This story contains adult content and language.

Listener discretion is advised.

It was my opinion that there was nothing else that could have killed him.

There is no other explanation that makes even a shred of sense in this case.

Welcome to the Knife.

I'm Patia Eton, I'm Hannah Smith, and today we have an interview for you with a forensic pathologist who worked on a murder trial.

But before we get into the interview, we're going to give you some information about this case because it's winding and intriguing and we've both been following it for a couple of years now.

Yeah, so we're going to start the story.

On March eighteenth, twenty twenty one, a woman named Natalie Cochrane from Beckley, West Virginia was sentenced to one hundred and thirty five months in federal prison, which is over eleven years.

And the reason that she's sentenced to prison, she's charged with wire of fraud and money laundry.

She's been running a Ponzi scheme.

She orchestrated this scheme that defrauded victims over two million dollars and she was ordered to pay two point five million dollars in restitution and She would also serve a term of three years of supervis released after the eleven year sentence.

You know, but this is actually just the beginning of Natalie's problems, right, Like she sent to prison she was caught for this Ponzi scheme.

But once she's already been charged and convicted, other things start to come out.

So she was arrested in October of twenty nineteen on this indictment for her Ponzi scheme.

But earlier that year, in February of twenty nineteen, her husband Michael died suddenly.

He was only thirty eight years old, and his death was very confusing and heartbreaking for his friends and family because he had been this healthy young guy and then he suddenly died.

Yeah, and Natalie and Michael had been married since the early two thousands.

They had two children.

Natalie worked as a pharmacist, Michael as a computer specialist.

I even read that they were actually childhood's sweethearts.

Wow.

Yeah, So they'd made this life for themselves in a small town where you truly feel like you know everyone.

And when Michael passed, the community really rallied around Natalie because she was suddenly this widow in her thirties, But leading up to Michael's death in February of twenty nineteen, there was a lot going on for Natalie and Michael.

Natalie had left her career as a pharmacist.

She and Michael had registered a company called Tactical Solutions Group or TSG, and this idea for the company was that it would been on contracts to sell weapons and other goods to the US government.

She needed to race capital, so she's bringing on investors.

Now, this was a company that they jointly owned, but Natalie had the majority stake and she was definitely the person at the wheel, and Michael trusted her implicitly.

So she leaves her career as a pharmacist and she goes all in on TSG.

They also opened another company, TMG, which is Technology Management Systems, similarly working with the US government.

So both of these companies were fraudulent, and Natalie would later admit in court that she never invested any of the money and she instead spent that investor money on things like, you know, real estate of fancy car, personal items, classic classic.

So Michael was totally unaware of this, which I'm going to get into, which was revealed later in text messages.

He thought that these companies that they'd started were legitimate and probably thought they were doing really well.

Yeah, or he would have never consented to them having their friends and family invest right.

Yeah.

So in the meantime, Natalie's living this high life, buying real estate, jewelry, a sports car.

Michael is unaware that all of this is a Ponzi scheme.

But in twenty nineteen, the walls are starting to close in.

You have to imagine there's probably an investigation starting to happen behind the scenes.

And in February of twenty nineteen, Michael collapsed.

He had a seizure, and Natalie told a friend who had been present that day that she was going to let Michael sleep it off.

So her friend said Michael should go see a doctor, and Natalie and her sister were both there.

You know, Michael is unresponsive.

He had fallen on the floor, and there's an account that Nataline and her sister changed his clothes because he'd lost muscle control.

So hours go by.

By the time they took Michael to the hospital, he was unresponsive, and then he died in hospice a few days later, and the first cause of death was quick natural.

It was a termine to be a natural death.

Natalie cochrane was then arrested for the Ponzi scheme months later in October of twenty nineteen.

She pled guilty to the charges against her in September of twenty twenty.

She was ready to serve this eleven year sentence, but as the investigation unfolded, Michael's death became more and more suspicious to law enforcement as they started to look at all of the events that led up to his death and that eventually led to her murder trial.

One of the things that came out through this investigation is that Michael had been totally unaware that either of these businesses were actually Ponzi's schemes, and this was revealed during the trial and text messages that were exchanged between Natalie and Michael.

