What Remains

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Speaker 11 It was my 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.

Speaker 10 Welcome to The Knife. I'm Patia Eaton.

Speaker 1 I'm Hannah Smith. And today we have an interview for you with a forensic pathologist who worked on a murder trial.

Speaker 1 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.

Speaker 1 So we're going to start the story. On March 18th, 2021, a woman named Natalie Cochran.
from Beckley, West Virginia was sentenced to 135 months in federal prison, which is over 11 years.

Speaker 1 And the reason that she's sentenced to prison, she's charged with wire fraud and money laundering. She's been running a Ponzi scheme.

Speaker 1 She orchestrated this scheme that defrauded victims over $2 million.

Speaker 1 And she was ordered to pay $2.5 million in restitution. And she would also serve a term of three years of supervised release after the 11-year sentence.

Speaker 1 You know, but this is actually just the beginning of Natalie's problems, right? Like she's sent to prison. prison, she was caught for this Ponzi scheme.

Speaker 1 But once she's already been, you know, charged and convicted, other things start to come out. So she was arrested in October of 2019 on this indictment for her Ponzi scheme.

Speaker 1 But earlier that year in February of 2019, her husband, Michael, died suddenly. He was only 38 years old.

Speaker 1 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.

Speaker 10 Yeah. And Natalie and Michael had been married since the early 2000s.
They had two children. Natalie worked as a pharmacist, Michael as a computer specialist.

Speaker 10 I even read that they were actually childhood sweethearts. Wow.
Yeah. So they'd made this life for themselves in a small town where you truly feel like you know everyone.

Speaker 10 And when Michael passed, the community really rallied around Natalie because she was suddenly this widow in her 30s.

Speaker 10 But leading up to Michael's death in February of 2019, there was a lot going on for Natalie and Michael. Natalie had left her career as a pharmacist.

Speaker 10 She and Michael had registered a company called Tactical Solutions Group or TSG.

Speaker 10 And this idea for the company was that it would bid on contracts to sell weapons and other goods to the U.S. government.
She needed to raise capital, so she's bringing on investors.

Speaker 10 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.

Speaker 10 So she leaves her career as a pharmacist and she goes all in on TSG. They also open another company, TMG, which is Technology Management Systems, similarly working with the US government.

Speaker 10 So both of these companies were fraudulent. And Natalie would later admit in court that she never invested any of the money.

Speaker 10 And she instead spent that investor money on things like, you know, real estate, a fancy car, personal items. Classic.

Speaker 1 Classic.

Speaker 10 So Michael was totally unaware of this, which I'm going to get into, which was revealed later in text messages.

Speaker 1 He thought that these companies that they'd started were legitimate and probably thought they were doing really well.

Speaker 10 Yeah, or he would have never consented to them having their friends and family invest.

Speaker 1 Right. Yeah.

Speaker 1 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 2019, the walls are starting to close in.

Speaker 1 You have to imagine there's probably an investigation starting to happen behind the scenes. And in February of 2019, Michael collapsed.
He had a seizure.

Speaker 1 And Natalie told a friend who had been present that day that she was going to let Michael sleep it off.

Speaker 1 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.

Speaker 1 And there's an account that Natalie 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.

Speaker 1 And then he died in hospice a few days later. And the first cause of death was, quote, natural.
It was determined to be a natural death.

Speaker 1 Natalie Cochran was then arrested for the Ponzi scheme months later in October of 2019.

Speaker 1 She pled guilty to the charges against her in September of 2020, and she was ready to serve this 11-year sentence.

Speaker 1 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.

Speaker 1 And that eventually led to her murder trial.

Speaker 1 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 schemes.

Speaker 1 And this was revealed during the trial in text messages that were exchanged between Natalie and Michael. Natalie was the majority owner, as you said, with the 51% stake in TSG.

Speaker 1 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.

Speaker 1 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.

Speaker 1 So she portrayed her company was in trouble. She secured all of these loans.

Speaker 1 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.

Speaker 1 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.

Speaker 1 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.

Speaker 10 Yeah, I mean, he truly had no idea.

Speaker 10 So that changes in August of 2018 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.

Speaker 10 And he could tell that something was not right. So Natalie and Michael get together and they put their heads together about this and try to come up with a way to pay people back.

Speaker 10 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.

Speaker 10 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.

Speaker 10 Let's make sure that happens and let's get these people paid back.

Speaker 10 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.

Speaker 1 Both options. It's a horrible feeling, I imagine.

