanted her to do. Email me the report now. March into the medical examiner’s office and tell her that she had an urgent call that needed to be answered right this minute.
Anything but leave me here in this swell of confusion, trying to understand the answer I’ve finally been given.
“No,” I tell her. “Thank you.”
“Of course,” she said with somber “Have a good day.”
As soon as I set the phone down on the dining room table, I opened my laptop. I went to the website, scrolled through the pages until I find the autopsy request form.
I fill it out and check the box indicating that I’d like the examiner who completed the autopsy to call me as soon as possible and go over the report with me.
After I calm down and have a chance to consider this, I realize it’s not a bad idea that I have to wait a moment to speak to the examiner. This way I can get the report, read it carefully, and write down all my questions. That way I’ll be better prepared for the call with the medical examiner.
Had I actually talked to her today, I’m sure I would’ve forgotten things, or asked the wrong questions anyway.
I use my debit card to pay my $30 fee for the report and provide my email. It tells me that I will receive the full autopsy report by email in 5-8 business days.
5-8 business days.
What’s 5-8 business days after fourteen weeks of waiting, I tell myself and submit the request.
As soon as it’s off, I begin a fresh research spiral. I want to learn everything I can about Fentanyl. What it is. What it looks like.
It doesn’t take me long to find answers. It’s a hot topic.
According to drugabuse.gov, fentanyl is a synthetic opioid similar to morphine, except it’s 50 - 100 times more potent. It’s a prescription drug, but it can also be made illegally. When used legally, it’s taken for pain.
The reason I’d probably heard of it was because the opioid epidemic consuming America has been in the news more and more often lately.
The CDC reported that 30,000 Americans died from opioid overdoses in 2014.
In 2010, only 14.3 percent of opioid overdoses involved Fentanyl. By 2017, it was 59%.
Much like heroin, when taken, fentanyl causes extreme happiness, drowsiness, nausea, confusion, sedation or unconsciousness as well as problems breathing.
Fentanyl is cheaper and easier to find than heroin. And many dealers use fentanyl to cut heroin and expand their profit margins.
My eyes snagged on a sentence and my heart sputtered. I read:
“Users or dealers may not realize that fentanyl is the drug they are using as it is often passed off as pure heroin.”
I needed to tell Shay the news. It wasn’t a call I wanted to make, but I’d promised to report the cause of death as soon as I found out, and that time had come. So I got on Facebook, opened our messenger chat and wrote “the cause of death was fentanyl intoxication. The internet says sometimes it’s used as a heroin filler or mistaken for heroin, so I don’t know if he shot her up with it or if it was a pill.”
I would have to ask the medical examiner clarifying questions as to how the fentanyl might have been ingested. But until I had the full autopsy report, I wasn’t sure what those questions might be.
Three hours later Shay replied. “He killed her then. He knew what fentanyl was and a lot of people have died from the same thing.” She goes on to tell me about an ex-girlfriend who passed the same way because a friend tricked her and laced her weed with it.
Before I can reply to this, she’s left six more messages:
Damn, damn, damn. She wouldn’t have no clue what Joe was about to shoot her with. No way.
How much was in her system?
SOB. That’s okay, he’ll get his. Karma is a bitch.
I’m calling him now.
I had just signed into Facebook when the last of the messages come through:
He’s saying of course she broke into the safe and must’ve taken them all.
Here I manage to get a word in:
I don’t believe she broke into the safe and took fentanyl. He said he kept his stuff in the safe because he knew she couldn’t get in there. How did she suddenly break in?
I think of his changing story about the safe. How he found it cracked open on the patio after returning from his weeks in jail. How he wasn’t sure if they police did that or his sister?
And how this story only emerged after I pressed him to explain why, after using the safe to effectively secure the drugs for four months, had it suddenly failed and become so penetrable?
To Shay I said,
Why did he tell the police he thought she got into his heroin? Why didn’t he say pills if he’d thought it was pills?
Because this was a sticking point for me.
When the police asked Joe what happened, he’d told him that he thought she’d gotten into his heroin.
Not, I think she took too many pain pills.
Not, I think she used my meth of which I’m about to be arrested with.
He’d said heroin.
And even when he was pressed, he continued to say heroin.
What reason would he have to say heroin? Unless he’d been certain it was heroin…
And how could he have been certain unless he knew what he’d given to her. Or at least, thought he knew.
Because Shay was under the impression that he was surprised to find out it was fentanyl. And I would’ve been surprise, too, if I’d bought enough pure heroin to kill a horse, only to find out I’d been ripped off and given the cheap stuff.
I asked, Did he say what form the fentanyl was in?
No, he didn’t say. He was in a hurry to get me off the phone, saying he wasn’t there, that he’d been working. At what job? I don’t know about that stuff either, she replied. I know it’s for pain. My mom had patches for her back and I know around here people are dropping like files that are using it. But no way she broke into his safe, that’s bullshit.