Natalie was the majority owner, as you said, with the fifty one percent stake in TSG, and she secured the startup capital through mostly friends and family, many of whom made investments repeatedly and then just never saw a return, which is heartbreaking, but not as heartbreaking as his death.

Obviously, it just gets worse and worse.

So first she got all of the startup capital from friends and family, and then she got it through loans, which were designed to help companies in trouble, so she portrayed her company was in trouble.

She secured all of these loans.

Michael knew about the investors and about the loans, but Natalie told him that the loans were grants that they wouldn't have to repay.

Michael was being extremely generous, thinking that they had been making a lot of money and that their companies were like thriving financially, because that's what Natalie had told him, And so he donated a weight room to a local middle school.

He bought a house for a local youth pastor.

Like he was just like very generous, which was really sweet.

Yeah, I mean, he truly had no idea.

So that changes in August of twenty eighteen when Michael gets into Natalie's phone and reads her text messages and starts to see the extent of the investors and the promises she's making to people about the returns on those investments, and he could tell that something was not right.

So Natalie and Michael gets together and they put their heads together about this and try to come up with a way to pay people back.

And at this point, the more that they discuss it, the more Michael realizes we will never be able to pay these people back.

But Natalie has a solution.

She tells Michael that they are just on the cusp of receiving millions of dollars in grants and bonds and government contracts.

So Michael's like, okay, well great, let's make sure that happens and let's get these people paid back.

And this is becoming very stressful for him because he doesn't want to, you know, have taken money from friends and family fraudulently or even not fraudulently, and then not being able to pay them back.

Both options horrible feeling, I imagine horrible feelings.

So Natalie comes up with this grand plan and tells him that the money is on the way, but in September of twenty eighteen, so in August he sees the text in her phone.

He has this little bit of a reckoning with her in September.

Michael's noticing that Natalie's continuing to lie to people and tell them the money's coming in when he's never seen any proof of that.

So Natalie then tells him, well, this is actually because of a government audit.

So they're auditing the company and it's just going to be a while before they can pay us out.

But the amount is huge.

Michael believes they're waiting on two hundred and forty eight million dollars.

That's wild.

It's a lot of money.

And so Natalie says, this is all going to be in our account by October twenty ninth.

Okay, great things are looking up, thank god.

Well then it doesn't happen on October twenty ninth.

She has some reason for it.

This is super stressful for Michael, and on October thirty first, he actually gets really sick and goes to the hospital.

Now that's a hospital.

They're not sure what's going on, but he's sick and he gets sent home.

Then he goes back to the hospital on November second.

Natalie tells the hospital staff that Michael has a history of seizures, but no one else in Michael's life knows this about him, which you know, probably means it's not true.

They all now think, in hindsight, this was Natalie laying the groundwork for Michael's murder, because he was starting to ask more and more questions.

Trying to create this history of medical problems exactly.

So in the fall, in November and into December, more lies, more lies, and then in December there's a federal government shut down.

Great, they can't pay us, So sorry, Michael, We're going to have to wait.

Michael's really upset and stressed in not acting like himself.

He's easily angerd he's irritable.

But I think anyone who thinks they're waiting on hundreds of millions of dollars and has investors that want to be paid back, it is nerve wracking and it would be very stressful.

Sure.

Yeah.

And so they get through December and the federal government is going to open back up and release funds the sol according to Natalie, in February.

So they're going to get everything in February of twenty nineteen, which we now know is the month that Michael was murdered.

So there's an incident at the bank.

When Michael believes that the funds are supposed to be released.

He goes to the bank where they have their business accounts and he finds out they're closing these accounts because these accounts don't have any money in them, and they don't know what's going on, and they're going to close the accounts.

Well, this is very upsetting for Michael because he's like, well, if you close the accounts, where are they going to put all of this money that they're going to pay us.

So he actually becomes so distressed by this and so angry about this that he gets really upset and the police are nearly called to sort of subdue him.

Wow.

Yeah, and he's not like a violent person.

He was just extremely stressed out about this and visibly angry that the bank was going to close these accounts.

