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Aug. 16, 2019 - Freedomain Radio - Stefan Molyneux
27:24
Epstein Strangled? An ER Doctor Weighs In
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Hi everybody, it's Stefan Molyne from Freedom Aid.
Hope you're doing well. So we're going to talk about Jeffrey Epstein's neck.
Now, of course, it's a rather technical discussion, so I'm going to defer to the fine gentleman you see on your left, Dr.
Kevin Waikasey. Thank you so much for taking the time today.
I wonder if you could introduce yourself to our listeners.
Well, thank you so much for having me on, Steph.
I really appreciate it. My name is Kevin Waikasey.
I'm an emergency physician.
I've I was residency trained in emergency medicine and I've been doing emergency medicine off and on now for 25 years.
It's hard to say, hard to believe that it's been that long.
But yeah, so I've seen my fair share of neck injuries, let me say that.
So, yeah. Now, when you read about the autopsy and as of the date of when we're recording this, which is Friday morning, As far as we know, the full autopsy has not been released.
So this is stuff that we've heard about through the news.
We're going to talk about it, but of course it remains somewhat theoretical, I think, until the full autopsy report.
So this is all tentative.
We're going to speak in absolutes, but of course it's all tentative based upon reports.
So when you first heard about the report on Jeffrey Epstein, what was it that began to tickle your skepticism?
The fact that he died.
Okay, I think that was true for pretty much the planet as a whole, but after that.
It pretty much blew away my Friday. But yeah, as things are coming out now, it's sounding more and more like, you know, the question, of course, is was this a homicide or was it truly a suicide, as many folks would have us believe?
And without sounding like a conspiracy theorist, I'm trying to take a look at the evidence as it appears.
And by the way, let me Disclaimer here.
I've not seen these records.
I never met Mr. Epstein.
I never examined him. So I'm not giving a definitive diagnosis or any type of and certainly not giving any medical advice or anything of that nature.
But just given the facts as they're coming out and is what everyone has heard in the media regarding especially the recent development of the the autopsies initial report showing multiple broken bones within his neck and I have to really question what happened there, and that's what I'd really like to discuss today.
So, the reports that I've heard say something like this, that, of course, you can strangle yourself from a doorknob and so on, so if you have something that you can tighten, like a belt or something like that, then you can lean against, put it around the doorknob, you can lean into it, and that's going to cause you to lose consciousness at some point, lack of oxygen, and then you're going...
To die. And that would probably not result in any kind of break in the hyoid bone or other bones in the neck.
Correct. But in this situation, he had, as far as I understand it, a bedsheet.
Now, whether the bedsheet was one of these tissue things or a full bedsheet, I'm not entirely sure.
But you'd have to tighten that pretty tight.
It'd be a pretty manual situation.
He's a tall guy. They say he did it off the top bunk.
I just don't see, okay, maybe you could find a way to strangle yourself, but a soft sheet and leaning into it, I don't see how that's going to result in not just the breaking of the hyoid, but multiple breaks in the neck bones.
Well, so what you just described pretty much was the way Robin Williams committed suicide.
He threw a belt over the top, is my understanding of, his closet door, shut the door, and then wrapped the belt around his neck and then just basically hung himself.
He was found kneeling on the floor.
And he did not sustain, I reviewed his autopsy, he did not sustain any broken bones in his neck.
So he really died of asphyxiation, which is a lack of oxygen where he just literally choked to death.
But, you know, the neck is a very important structure.
It's got a lot of important things running through it.
It's got blood vessels, it's got the windpipe, it's got multiple bones that protect the spinal cord.
And so there's numerous ways that you can die from a neck injury.
And when we think about hanging, which is what Epstein apparently did, is the mechanism through which he died was some sort of hanging mechanism.
When we think about that, there's two ways really that a person can die.
There's the miserable way, which is what sounds like Robin Williams did.
Through asphyxiation, it takes a while for that to happen.
And that's where you literally close off the windpipe so you can't breathe.
You lose your oxygen. And once that happens, I will ask this, how long do you have to survive?
Hold your breath. That's how long you have to survive.