Speaker 10 Horrible feeling. So Natalie comes up with this grand plan and tells him that the money is on the way.
But in September of 2018, so in August, he sees the text in her phone.

Speaker 10 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.

Speaker 10 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.

Speaker 10 Michael believes they're waiting on $248 million.

Speaker 1 That's wild.

Speaker 10 It's a lot of money. And so Natalie says, this is all going to be in our account by October 29th.
Okay, great. Things are looking up.
Thank God. Well, then it doesn't happen on October 29th.

Speaker 10 She has some reason for it. This is super stressful for Michael.
And on October 31st, he actually gets really sick and goes to the hospital.

Speaker 10 Now, at the 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.

Speaker 10 On November 2nd, 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.

Speaker 10 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.

Speaker 1 Trying to create this history of medical problems. Exactly.

Speaker 10 So in the fall, in November and into December, more lies, more lies. And then in December, there's a federal government shutdown.
Great. They can't pay us.
So sorry, Michael.

Speaker 1 We're going to have to wait.

Speaker 10 Michael's really upset and stressed and not acting like himself. He's easily angered.
He's irritable.

Speaker 10 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.

Speaker 10 And so they get through December and the federal government is going to open back up and release funds, the sold according to Natalie, in February.

Speaker 10 So they're going to get everything in February of 2019, which we now know is the month that Michael was murdered.

Speaker 10 So there's an incident at the bank when Michael believes that the funds are supposed to be released.

Speaker 10 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.

Speaker 10 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?

Speaker 10 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.

Speaker 10 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.

Speaker 10 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.

Speaker 10 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.

Speaker 10 She picks up a prescription that I believe was an antihistamine, but it was a prescription antihistamine, something that Michael was known to be allergic to.

Speaker 10 And by February 6th, Michael is unconscious. And Natalie sees that he's unconscious and does not immediately seek medical care for him.

Speaker 10 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.

Speaker 10 So Michael officially passes passes away February 11th, 2019 on hospice. And we're going to talk today to Dr.

Speaker 10 Paulie Ribe, a forensic pathologist who did the second autopsy on Michael Cochran's remains for Natalie Cochran's murder trial. Let's get into it.

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Speaker 1 Today we're speaking with Dr. Paul Uribe about his work as a forensic pathologist and his role in a murder trial that was years in the making.

Speaker 1 The murder of Michael Cochran in Beckley, West Virginia, back in 2019. Paul, hi, can you please start by introducing yourself?

Speaker 11 Hi, my name is Dr. Paul Uribe.

Speaker 11 I am the current deputy chief medical examiner at the Fort Bend County Medical Examiner's Office, which is located southwest of Houston.

Speaker 11 I also work as a locum tenins forensic pathologist, which is a part-time forensic pathologist in a couple of jurisdictions, namely Clark County, Nevada, which incorporates Las Vegas and southern Nevada, as well as the state of Mississippi.

Speaker 11 And

Speaker 11 as a third part-time job, I have my own forensic consulting company, DMH Forensics, or Dead Man's Hand Forensics.

Speaker 1 Wow. And so for people who might not be familiar, what is the sort of brief explanation of what a forensic pathologist does?

Speaker 11 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.

Speaker 11 So in a nutshell, we study death and see what we can learn from it. And we do that, namely by performing autopsies.

Speaker 1 And so we're going to get into Natalie Cochran's trial, the death of Michael Cochran.

Speaker 1 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?

Speaker 1 What was the sort of understanding of yours at that time of what this case was all about?

Speaker 11 So I was contacted by the Raleigh County prosecutor who

Speaker 11 heard of me from my involvement in another high-profile insulin case in West Virginia, which was the prosecution of Rita Mays.

Speaker 11 She was a nursing assistant who was accused of essentially poisoning VA patients at the Clarksburg VA with insulin.

Speaker 11 And this was a case that I did while active duty in the military with the Armed Forces Medical Examiner's Office.

Speaker 11 And because of my involvement in that case, which was relatively high profile, they reached out to me because

Speaker 11 I had done a lot of research and testimony in terms of of insulin homicides. And they reached out to me saying, hey, can you help out with this?

Speaker 11 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.

Speaker 11 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.

Speaker 11 And they just wanted me to take a look at it to essentially see what I could see.

Speaker 1 What 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.

Speaker 11 So the first autopsy was not done by me. And there's a little bit of a backstory here because

Speaker 11 when

Speaker 11 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.

Speaker 11 Now, once again, I know a lot of the docs at West Virginia. I'm not saying this to throw shade at them or anything, but I do think the case was missed.