Well, of course that's because there was never any money in the accounts.

Natalie had lied about everything.

So Michael goes home and he's very upset, and they have this heated text exchange and Natalie knows he's about to find this out.

So in the early days of February, Natalie goes to the doctor.

She says she's not feeling well.

She thinks she has the flu.

The doctor says, you don't have the flu.

She picks up her prescription that I believe was an anti histamine, but it was a prescription anti histamine, something that Michael was known to be allergic to.

And by February sixth, Michael is unconscious, and Natalie sees that he's unconscious and does not immediately seek medical care for him.

She has people move him to the sofa and lets him lay there for six to seven hours until one of his friends says he needs to go to the hospital.

So Michael officially passes away February eleventh, twenty nineteen, on hospice.

And we're going to talk today to doctor pauli Rebe, a forensic pathologist who did the second autopsy on Michael Cochrane's remains for Natalie Cochrane's murder trial.

Let's get into it today.

We're speaking with doctor Paul Eurebe about his work as a forensic pathologist and his role in a murder triald that was years in the making, the murder of Michael Cochrane and Beckley West Virginia, back in twenty nineteen.

Paul, Hi, can you please start by introducing yourself.

Hi.

My name is doctor Paul Eurebe.

I am the current Deputy Chief Medical Examiner at the Fort Benk County Medical Examiner's Office, which is located southwest of Houston.

I also work as a locum Tenans forensic pathologist, which is a part time forensic pathologist and a couple of jurisdictions, namely Clark County, Nevada, which incorporates Las Vegas and southern Nevada as well as the state of Mississippi.

And as a third part time job, I have my own forensic consulting company PMH Forensics or dead Man's Hand and Forensics WOW.

And So for people who might not be familiar, what is the sort of brief explanation of what a forensic pathologist does?

So how I explain it in court?

For juries is well, pathology is the study of disease.

Forensic pathology is the specialization that studies unnatural, unexpected or violent death.

So, in a nutshell, we study death and see what we can learn from it, and we do that, namely by performing autopsies.

And so we're going to get into Natalie Cochrane's trial, the death of Michael Cochrane.

When you were brought onto this case, you know, before we get into your involvement specifically, how that happened, What did you know, like what had happened with the case so far, What was this sort of understanding of yours at that time of what this case was all about.

So I was contacted by the Rawleigh County prosecutor who heard of me from my involvement in another high profile insulin case in West Virginia, which was the prosecution of Rita Mays.

She was a nursing assistant who was accused of essentially poisoning VA patients at the Clarksburg VA with insulin.

And this was a case that I did while active duty in the military with the Armed Forces Medical Examiner's Office, and because of my involvement in that case, which was relatively high profile, they reached out to me because I had done a lot of research and testimony in terms of insulin homicides, and they reached out to me saying, hey, can you help out with this.

We think that she may have poisoned her husband with insulin, but we're not sure we can prove it.

So I got involved probably two to three years I think it was over three years after Michael's death, and they brought me in to take a look at everything that had been done at that point.

The first autopsy was already done and they just wanted me to take a look at it to essentially see what I could see well, can.

You tell us about that first autopsy, you know, as you opened it and looked at what had been done, kind of walk us through what you saw there.

So the first autopsy was not done by me.

And there's a little bit of a backstory here because when Michael died, he was technically on hospice care already, and because he was on hospice care, that did not generate a flag for the West Virginia State Medical Examiner's Office.

Now, once again, I know a lot of the docks at West Virginia.

I'm not saying this to throw shade at them or anything, but I do think the case was missed.

When you have a thirty eight year old male on hospice for reasons that aren't really clear.

It's different if someone has like ALS, which is amiotrific lateral loleurosis, the same disease that Stephen Hawking had, or Huntington's disease, or like some progressive neurologic condition that causes someone of relatively young age to die when they're younger.

That's a legitimate reason for a younger person to be on hospice.

But he didn't really have a great diagnosis.

But anyway, regardless of how that was missed.

The prosecutors started looking into it in the months after his death, and they found his death really, really suspicious because at that point she was being investigated for the Ponzi scheme and so forth.