But there's another way in which you can die from a neck injury, and it's when you actually fracture the bones of the neck.
You remember that movie, The Hunt for Red October?
There was a scene where Captain Ramius took this Soviet In the book, Clancy talked about Ramius was hoping to achieve what's called a hangman's fracture.
And that's where the two bones, two of the bones, do this.
They either break or they dislocate in the neck.
And that's the point of actually hanging, right?
You know, the scaffold thing where they fall through and then the rope snaps taut.
That's designed not just to asphyxiate, but to break the bones in the neck.
Aha! Yes.
In a merciful situation, that is the merciful way to go, is to have your spinal cord severed.
Then you cannot breathe.
But the bottom line is that doesn't always work in hanging.
If you look at hanging reports like, say, of Saddam Hussein, who was executed back in 2006, all the eyewitness reports say that when he hit the bottom of the rope, when the rope stretched taut, there was a snapping sound and he didn't make any motion after that.
But if you go back and look at numerous examples throughout history, there were four co-conspirators executed for the assassination of Abraham Lincoln way back in 1865.
They were quick.
With her executions back then, quick with justice.
But the bottom line is, of these four people, including Mary Surratt, one of the conspirators, she died instantaneously, according to eyewitnesses.
Apparently, her neck snapped.
She got a hangman's fracture.
She couldn't move. She was paralyzed.
I mean, she didn't die instantaneously.
It still took probably a minute or two for her to lose the oxygen.
But she couldn't move. There was another gentleman who made a couple of kicking motions, and then he stopped.
But the other two lingered for a few minutes, and it was quite obvious that they were choking.
So my point being that if you get these variable results from dropping from several feet in a hanging scenario with a rope stretched around your neck, And those don't always cause fractures and massive forces in the neck.
Well, then the likelihood of this guy tying a bed sheet, especially if it was not linen, around a top bunk and then, you know, lying down or sitting down and slowly asphyxiating himself, slowly choking himself.
In other words, there's just no way he could have jumped off that top bunk and achieved the kind of forces necessary to break multiple bones in his neck.
I just find it impossible to believe.
Well, I did look up. So there's a study of suicidal hangings of young adults and middle-aged people.
This was done from 2010 to 2013 in India.
The hyoid damage was found in just 16 of 264 cases, so that's 6%.
Now, that is younger people and middle-aged people.
He, of course, I think was 66.
Add one more six, and I think we have his number.
But what happened was, or what can happen, of course, is the hyoid bones, as all bones, can get more brittle as you age.
And that's sort of the argument to say, well, yeah, but he was older, and therefore the likelihood could be higher.
Well, let's talk about neck anatomy because there's a lot to go over here as far as the idea that he sustained multiple broken bones in his neck.
Well, you have seven bones in your neck.
You have eight, including the hyoid bone, but you have seven bones that comprise the cervical vertebra.
This is the neck part of the backbone, if you will.
And the very first one, the very first bone, they're labeled C1 through C7. That stands for cervical one through cervical seven.
And the first bone is the literally, it's called the atlas.
It's a round bone just like this.
I think we can get some drawings if you'd like.
But it's a round bone and it supports the skull.
The second bone, C2, sticks up through.
There's a process that sticks up through that round thing.
It's called the dens.
It's called the axis.
The C2 bone is called the axis.
And that's what provides us with the ability to rotate our head and look this way.
Well, the problem with neck injuries is the higher up you go from C7 to C6, C5, C4, C3, C2, C1, the higher up you go, the more substantial the damage, the less likely you are to survive.
So let me give you an idea of this.
When you're talking about fractures and breaks involving C7 level down here, You're talking about people who are spastic quadriplegics.
They may or may not have use of their arms, but their legs, everything from the chest down, is pretty much paralyzed.
They can't move it. We have a saying in medicine, 3, 4, 5 keep you alive.
Any nerve damage above C3, because C3, C4, and C5, those nerves that exit from these vertebrae, from the spinal cord at the level of these vertebrae, These are the nerves that innervate the chest wall and the diaphragm, which is responsible for your breathing.
