I spoke with the medical examiner himself.*

Let me attempt to make sense of my barrage of scratchy notes that I took while he explained things to me. Very nice guy, by the way. He was very thorough. So, here it goes. If anyone in the medical field sees something that doesn't make sense or needs clarification, by all means, correct me.

I will just go from start to finish even though this is all over the place.

The medical examiner first determines if foul play was involved in the death. In Matt's case, no. So they did not do a full autopsy. Plus, his immediate cause of death was fairly obvious. There were three main factors, however. And, wouldn't you know... Matt's injuries all involved his lungs, heart AND brain.

The first problem he mentioned was tension pneumothorax. When there's trauma to a lung, it's oftentimes caused when the edge of a rib lacerates the lung. This laceration on Matt created a flap where the rib punctured his lung. He was able to inhale air into his chest but when he exhaled, the flap closed. So air was going in, but not out. This causes air to fill the chest cavity and pushes the heart to the side, causing it to stop beating. They inserted a chest tube where the collapsed lung was.

The second thing they did was insert a needle into his abdomen to see if blood came out. Sometimes, when a rib is broken, it can tear an artery. They already had the chest tube in place because they check the chest and the abdomen for this. No blood came out when they inserted the needle.

The third thing was where they check the head. There were a number of lacerations on Matt's head and his scalp was torn (so lots of bleeding). There is something written here about two big signs. Oh, I know. He said there were two big signs of head trauma that led him to conclude that his immediate cause of death was head trauma (I think I'm saying this right). Periorbital hemorrhage - this is bruising around the eyes caused by a blow to the face. And a basal skull fracture - a horizontal fracture at the base of the skull where the spine comes in. This is getting difficult to type but I just have to keep reminding myself that he was unconscious.

A bad sign was blood draining from his ear as a result of the basilar skull fracture. This indicates life threatening damage to the brain.

At PCMH (Pitt Co. Memorial Hospital), they will immediately do a CT scan. I'm not sure if he was telling me this was done on Matt or if he was saying what is typically done. I can't remember. But he said if someone comes in in bad enough shape, they obviously don't worry about performing x-rays right away. He looked at the chest film. Matt was brought in with PEA, which is pulseless electrical activity. If I remember correctly, there are two common fatal arhythmias: Fibrillation where the heart wiggles in an unorganized pattern. This type is better than the other because usually they can shock the heart and it will go. I'm guessing PEA is the other type and he said something about the chest tube being put in because Matt wasn't making any breath sounds or something.

So Matt came in and his heart was not beating. And I have bradycardia written down... and after that I wrote wide complex - heart dying. Not sure what the wide complex part was about. He said they did a fast scan ultrasound of his chest and there was no movement of his heart. Which is obviously a bad prognosis. Oh, here we go... so the PEA means there was a regular heartbeat trying to beat but the heart was not responding. If that makes sense.

And here is my last little section of notes. There was an air rush on the right side of his chest and breath sounds were obtained.

The blunt head trauma coupled with bradycardia = not survivable.

He had fractures on the left of his face; well, a number of fractures on his face. And then again I wrote down periorbital hemorrhage and basal skull fracture.

The accident occurred at 10:23am. He arrived at the trauma center at about 10:45am. His time of death was 11:35am. When I asked him about when Matt arrived at the trauma center, he gave me a series of times where notes were inputted into the computer system. 10:59, 11:08, 11:13... and so he said Matt arrived before they started entering notes, of course. So that's where I just kind of guesstimated 10:45.

I thought it was so nice of him to take the time and explain all this to me. I feel so much better knowing more about what exactly happened to Matt.