So I believe about seven months after Michael's death, the state office in West Virginia went back and they exhumed Michael, and they did an initial autopsy of him, and they found nothing particularly significant.

The medical examiner of record who did it there wasn't really good sample to check for insulin or seapeptide.

We'll talk about the importance of those two things later, and he didn't really look for insulin injection sites either.

Now, whether or not you can find insulin injection sites and someone who's been essentially buried for seven months, it's very tough.

Yeah.

That actually prompts a question for me, which is, you know, this is all pretty morbid, but after seven months, because the initial autopsy happened after he was buried, so his remains were exhumed, is that correct?

Yes, Okay, I don't think he was buried in the ground.

I think he was interred in a mausoleum.

Oh, Okay, basically above ground.

Okay, and so seven months after his death, what state or someone's remains in It depends.

It depends on the level of embalming.

It depends on the environmental temperatures.

It depends on if it's an above ground mausoleum or you know, below ground and under the earth.

It depends on the humidity, It depends on the temperature, It depends on lots of things.

From my review of the first autopsy, he seemed to be in pretty decent shape.

There was some decomposition, which naturally you would expect, but it wasn't terrible.

So there was some information that could be obtained from the primary autopsy, which, once again, any information is helpful in a case like this.

But once again, if you have a body that's not embalmbed and is in the ground and then you have water that leaks into the casket and everything, that just accelerates decomposition.

In this case, for the first autopsy in Michael Cochrane, they had remains that were in a state they felt like they could conduct an autopsy on and get strong results or decent results.

Yes, And when it comes to post mortem detection of insulin, that's where things get really really tricky because insulin levels in blood are not stable.

Insulin levels, just normally in humans, vary, like you know, it varies on what you eat, it varies with your circadium rhythm.

Sometimes you're pancreas secretes insulin.

When you wake up in the morning, you have an insulin spike.

So there is no like really tight, nice normal range of insulin because if you have a couple donuts in the morning, then guess why your insulin's going to spike after that.

If you wake up in the morning, your insulin's going to spike.

So there's no real good range for normal.

I want to go back actually to something that you talked about before, where he was on hospice.

Can you kind of explain what was going on, because when I had read about the case, it seemed like he was healthy, and then there was an incident where he collapsed, he wasn't responding.

It took a while for his wife, Natalie to actually call you know, naimon one or to bring him into a hospital, way too late, some would say, and it was suspicious that he was this supposedly overall healthy thirty eight year old who died.

So I'm curious if you can explain a little more about what the circumstances were of him being on hospice, as well as how this idea of insulin ever arose in the first place.

So how we got on the hospice.

So going back to the circumstances that I understood that and once again, these circumstances, when you look at them retrospectively, are incredibly suspicious.

Let's put it that way.

The history that I received was that Michael was found down around eleven thirty noonish in the morning one day Natalie.

She was the only one home at the time.

Natalie suspected that he either had a seizure or hid his head on the counter on the way down, and she found him unconscious on the kitchen floor.

Then she took pictures of his unconscious body and sent it to friends and family, which is sort of bizarre and strange, very weird.

She had some contractors who happened to be doing some work at the house.

I'm not sure when the contractors got there, I can't remember that detail, but she had them move him to the couch where he stayed there for approximately seven hours.

The only medical intervention that she testified to was she reported checking his blood sugar twice and reported that those levels were normal even though he's unconscious on the couch.

She had one family friend who was in healthcare come by and or that friend came by anyway and said, you really need to take him to the hospital.

This is not well, and she's like, oh, he'll sleep it off, that's fine.

And then apparently one of Michael's friends who couldn't get a hold of him, came by the house, found him unresponsible on the couch.

Coach basically ordered, Natalie, you know, we are taking him to the hospital right now.

So he loaded him up in the car, got him to the hospital.

When he got to the hospital, his blood glucose was under thirty milligrams per desolader.

Now, normal blood glucose ranges from like eighty to one hundred.

So a blood glucose in someone, especially someone who's not a diabetic, anything below sixty in an otherwise healthy person, there's usually something going on, like you know, hey, there might be septic or something like that, or have an overwhelming bacterial infection.