Speaker 11 When you have a 38-year-old male on hospice for reasons that aren't really clear, it's different if someone has like ALS, which is amyotrophic lateral sclerosis, 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.

Speaker 11 That's a legitimate reason for a younger person to be on hospice. But he didn't really have a great diagnosis.

Speaker 11 But anyway, regardless of how that was missed, the prosecutors started looking into it in the months after his death.

Speaker 11 And they found his death really, really suspicious because at that point she was being investigated for the Ponzi scheme and so forth.

Speaker 11 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.

Speaker 11 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 C-peptide.

Speaker 11 We'll talk about the importance of those two things later.

Speaker 11 And he didn't really look for insulin injection sites either. Now, whether or not you can find insulin injection sites in someone who's been essentially buried for seven months, it's very tough.

Speaker 10 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.

Speaker 10 So his remains were exhumed. Is that correct?

Speaker 11 Yes.

Speaker 11 I I don't think he was buried in the ground. I think he was interred in a mausoleum.
Oh, okay. Basically above ground.

Speaker 10 Okay. And so seven months after his death, what state are someone's remains in?

Speaker 11 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, under the earth.

Speaker 11 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.

Speaker 11 There was some decomposition, which naturally you would expect, but it wasn't terrible.

Speaker 11 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.

Speaker 11 But once again, if you have a body that's not embalmed and is in the ground, and then you have water that leaks into the casket and everything, that just accelerates decomposition.

Speaker 10 In this case, for the first autopsy, Michael Cochran, they had remains that were in a state they felt like they could conduct an autopsy on and get strong results or decent results.

Speaker 11 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.

Speaker 11 Like, you know, it varies on what you eat. It varies with your circadian rhythm.
Sometimes your pancreas secretes insulin. When you wake up in the morning, you have an insulin spike.

Speaker 11 So there is no like really tight, nice, normal range of insulin. Because if you have a couple of donuts in the morning, then guess what? Your insulin is going to spike after that.

Speaker 11 If you wake up in the morning, your insulin is going to spike. So there's no real good range for normal.

Speaker 1 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?

Speaker 1 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.

Speaker 1 It took a while for his wife, Natalie, to actually call, you know, 911 or to bring him into a hospital way too late, some would say.

Speaker 1 And it was suspicious that he was this supposedly overall healthy 38-year-old who died.

Speaker 1 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.

Speaker 11 So, how he got on the hospice. So, going back to the circumstances that I understood this, and once again, these circumstances, when you look at them retrospectively, are incredibly suspicious.

Speaker 11 Let's put it that way. The history that I received was that Michael was found down

Speaker 11 around 11:30 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 hit his head on the counter on the way down.

Speaker 11 And she found him unconscious on the kitchen floor. Then

Speaker 11 she

Speaker 11 took pictures of his unconscious body and sent it to friends and family, which is sort of bizarre and strange. Very weird.

Speaker 11 She had some contractors contractors who happened to be doing some work at the house.

Speaker 11 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

Speaker 11 he stayed there for approximately seven hours.

Speaker 11 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

Speaker 11 one family friend who was in health care 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.

Speaker 11 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 unresponsive on the couch, basically ordered.

Speaker 11 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.

Speaker 11 When he got to the hospital, his blood glucose was under 30 milligrams per deciliter. Now, normal blood glucose ranges from like 80 to 100.

Speaker 11 So a blood glucose in someone, especially someone who's not a diabetic, anything below 60 in an otherwise healthy person, there's usually something going on.

Speaker 11 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.

Speaker 11 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.

Speaker 11 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.

Speaker 11 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.

Speaker 11 That whole situation just seems really weird.

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Speaker 12 Some moments in your life stay with you forever.

Speaker 12 In a special segment of On Purpose, I share a story about a book that changed my life early in my journey and how I was able to find the exact same edition on eBay years later.

Speaker 12 There are certain books that don't just give you information, they shift the way you see the world. I remember reading one when I was younger that completely changed me.

Speaker 12 Years later, I found myself thinking about that book again. I wanted the same edition back.
Not a reprint, not a different cover, that exact one.

Speaker 12 So I started searching, and that's when I found it on eBay. That's what I love about eBay.
It's not just a marketplace, it's a place where stories live.

Speaker 12 Shop eBay for millions of finds, each with a story. eBay, things people love.

Speaker 12 Listen to OnPurpose on the iHeartRadio app, Apple Podcasts, or wherever you listen to podcasts.