Then how did she get it? I asked.
He’s saying that maybe she walked down to the apartment complex at the end of the road and got herself some.
He’s saying she walked down to the end of the road, and bought fentanyl? With what money?
I recall Detective Barnes telling me, he says they had a fight about money that night, but that he swears he hadn’t hurt her over that.
Had that been true? Had my mother found where Joe had hidden her SSI and taken some for herself.
I find this very difficult to believe. My mother, who’d been setting pans on fire, and forgetting what she said to me fifteen minutes into a conversation, was somehow capable of 1) finding money. 2) Remembering that she’d found the money 3) Walk down the quarter mile down the road and around the complex enough to find someone who would be willing to sell her drugs.
It’s the third condition that seems the most impossible to me. Even if we overlook the enormously questionable steps of whether or not she had the cognitive consistency to walk down the street and back alone, and not get lost there’s the fact that my mother was nearly blind.
Her vision had been terrible for years but seeing was nearly impossible for her once she’d lost her glasses.
In May, after Nana had died, but before her phone was cut off, I’d offered to buy her new glasses, because seeing was such a problem for her. Just go down to the Wal-Mart vision center, get your exam and pick out your glasses and have them call me. I’ll pay for everything over the phone, I told her.
Joe even promised to take her. But later left a message on my voicemail saying that he went down there but it was closed.
For whatever reason, he hadn’t tried to take her again, though I’d brought it up every time I’d spoken to her.
So if my mother can’t see well enough to navigate the house she knows by heart. And can’t think straight long enough not to set something on fire, or stuff it in the freezer, how did she manage to walk down the road and back?
And if Joe he really thought this was a possibility, then why didn’t he say so before? Why go on and on and insist that she’d broken into his safe, only to later say, just kidding, she might’ve bought drugs from someone down the road?
I did a bit of research about the apartment complex at the end of the road. Google had 59 reviews for the place, with an average rating of 3.1. Several praised the location and the friendly staff. Others complained about maintenance issues. Only one reviewer, the daughter of a resident, painted a more sinister picture, saying that the police often knocked on doors, looking for fugitives and suspicious looking men loitered in the parking lot.
Is this the story I’m to believe? That my blind mother, with her newly discovered money, wandered down the street and found some fentanyl-laden young men in the parking lot, from whom she bought the drugs that would kill her?
The only thing my mother would’ve willing bought was a pill. So let’s say she did buy a pill. And she what? Walked home with it in her hand and, despite having the memory of a goldfish at present, didn’t forget she had it in her, or that she’d slipped it into her pocket. She didn’t drop it—because if she’d dropped it, that would’ve been the end of it.
She would’ve been in the road or ditch searching until well into the night.
Hell, halfway through she would’ve most certainly forgotten what it was she’d been looking for.
And if she’d taken it in the parking lot, the moment she bought it—would she have even made it home? If it was a pill or lozenge it can hit you within minutes.
So then how did she make it home in time to collapse in the floor where Joe supposedly found her?
None of this is enough to corroborate Joe’s story.
Probably because the story itself isn’t cohesive enough to support.
Which possibility is more likely: that Joe really didn’t know what happened that day? That sure, he knew what an overdose looked like and sure he was certain of all the drugs in the world, which one it was that killed her. That even though he had multiple drugs in his safe, it had to have been the heroin. And all these changing stories just reflect the wild speculation on his part, because he, like us, is absolutely flabbergasted by all of this.
Or that he’s lying. And when one lie stopped working, he tried another. That the changing stories are simply that, smoke and mirrors to keep us from seeing a more damning truth.
That he said heroin because he thought it was heroin that he’d bought. That he’d given her.
He’d said overdose because he knew it was an overdose because he was there, he’d seen it.
Two weeks later, Joe tried to reach Shay through Facebook, begging her to call him back, making it sound like an urgent emergency. When she finally contacted him the next day, all he did was reiterate his story again. Telling Shay that he had been at work that night, that he didn’t know how my mother had got a hold of the fentanyl, that whatever had happened, it had been an accident.
He didn’t tell her anything she hadn’t already heard.
Then why I wonder, did he insist on calling?
Because shay wasn’t convinced. Nor am I.
She would’ve never taken that shit, Kory. Never, she’d said.
And I agree.
For me, the form of the drug matters. The form of the drug, for me anyway, is the deciding factor in determining how guilty Joe for my mother’s death.
Apparently fentanyl is a highly versatile drug. It comes in pill, patch, lozenge, tablet, injectable liquid, and powder forms. It can even be put on blotter paper that dissolves under the tongue.
However, I can’t imagine my mother putting something under her tongue, so I discredit this possibility immediately. There’s also the possibility that she absorbed it through her skin, which can also be lethal.