There's a couple natural disease processes that cause that, but he wasn't demonstrating any of those.

And one of the first imaging studies that they did.

When they did do an MRI, they saw no evidence of trauma.

But the radiologist called it, and this is a really interesting term, he called it diffuse hypoglycemic encephalopathy, meaning he was having cerebral edema, likely related to the low blood glucose.

So when you have blood glucose that's too low for too long, your brain starts to freak out and it starts to swell.

And that's exactly what was happening.

And when Natalie got to the hospital, I think it was probably within a matter of hours where she wanted him put on hospice care.

Oh wow, which once again, your husband comes into the hospital, if you're not entirely sure why he's there, you just walk in and be like, yeah, we want to put him on hospice, even though we don't know exactly what's going on.

That whole situation just seems really weird.

So I imagine when you're getting this information, you're assessing her behavior, Michael's blood glucose level when he died, the request from now to put her thirty eight year old husband, who, you know whatever, a day two days before was completely healthy.

That seems super weird, like you would think you would be like save his life, please, but she requests for him to be put on hospice.

And so are you looking at all of these factors plus the medical autopsy when you're looking at the case.

Yes, absolutely, because autopsy is only one part of the equation.

There's the scene investigation, there's medical history.

All of that goes into it.

Like the autopsy is just one part of it.

We also have post mortem samples that we can send out, like toxicology.

We can look at tissue under the microscope for histology.

And it's our job as forensic pathologists to take the autopsy and the scene investigation and the ancillary studies and put it all together to figure out what happened.

So I had a lot of that history.

Now once again, you have to be careful and not let the history bias you too much.

Right, you know, the whole topic of cognitive bias.

That's a whole separate thing that I lecture on, but that's outside the scope of this.

But you don't want to let the scene investigation bias you too much, if you know what I mean, Because you have to look at the big picture, and you know, like an example of it is relying on someone's confession.

If you're rely on someone's confession that they smothered someone, but you have no other findings to go against that, then if they recant their confession, you're left with nothing and you're just like, Okay, what do I do with this?

The bottom line is you have to look at the big picture, right So in this one of the things that I suggested to the district attorney was to take a second look at Michael, which meant a second exhamation, because my thought process here is there are some things that they did not look at in the first autopsy, like they didn't do soft tissue dissections of the arms and abdomen and legs to look for possible injection sites.

Once again, is it low ye or not?

I don't know.

I mean my opinion also is you don't know if you don't look.

So we had to exhaust all the options there.

Yeah, I'm pretty sure that's the point in time when we decided, Okay, I'm going to go out to West Virginia and we're going to do a second autopsy and a second exhamation.

So, as you mentioned, the first autopsy was done seven months after Michael died and at that point the cause of death was listed as undetermined.

So I was reading about how the case was actually dropped by the Raleigh County DA's office the first time around, because it's really hard to bring homicide charges against someone when you don't have the cause of death listed as a homicide, let alone any cause of death.

But then two years later the case was refiled when you were brought in to take a second look.

You've explained how difficult it is to get physical evidence of someone being killed by insulin injections during an autopsy.

So what were you hoping to find in the second autopsy that might have been missed the first time around.

So I don't mean this to like, once again throw shade at the West Virginia office, because post mortem detection of insulin it's been problematic for forensic pathologists ever since the discovery of insulin over sixty years ago.

So figuring out post mortem insulin levels and whether or not it's an insulin suicide or homicide, it's such a tricky issue.

So one of the things they did not do in the first autopsy was they didn't do a soft tissue dissection, basically cutting into the skin looking for subcutaneous hemorrhage that could be consistent with a insulin injection, because that's how insulin is administered.

It's administered subcutaneously.

It's not administered orally.

It's not administered by IV generally, but when you inject insulin, you inject it under the skin and then it creates a little pocketive insulin that acts as a depot and it's sort of released over time and usually works for like four to six So there are ways where you can do soft tissue dissection to look for that, and if you see a possible injection site, then you can take that tissue, look at it under a microscope and do a process called aminohistochemistry where you can stain the slide for insulin.