Speaker 13 Ah, greetings for my bath, festive friends. The holidays are overwhelming, but I'm tackling this season with PayPal and making the most of my money, getting 5% cash back when I pay in four.

Speaker 14 No fees, no interest.

Speaker 13 I used it to get this portable spa with jets.

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Speaker 15 Save the offer in the app. NS1231, see paypal.com promo terms, points keep your reading for cash and more paying for subject to terms and approval.
PayPal Inc. and MLS 910-457.

Speaker 1 So I imagine when you're getting this information,

Speaker 1 you're assessing her behavior, Michael's blood glucose level when he died, the request from Natalie to put her 38-year-old husband, who, you know, whatever, a day, two days before was completely healthy.

Speaker 1 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.

Speaker 1 And so, are you looking at all of these factors plus the medical autopsy when you're looking at the case?

Speaker 11 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.

Speaker 11 We also have post-mortem samples that we can send out, like toxicology. We can look at tissue under the microscope for histology.

Speaker 11 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.

Speaker 11 So I have a lot of that history. Now, once again, you have to be careful and not let the history bias you too much.
Right.

Speaker 11 And, 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.

Speaker 11 But you don't 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.

Speaker 11 And, you know, like an example of it is, you know, relying on someone's confession.

Speaker 11 If you're relying 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.

Speaker 11 And you're just like, okay, what do I do with this? The bottom line is you have to look at the big picture.

Speaker 1 Right.

Speaker 11 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 examation.

Speaker 11 Because my thought process here is there are some things that they did not look at in the first autopsy.

Speaker 11 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 yield or not? I don't know.

Speaker 11 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.

Speaker 11 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 examination.

Speaker 10 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.

Speaker 10 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 any cause of death.

Speaker 10 But then two years later, the case was re-filed when you were brought in to take a second look.

Speaker 10 You've explained how difficult it is to get physical evidence of someone being killed by insulin injections during an autopsy.

Speaker 10 So what were you hoping to find in the second autopsy that might have been missed the first time around?

Speaker 11 So

Speaker 11 I don't mean this to...

Speaker 11 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 60 years ago.

Speaker 11 So figuring out post-mortem insulin levels and whether or not it's an insulin suicide or homicide, it's such a tricky issue.

Speaker 11 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.

Speaker 11 It's administered subcutaneously. It's not administered orally.
It's not administered by IV generally.

Speaker 11 But when you inject insulin, you inject it under the skin and then it creates a little pocket of insulin that acts as a depot and it's sort of released over time and usually works for like four to six hours.

Speaker 11 So there are ways where you can do soft tissue dissection to look for that.

Speaker 11 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 immunohistochemistry where you can stain the slide for insulin.

Speaker 11 Now, this is the technique that we did in the Rita Mays investigation. And we actually had some success with it, even in patients who were exhumed a year and a half after the fact.

Speaker 11 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.

Speaker 11 And they also did not send out special testing for insulin or C-peptide just because I don't think the West Virginia office, and actually most medical examiner offices, just don't have access to that.

Speaker 1 Yeah.

Speaker 10 The second autopsy that you end up doing, you have to exhume his remains. I'm curious if you heard anything about how his family felt about a second autopsy.

Speaker 10 How did they feel about it? Did you ever hear?

Speaker 11 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.

Speaker 11 So

Speaker 11 could we have done it without the family consent? Yes. But generally, when you do exhumations, it's usually good to have the family permission and consent on board.

Speaker 1 Yeah.

Speaker 11 I really like providing reasonable expectations to family members too, exhumations are incredibly traumatic. And I want them to be like, look, this is why we're doing this.

Speaker 11 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.

Speaker 10 Yeah, that's really good to know. So, Michael.
The date that he actually passed, and you mentioned he was on hospice, was February 11th, 2019. And you performed your autopsy in July of 2023.

Speaker 10 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 the remains were for the first autopsy.

Speaker 10 What was the state of his remains by the time you did your autopsy?

Speaker 11 There were significant amounts of decomposition,

Speaker 11 and

Speaker 11 really the only soft tissue left was in a form that we call it a adiposere, which is

Speaker 11 when

Speaker 11 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.

Speaker 11 It was largely skeletonized remains with some adiposere type soft tissue. So was not able to get that much information from it.
But once again,

Speaker 11 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. You don't know if you don't look.

Speaker 10 Right. And so you did look, you did test the remains for insulin.
And what did you find?

Speaker 11 I did not test the remains for insulin.

Speaker 10 You did not test the remains for insulin.