But that means that Joe would’ve had to intentionally put it on her skin or left it out somewhere so she could come into contact with it. Later, when I learn how much was in her body, I find the skin contact unlikely.
But that still leaves us with many other possibilities.
If it was a patch, then it likely would have been prescribed to my grandmother for pain and perhaps Joe had the patches on hand. Though I suspect that the patches are not strong enough to kill a person, so I doubt this.
Because fentanyl can be ingested, snorted, smoked or injected, I have to consider the vehicles Joe might have used for getting it into her body. Or, to be fair, how she might have gotten it into her body herself.
My only clue is that Joe had been so adamant that it had been heroin, and for this reason, I’m tempted to believe that the fentanyl was likely in a form that could’ve been injected, smoked or snorted like heroin.
My mother wouldn’t have snorted something, so that rules that out. I can’t ask about injections until I talk to the medical examiner, who can let me know if there were any marks or puncture wounds on her body.
So how did she get a powder or liquid inside of her?
Well, injections aside, I can think of a few ways.
Here we go from most to least ridiculous.
First of all, soda. Stay with me. My mother drank diet soda every day. A lot of it. I don’t think she’d ever drank just a glass of water in her life, living instead off of an diet soda with ice or sometimes a coffee. Is it possible that Joe dumped some heroin in her drink when she wasn’t looking? The internet can’t seem to tell me how much liquid or powdered fentanyl someone would have to put in a drink in order for it to be lethal, but I can imagine him dumping in a heavy dose when she went to the bathroom or stepped outside to smoke a cigarette.
Though I can’t imagine Joe having the patience to wait around to make sure she drank enough soda to kill herself, which is why this idea is the most ridiculous to me.
A slightly more plausible possibility was her cigarettes.
Because of their lack of funds, Mom and Joe smoked hand-rolled cigarettes. Because of my mom’s eyes, Joe rolled those cigarettes for her. Was it possible that he laced her cigarettes was the powder, filling her cigarette case for the day with enough heroin to sink an elephant?
This seemed unlikely to me because it just isn’t a good idea. What if she smoked enough cigarettes to pass out but not die.
It was far from a fail-safe plan and surely Joe realized this. Of course, it’s very possible he didn’t think this through.
There’s one other possible scenario, in which my mother would willingly ingest powder.
My mother got bad headaches. This had been true for years. When I was a child, and she’d have me run into the gas station with a dollar bill to buy a headache powder for her. They’re exactly like they sound. A small packet that you open, and on a small piece of paper is a mound of white powder. It’s essentially crushed aspirin with a bit of caffeine mixed in.
But being that it’s in powder form, it acts fast.
Had she had a headache? Had Joe offered her a “headache powder” to make it go away?
Maybe even handing over her diet soda so she could wash it down?
These scenarios will remain the most likely after I receive the full autopsy report five days later.
Among the many illuminating things the report will tell me, there is one other thing.
She had bleeding under her scalp. The medical examiner will tell me later that my mother either hit her head hard, possibly when she collapsed at the on-start of her overdose, or because something—someone—hit her head hard.
Did Joe do that?
Did he hit her then offer her a “headache powder” or worse a “pain pill” just to get her to shut up, to quiet down?
Did he pour apologies into her ear as he handed over what he hoped would end her suffering?
Because it is still possible that my mother would’ve taken a pain pill of her own volition.
I know that.
And Joe could’ve kept insisting that it was heroin to make himself look a little more clueless, a little more innocent.
But if Joe really had everything locked up, that still leaves the question of how did she get it? If not from him either indirectly, left carelessly on a bathroom sink or kitchen table or perhaps, even, left by her soda cup on the side table.
Or directly. Pressed into her hand after he struck her, telling her to quiet down now. He was sorry. He lost his patience is all. But really wasn’t it her own fault for riling him up the way she alway does? Hadn’t she learned after all these years not to do that?
But see? He was a good brother. He knew what she wanted and could give her what she needs.
It doesn’t matter really.
He was responsible for her. Legally. He agreed to that the moment he signed his name to her SSI check. And he understood her impulses well enough to lock up her pills, so he can’t claim that he didn’t understand the risks.
He knew the risks. The danger.
And he was the only one bringing drugs into the house. My blind mother with a memory problem wasn’t capable of that.
What form was the fentanyl in was and how the night of July 3rd might have unfolded are just a few of many questions building in my mind. I knew even then that there were questions I probably didn’t even know to ask yet.
That once I read the full autopsy report, a clearer picture of my ignorance would form in my mind.
Boy, had I been right.
Crane, Marisa. “Fentanyl vs. Heroin: The Similarities and Differences Between Two Powerful Opioids.” American Addiction Centers. https://americanaddictioncenters.org/fentanyl-treatment/similarities
NIDA. 2019, February 28. Fentanyl DrugFacts. Retrieved from https://www.drugabuse.gov/publications/drugfacts/fentanyl on 2021, January 25