Now, this is the technique that we did in the Rida May's investigation, and we actually had some success with it, even in patients who were exhumed a year and a half after the fact.

So that is a pretty decent way to do it if you can find a suspected insulin injection site.

But that was not done in the first autopsy, and they also did not send out special testing for insulin or cepeptide, just because I don't think the West Virginia office, and actually most medical examiner offices just don't have access to that.

Yeah, the second autopsy that you end up doing, you have to exhume his remains.

I'm curious if you heard anything about how has family felt about a second autopsy.

How did they feel about it?

Did you ever hear They were absolutely on board with it, and they suspected pretty much from the beginning that she did something to Michael and they wanted to prove it.

So could we have done it without the family consent?

Yes, but generally when you do exhamations, it's usually good to have the family permission and consent on board.

Yeah.

I really like providing reasonable expectations to family members too, because exhumations are incredibly traumatic, and I want them to be like, look, this is why we're doing this, this is what I hope to gain from this, this is what we're specifically looking for, just so they are on the same page with what we're doing and why.

But they were absolutely on board with this.

Yeah, that's really good to know.

So Michael, the that he actually passed, and you mentioned he was on hospice was February eleventh, twenty nineteen, and you performed your autopsy in July of twenty twenty three, so you know, there's a pretty significant passage of time between his death and the second autopsy.

You told us a little bit about what the state of their remains were for the first autopsy.

What was the state of his remains by the time you did your autopsy.

There were significant amounts of decomposition, and really the only soft tissue left was in a form that we call it adipis here, which is when skin and soft tissue turn into like a white, waxy soap like substance, And there wasn't much to be gained from it.

There wasn't much to analyze.

It was largely skeletonized remains with some adipis here type soft tissue, so was not able to get that much information from it.

But once again, if we're looking for something that wasn't done in the first autopsy, I'm generally of the opinion if you're going to exhaust all options, exhaust all options if you don't know, if you don't look right.

And so you did look, you did test the remains for insulin, and what did you find?

I did not test the remains for insult.

You did not test the remains, did not that there was there was there was nothing useful to.

Test, Okay.

So then in that case, because the prosecutor had called you and said we suspect that you know, he was given insulin and that led to his death.

So what do you do with the remains then?

Since you couldn't test for insulin at that point.

So the remains got sent, they got reintered, and you know, at some point the prosecutor changed, so we had a different prosecutor.

So once again I worked on this case with both prosecutors and just to make sure we're on the same page.

And the question that we had to answer was, well, we have a lot of circumstantial evidence, but do we have enough to get a conviction because we don't have the proverbial smoking gun, we don't have evidence of an insulin injection site.

But we have really good medical history where you have someone who's thirty eight year old male, otherwise healthy, not taking insulin, who comes in after being unconscious for seven hours, coming into the hospital with the blood glucose level of less than thirty.

There is not a whole lot of other things that can do that, and unfortunately, there was no samples that we could retrospectively send out for testing.

All of the stuff that was collected from the West Virginia Medical Examiner Office from the first autopsy that was already destroyed because we were already a couple of years out.

So we realize this is a circumstantial case.

Question is do you have enough circumstantial evidence to even try for a conviction in this case?

Yeah?

And so given that, how did that impact what you were able to testify about as a forensic pathologist that looked at his remains.

So going back a step in the Rita May's case, we consulted with a clinical endocrinologist, doctor Dian Krieger, who specializes in the treatment of diabetic patients.

Her help in that case and this case as well was absolutely essential because she understands the clinical aspects of treating diabetics, the clinical aspects of hypoglycemia and what causes this profound hypoglycemia in someone which I don't necessarily see as a forensic pathologist because all my patients are dead.

So we recruited her on this case too and got her opinion, and she was of opinion that yeah, this is likely insulin related, right, And going back another step, because one of the questions that you asked is, well, how was insulin brought up to begin with?

In talking with one of the main investigators about this, the first time insulin was even put on his radar was in one of his interviews with Natalie.

She just brought up insulin sort of out of the blue, really, and it kind of struck him as really odd because he wasn't thinking about that beforehand.