Speaker 11 I did not.

Speaker 11 There was nothing useful to test.

Speaker 10 Okay, so then in that case, because the prosecutor had called you and said we suspect that he was given insulin and that led to his death.

Speaker 10 So what do you do with the remains then since you couldn't test for insulin at that point?

Speaker 11 So the remains got sent, they got reinterred and you know at some point the prosecutor changed. So we had a different prosecutor.

Speaker 11 So once again, I worked on this case with both prosecutors and just to make sure we're on the same page.

Speaker 11 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 have the proverbial smoking gun.

Speaker 11 We don't have evidence of an insulin injection site, but we have really good medical history where you have someone who's a 38-year-old male, otherwise healthy, not taking insulin, who comes in after being unconscious for seven hours,

Speaker 11 coming into the hospital with a blood glucose level of less than 30.

Speaker 11 There is not a whole lot of other things that can do that.

Speaker 11 And unfortunately, there was no samples that we could retrospectively send out for testing.

Speaker 11 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.

Speaker 11 So we realized this is a circumstantial case. And the question is, do you have enough circumstantial evidence to even try for a conviction in this case?

Speaker 10 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?

Speaker 11 So going back a step, in the Rita Mays case, we consulted with a clinical endocrinologist, Dr. Diane Krieger, who specializes in the treatment of diabetic patients.

Speaker 11 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.

Speaker 11 So we recruited her on this case too and got her opinion. And she was of the opinion that, yeah, this is likely insulin related.

Speaker 1 Right.

Speaker 11 And

Speaker 11 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,

Speaker 11 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?

Speaker 11 And it kind of struck him as really odd because he wasn't thinking about that beforehand.

Speaker 10 Do you know what she said about it?

Speaker 11 I don't remember exactly.

Speaker 10 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.

Speaker 1 That she had brought it up. Okay.

Speaker 1 And then that is what got on their radar as like a potential cause of death, potentially?

Speaker 11 Yes. And

Speaker 11 I believe it was a couple months after Michael's death, they finally got a search warrant for the house.

Speaker 11 Now, once again, you can argue, you know, well, how useful is a search warrant a couple months after the fact? And that is what it is.

Speaker 11 But in the search of the house, in the refrigerator, ironically, under a candy bar, they found a vial of insulin.

Speaker 1 Wow.

Speaker 11 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 bottle.

Speaker 1 And was Natalie taking insulin?

Speaker 11 So the story, how this goes is per her testimony and her statements, she said that she got the insulin vial from her neighbor.

Speaker 11 Her neighbor had a child who was a type 1 diabetic and was prescribed insulin. She had asked the neighbor, hey, do you have any insulin? I ran out because

Speaker 11 I need the insulin for side effects of my chemotherapy for my treatment of breast cancer. Her neighbor says, oh, of course you can borrow one of these.

Speaker 11 That was, I believe, the day before Michael died.

Speaker 1 Wow.

Speaker 11 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.

Speaker 11 And it's circumstantial evidence, but circumstantial evidence in the right context can be incredibly powerful.

Speaker 10 Yeah. And, you know, something that in the trial, the defense was really, at least from my perspective, leaning on is that Michael Cochrane was really into fitness and bodybuilding.

Speaker 10 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 endocrinologist you mentioned?

Speaker 11 Absolutely. And

Speaker 11 the

Speaker 11 substances that Michael was taking, they were tested by the FBI. It turns out they were other medications, not what he was supposedly taking, but I don't know.

Speaker 11 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

Speaker 11 on heavy anabolic steroids and actively bodybuilding, like actively building muscle, bodybuilders who are in that, you know, sort of cycling phase, they consume enormous amounts of calories.

Speaker 11 Like we're talking 8,000 to 10,000 plus calories a day.

Speaker 11 And those higher end bodybuilders can take insulin to help with their insulin spikes or things like that.

Speaker 11 Because when you're eating like three full plates of pasta 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.

Speaker 11 Michael, it doesn't seem like he was that type. He was never prescribed insulin.
He wasn't doing heavy anabolic steroids.

Speaker 11 I believe he was on testosterone supplementation and got some other supplements from Mexico. One of them, I believe, was something called enclomaphene or clomid,

Speaker 11 which bodybuilders do use, but they use that to sort of kick in natural testosterone production. But to my knowledge, he was not a heavy anabolic steroid user.

Speaker 11 There was no evidence that he had used insulin before.

Speaker 11 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, sick and had a bad heart and was, you know, very ill.