So C3, C4, and C5, if you knock out one of those, if you knock out the spinal cord at one of those levels of the neck, then you're in major trouble.
You're going to have some serious issues.
You'll probably be dependent on a ventilator like Christopher Reeve was after his neck injury from the horse.
Anything above C3, C2, or C1, a fracture at those things That's pretty much devastating.
If you survive that, you're going to be basically, you're just going to be a talking head.
You're not going to be able to do much on your own at all.
You won't have any feeling or any type of motion.
And if you don't get to, if you're not gotten too quickly after that type of injury, you'll die for sure.
In fact, we call that an injury of C1. When C1 or C2 gets knocked off and the spinal cord is severely damaged, But the head is still intact with the body.
We call that an internal decapitation.
Because basically the patient is just, there's no way they're going to survive.
Again, how long do you have to survive if you sustain an injury like that?
Hold your breath. It's not very long at all.
So the fact that Epstein was shouting, apparently there was some commotion heard from his cell prior to them finding him, or that's the report I've heard so far.
Indicates to me that either this guy was yelling Bonsai or something like that as he jumped from this, you know, second story or this top bunk and ultimately hanged himself or something else was going on.
But the forces involved in breaking the bones of the vertebrae are significant.
Let me just repeat that.
Again, all hangings do not result in broken bones of the vertebrae.
And a hangman's fracture is defined as a C2 fracture.
A break or a dislocation of that second cervical vertebrae, the axis as we call it.
If that doesn't happen, then the person is destined to just die a slow death by asphyxiation, which is what Robin Williams did.
So let's get back to the neck anatomy here.
Let's talk about the hyoid bone.
There's something fascinating about the hyoid bone.
It's really a unique bone within the body because A, it's not attached to any other bone, unlike the Leg bone is connected to the ankle bone.
It's connected to the foot bone.
The hyoid bone sits in the neck.
It sits right about here.
And it's a very small...
It looks like an extra jaw if you look at the thing.
It's U-shaped. And basically, it's not connected to any other bones.
What it does is it serves as a fulcrum, if you will, for all these big muscles that comprise the bottom of the floor of the mouth and the base of the tongue.
So it's very important in speech.
It's very important in swallowing.
Very important in maintaining your airway.
So the hyoid bone is just sitting there on its own, and it's got another unique characteristic in that it's U-shaped.
In fact, the name hyoid comes from the Greek letter Ypsilon, which stands for U. How is it tethered?
Oh, it's connected by tendons to all these massive muscles.
Literally muscles hold the hyoid bone in place.
It's not tethered to any other bones.
So it's various muscles within the floor of the mouth and the base of the tongue that hold it there.
Absolutely. Does that make sense?
Yep. So the bottom line is, when the hyoid bone, given its unique structure, its shape, and its architecture, and the fact that it's not articulated with other bones, there's only a very few ways that it can be broken.
And so the first way is called an avulsion fracture.
And the most common avulsion fractures that most of your viewers have heard of probably is the ACL tear or the PCL tear that athletes get.
And that's where the ligaments that hold the knee together, if one of them pops off the bottom or the top, it can pull a chunk of the bone off.
That's called an avulsion fracture where a little piece of bone where one of the muscles that attaches, let's say if the hyoid bone has an avulsion fracture, If a muscle that's attached to the hyoid bone gets forcefully ripped from it, it can pull a piece of it off.
That's not what happened here.
I would be willing to bet a lot of money that that's not what happened in this case.
What we're talking about is Epstein probably if his hyoid bone was fractured according to the reports, I highly doubt it was an avulsion fracture because that would involve forces that would involve tremendous forces like A giant whiplash where your neck goes back and forward and these muscles get overstretched and it pulls a piece of the hyoid off.
I don't think that happened in this case.
So that leaves us two other possibilities when it comes to what's going on with Epstein's hyoid bone.
And that is this.
The hyoid bone can either be fractured by pushing on it.
Let's say that this is the front of the hyoid bone.
Yeah, it's U-shaped. Just for those who are just listening, it's U-shaped.
So you think of a bent stick with your hands on either side.