Do you know what she said about it?

I don't remember exactly.

Yeah, okay, So that's interesting.

So the first time investigators ever even took note of insulin was just from an interview with Natalie Cochrane that she had brought it up, okay, and then that is what got on their radar.

Is like a potential cause of death?

Potentially, yes, And I believe it was a couple months after Michael's death they finally got a search warrant for the house.

Now, once again you can argue, you know, well, how useful is the search warrant a couple months after the fact, and if that is what it is.

But in the search of the house, in the refrigerator, ironically under a candy bar.

They found a vial of insulin Wow, with one hole punched in the top of it, and you could tell It's hard to tell exactly how much was missing, but it was not a full bump.

And was Natalie taking insulin.

So the story how this goes is her her testimony.

In her statements, she said that she got the insulin vile from her neighbor.

Her neighbor had a child who was a Type one diabetic and was prescribed insulin.

She had asked the neighbor, Hey, do you have any insulin?

I ran out because I need the insulin for side effects of my chemotherapy for my treatment of breast cancer.

Her neighbor says, oh, yeah, of course she can borrow one of these.

That was I believe the day before Michael died.

Wow.

And it turns out she was not on chemotherapy for breast cancer, she was not prescribed insulin, and she did not have breast cancer.

So once again, just red flags all over the place.

And it's circumstantial evidence, But circumstantial evidence in the right context can be incredibly powerful.

Yeah, and you know something that in the child the defense was really at least from my perspective leaning on is that Michael cochrane was really into fitness and bodybuilding, and he took a lot of supplements and also supposedly took steroids.

Did you take that into account when you were conducting the autopsy or speaking with the endocinologist you mentioned.

Absolutely, And the substances that Michael was taking, they were tested, you know, by the FBI.

It turns out they were other medications, not what he was supposedly taking.

But I don't know.

I think it was more inert substances than when he was prescribed, but I did take that into consideration.

Now, one of the things that I have learned since the trial is that if you are on heavy anabolic steroids and actively bodybuilding, like actively building muscle bodybuilders who are in that sort of cycling phase, they consume enormous amounts of calibers, like we're talking eight to ten thousand plus calories a day.

And those higher end bodybuilders can take insulin to help with their insulin spikes or things like that, because you know, when you're eating like three full plates aposta at a time to get the calories that you need to build the type of mass that you're talking about that is a consideration.

Michael, it doesn't seem like he was that type.

He was never prescribed insulin, he wasn't doing heavy anabolic steroids.

I believe he was on testosterine supplementation and got some other supplements from Mexico.

One of them, I believe was something called enclomaphene or clomid, which you know bodybuilders do use, but they use that to sort of kick in natural testoster and production.

But to my knowledge, he was not a heavy anabolic steroid user.

There was no evidence that he had used insulin before, and this sort of played into I guess one of the games that the defense was playing was that, oh, yeah, well Michael was you know, now sick and had a bad heart and was very ill.

But then on the other hand, he was actively health conscious and taking lots of supplements to take care of himself in actively bodybuilding.

So it's like, Okay, which one is it?

Is he on the sick side and could have died at any time, or is he actively health conscious and doing what he can to take care of himself and actively health not bodybuilder, So it's like which one?

And I remember during the trial, the defense couldn't really make up their mind in terms of which way they wanted to go with that, so they were trying to play both of those cards at the same time.

Yeah, and there's probably a more elegant way for me to ask this question.

But given that you were not able to test for insulin because of the state of his remains and your role here as you're a forensic pathologist, why does the state then still bring you in to testify if you essentially couldn't come to a definitive like, hey, I tested for this, it's here.

Because there was enough circumstantial evidence to go forward with it, even though you did not have the proverbial smoking gun, which is, you know, obviously the best smoking gun would be video of her injecting him.

I mean, of course we're not going to have that.

The next one would be, well, if there were samples that were taken and we can test for that and they would show evidence of insulin poisoning something like that.

In that case, we didn't have that either.

So my testimony was, well, this is what they could have done to look into it, namely on the clinical side, which is it is very tricky to pick up insulin intoxication or insulin overdose on the clinical side, because you have to suspect it immediately.