Speaker 11 But then on the other hand, he was actively health conscious and taking lots of supplements to take care of himself and actively bodybuilding. So it's like, okay, which one is it?

Speaker 11 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?

Speaker 11 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.

Speaker 1 Yeah.

Speaker 10 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 and it's here?

Speaker 11 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.

Speaker 11 I mean, of course, we're not going to have that.

Speaker 11 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.

Speaker 11 And in that case, we didn't have that either. So my testimony was, well,

Speaker 11 this is what they could have done to look into it, namely on the clinical side, which is very tricky to pick up insulin intoxication or insulin overdose on the clinical side because you have to suspect it immediately.

Speaker 11 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.

Speaker 11 And that didn't happen, which isn't terribly surprising. At autopsy, from when he he collapsed to when he died was several days.
So, post-mortem insulin testing,

Speaker 11 you know, three to five days after the hypoglycemic event. So, after your blood sugar tanks, it's very, very low yield with that.

Speaker 11 Your best option would probably be to try and find an insulin injection site. That wasn't done either.

Speaker 11 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 30 in an otherwise healthy person, there's only a couple things that can do that.

Speaker 11 And some of them, you know, we're able to rule out. Like he was not rampagingly septic.
He didn't have a huge bacterial infection that was overwhelming his system.

Speaker 11 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.

Speaker 11 But we have this weird history of insulin and how Natalie got it. And there was a used insulin vial in the house, even though no one was using insulin.

Speaker 11 And you have no other viable explanation for why a healthy male comes in with a blood glucose of less than 30.

Speaker 11 And based on that circumstantial evidence, I want to say that circumstantial evidence alone, because we didn't have the smoking gun evidence evidence from autopsy.

Speaker 11 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.

Speaker 1 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?

Speaker 11 I don't recall how long they deliberated, but they found her guilty.

Speaker 10 Yeah, so she was found guilty of first-degree murder for the murder of her husband, Michael Cochran, and she was sentenced to life in prison without parole.

Speaker 11 Yep, that sounds about right.

Speaker 1 Was there anything else about the case that stood out to you as strange, unusual, or notable from a forensic pathologist's standpoint?

Speaker 11 I think the most significant thing about this case in particular and how it differs from the Rita Mays investigation is

Speaker 11 we got a successful prosecution for murder using insulin on just circumstantial information. Now,

Speaker 11 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.

Speaker 11 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.

Speaker 11 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 them put on hospice.

Speaker 11 And, you know, oh, yeah, I got this insulin vial from the neighbor for the chemotherapy and breast cancer that I don't have.

Speaker 11 And ironically, the thing that astounds me the most is even months after Michael's death, when they searched the house, the insulin vial was still there.

Speaker 1 That is bananas.

Speaker 10 That is like someone who is so confident that they are just so smart that they can get away with anything.

Speaker 1 Or like dumb, like, I don't know.

Speaker 1 Yeah. What in what world would you not get rid of that?

Speaker 11 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.

Speaker 1 She was not careful. to like cover her tracks.
She really wasn't. Texting, going to the neighbors.

Speaker 1 And I guess fortunately, right, that all of that happened so that she was able to be found guilty for killing her husband. Yeah.

Speaker 10 Which I'm sure Michael Cochran's family was just like so relieved by that verdict.

Speaker 11 Yeah, I think so. I've not spoken with the Cochran family, but I can imagine it's relief on all fronts from them.

Speaker 11 Once again, it's not going to bring Michael back, but at least it provides some type of closure.

Speaker 1 Yeah. Well, this has been really interesting.
We really appreciate you joining us and walking us through, you know, all the technical aspects of this case and your involvement in the trial.

Speaker 10 Yeah. Thank you so much.

Speaker 11 Well, thank you for having me.

Speaker 10 If you have a story for us, we would love to hear it. Our email is theknife at exactlyrightmedia.com, or you can follow us on Instagram at theknife podcast or Blue Sky at the Knife Podcast.

Speaker 1 This has been an exactly right production, hosted and produced by me, Hannah Smith, and me, Patia Eaton.

Speaker 10 Our producers are Tom Breifogel and Alexis Amorosi.

Speaker 1 This episode was mixed by Tom Breifogel.

Speaker 10 Our associate producer is Christina Chamberlain.

Speaker 1 Our theme music is by Birds in the Airport.

Speaker 10 Artwork Artwork by Vanessa Lilac.

Speaker 1 Executive produced by Karen Kilgariff, Georgia Hardstark, and Danielle Kramer.

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