Sorry, go ahead. Exactly. And the U is pointed forward.
So the U is pointed towards the front of your body.
If that U gets pushed on like this, if it gets compressed, like let's say you're in a car accident and you hit your neck directly, you hit your hyoid bone directly on a dashboard or the top of a steering wheel, that would give you this type of a compression fracture where it's literally pushed in and you can get a break in the U of that hyoid bone.
But most commonly what happens is the hyoid bone gets crushed from the sides.
Imagine taking a wishbone or a U-shaped stick and doing this to it, just taking the ends and breaking it like this.
Now, the way this works is this is absolutely easy to determine on an autopsy, by the way.
If the hyoid bone is fractured from anterior forces, in other words, if it's fractured from Like striking your hyoid bone, your neck, against a solid object.
Like, let's say he, I don't know, hit a rung, hit the rung of the second bed on the way down, which may end up trying to be the story that's told.
If he hit the end of the bed on the way down and broke his hyoid bone that way, you can tell because the fracture pattern that the hyoid bone exhibits on autopsy microscopically, if it's microscopically examined, you can determine this by looking at what's called the periosteum.
Now, the periosteum is a membrane that surrounds every bone in your body.
It's sort of like this thick, fibrous connective tissue that coats every bone.
So when we break bones, like let's say you break your femur, your thigh bone, you're going to break the periosteum as well.
Well, based upon the pattern of breakage of the periosteum, you can determine whether that break occurred as a result of an anterior force, a force from the front, or a force from the side.
And it's really simple to remember this.
If the hyoid bone is shaped like a U, if you break it like this, then the breaks are going to be on the inside, and the breaks in the periosteum are going to be on the inside of the hyoid bone.
If you break it like this, if you take it like this, think about a stick.
The break in the periosteum is going to be on the outside of the hyoid bone.
Yeah, it's just like if you have a piece of celery, right, and you turn it, you know which side the break is going to be.
It's like a little V from the outside if you're bending it down and the other way if you're bending it up.
Super easy to find with an autopsy.
Now, here's the point I want to make, and I don't know if it's significant or not, but I'll be very curious to see the final autopsy results, to see what level of detail the pathologist goes into to describe this hyoid bone.
Again, if it is fractured, I'm not saying it is, but based upon the preliminary reports, we hear that it is broken.
If it's broken, which by the way, fracture means broken, okay, for those of you who confuse the two, fracture just means broken.
So if the hyoid bone, if Epstein's hyoid bone was broken, well, then we ought to get some gnarly details about the periosteum.
We ought to hear about the mechanism involved, because looking at that, again, microscopically can tell the pathologist and tell us, tell the American people and the world, the mechanism through which that hyoid bone was broken.
You could make the argument, does that tell us whether he hung himself or not?
No, not necessarily.
I'd be hard-pressed to say that, you know, is it possible that he hung himself and he fractured his hyoid bone?
I would say extremely unlikely, extremely unlikely, especially with just a bed sheet.
But if the autopsy report does not show this level of detail, Look, if I, as an emergency physician, know this much about hyoid bones and their injury patterns, a pathologist ought to know this as well.
And if this isn't part of the autopsy, then I would say, you know, this is added to the list of unsolved mysteries and what's going on.
Well, let's talk strangulation.
Okay, so the other way, of course, in which neck bones, particularly the hyoid, can be fractured is through strangulation.
Now, I don't know much about strangulation.
Do people push their thumbs in, like below, like where the hyoid would be?
Do they go in from the side?
In other words, what kind of break would you expect in a strangulation victim?
Well, anybody who's strangled is going to have a compressive, a constrictive force placed around their entire neck.
Their entire neck's going to be choked off like this.
You don't strangle somebody by putting acupressure points or anything like that on somebody's neck.
If you strangle someone, and by strangulation I'm talking cut off their air supply.
Then you're literally crushing the trachea.
You're smashing the windpipe.
And let me tell you, that's a very firm, tough structure in and of itself to do that.
That takes a lot of force as well to constrict that windpipe, whether you do it here at the level of the larynx, which is the Adam's apple, or whether you do it lower, which is actually on the trachea, which is much harder to do.