You have to suspect it, like right when the person walks in to the emergency room and they're crashing in front of you.

That's when you have to test for it.

I see, and that didn't happen, which is not terribly surprising.

At autopsy from when he collapsed to when he died was several days, so post mortem insulin testing three to five days after the hypoglycemic event, so after your blood sugar tanks.

It's very very low yield.

With that, your best option would probably be to try and find an insulin injection site.

That wasn't done either.

But even though you don't have the smoking gun.

My testimony was, well, there's nothing else that really explains this, because when you have a blood glucose level of less than thirty in an otherwise healthy person, there's only a couple things that can do that, and some of them were able to rule out, like he was not rampagingly septic, he didn't have a huge bacterial infection.

That was overwhelming as there was no evidence that he was taking other drugs like you know, some of the oral hypoglycemic agents.

There was no history of that.

But we have this weird history of insulin and how Natalie got it, and there was a used insulin vile in the house even though no one was using insulin, And you have no other viable explanation for why a healthy male comes in with a blood glucose of less than thirty And based on that circumstantial evidence, I want to say that circumstantial evidence alone, because we didn't have the smoking gun evidence from autopsy.

It was my opinion that there was nothing else that could have killed him.

There is no other explanation that makes even a shred of sense in this case.

Yeah, that's a pretty strong assessment.

And I imagine that was impactful in the courtroom.

And do you recall how long the jury deliberated and what was the outcome.

I don't recall how long they deliberated, but they found her guilty.

Yeah.

So she was found guilty of first degree murder from the murder of her husband, Michael cochrane, and she was sentenced to life in prison without pearl.

Yep.

That sounds about right.

Was there anything else about the case that stood out to you as strange, unusual or notable from a forensic pathologists standpoint.

I think the most significant thing about this case in particular, and how it differs from the riad A Maze investigation, is we got a successful prosecution for murder using insulin on just circumstantial information.

Now, circumstantial evidence can be just as powerful as objective autopsy evidence if it's in the right context, and in this particular case, there was literally mountains of circumstantial evidence, like literally so many things that didn't make sense, Like, you know, you find your husband down in the kitchen.

You know, what do you do?

Oh well, let's just leave him there.

It's like, wait, no, that's not a normal reaction.

You go to the hospital and be like, yeah, we don't know what's wrong, but we just want to put on hospice and you know, oh yeah, I got this insulin vile from the neighbor for the chemotherapy and breast cancer that I don't have.

And ironically, the thing that astounds me the most is even months after Michael's death, when they searched the house, the insulin vile was still there.

That is bananas.

That is like someone who is so confident that they are just so smart that they can get away with anything.

Or like dumb like why don't know?

Right, Yeah, what in what world would you not get rid of that?

I don't know, I really don't.

But that's one of the little factoids about this case that just it blows me away.

She was not careful to like cover her track.

She really wasn't texting, going to the neighbors.

And I guess fortunately, right that all of that happened so that she was able to be found guilty for killing her husband.

Yeah, which I'm sure Michael Cochrane's family was just like so relieved by that verdict.

Yeah, I think so.

I've not spoken with the Cochran family, but I can imagine it's relief on all fronts from them.

Once again, it's not going to bring Michael back, but at least it provides some type of closure.

Yeah.

Well, this has been really interesting.

We really appreciate you joining us and walking us through all the technical aspects of this case and your involvement in the trial.

Yeah, thank you so much.

Well, thank you for having me.

If you have a story for us, we would love to hear it.

Our email is the Knife at exactly rightmedia dot com, or you can follow us on Instagram at the Knife Podcast or a Blue Sky at the Knife Podcast.

This has been an exactly right production, hosted and produced by me Hannah Smith.

And me Patia Eating.

Our producers are Tom Bria Bogel and Alexis Amorosi.

This episode was mixed by Tom Bryfogel.

Our associate producer is Christina Chamberlain.

Our theme music is by Birds in the Airport, artwork.

By Vanessa Lilac.

Executive produced by Karen Kilgarriff, Georgia Hardstark and Danielle Kramer.