It's possible to do it down here in the actual windpipe, but up here in the Adam's apple, pretty tough to do that.
You can do it above it as well, but if you look at the photos, I saw the photo of Robin Williams, unfortunately, after he passed.
I saw his post-mortem photo, and it looked like he got himself down here.
He had a very tight constriction around his neck down here where he used a belt.
That required tremendous force.
Again, he threw a belt buckle over a door and lodged it in the door, wrapped it around his neck, and then just laid on it and it just tightened.
It just self-tightened until it gave him this amazing constriction around the bottom of his neck.
That was enough to asphyxiate him, to strangle him.
It wasn't enough force to break any bones.
And the reason is because when he did this, it was a Think about the application of the force involved over time.
If you take someone and you squeeze and you apply pressure and then you get the right squeeze on there, you're going to asphyxiate them, but you're not necessarily going to imply a lot of force over a short period of time.
Let me be clear on this.
If you drop from a gallows and you hit the bottom, that is a tremendous amount of force involved, enough to break bones, as it often happens in hanging victims.
But not necessarily enough to break bones.
Sometimes, again, two of the four that were executed for assassinating President Lincoln, they obviously didn't have neck fractures.
They suffered for minutes there, just strangling, just dying of asphyxiation.
They were choking to death. So the force involved to break multiple bones, according to reports on Epstein, had to be a tremendous amount of force applied very, very quickly in order to transmit the force through all the soft tissues of the neck into those bones.
Let me explain something called a chance fracture.
And this is involving the lower part of the spine, the lumbar spine.
And we typically see this in automobile crashes, where somebody wears their seat belt too high.
They don't wear it across their hips.
They're wearing it across their abdomen, across their belly.
When they hit something really quickly and come to a sudden deceleration, that transmits a lot of force into that person's body.
And if they hit the seatbelt just right, that force gets transmitted through the soft tissues Of the intestinal tract, of the internal organs, the kidneys, the stomach, whatever's in the way, these things aren't injured necessarily.
But in a chance fracture, the injury results in the lumbar spine being fractured.
It's an amazing injury when you think about it.
There's a tremendous amount of force that gets transmitted through the soft tissue of the abdomen and all those internal structures that are very important.
They're not damaged.
But this really thick, huge lumbar spine bone, this vertebra, which is about twice the size of a cervical vertebra, a spinal bone in the neck, this lumbar bone can get cracked.
And typically in a chance fracture, what happens is the body of the bone, if the body of the bone is like this, the fracture extends like this and it opens up.
It's an amazing looking fracture.
If we can get a picture of it, that'd be wonderful.
But that's the kind of force involved, that's the kind of force necessary, is an instantaneous massive amount of stress placed on the body at just the right time with the right circumstances.
I don't see how this happened in Epstein's jail cell.
The thing is, too, if you're going to strangle someone, let's say that you need like 100 units of strength to strangle someone.
You don't sit there and say, go, 97, 98, 99, 100.
We have achieved optimum strangulation.
Like what you do is you just, I mean, you're full of adrenaline, the murderer.
You're just going to...
You're going to overcompensate, is kind of what I'm saying, because you don't want to undercompensate, because then he's going to scream and, you know, maybe he might even wake up the guards.
Who knows? Could be anything.
Absolutely. So when I think of a strangulation, I think of a massive amount of force Because you don't care if you're breaking the guy's bones because you're just trying to kill him as quickly as humanly possible.
And so that's where I could see the strangulation resulting in these kinds of multiple fractures that I just can't see coming out of a bedsheet.
Because even this study in India, this is people who sometimes went from a fairly high height with hard rope, right?
So that's more like kind of jolt.
Yeah, exactly. So I can see this multiple fracture scenario more likely in strangulation just because, you know, excessive force is the name of the game that way.
Absolutely. Well, you brought up a great point.
Let's give it a scale. Let's say that it requires 100 units of strength to strangle someone.
How quickly you get there.
Okay, let's talk about a strangulation, a pure asphyxiation like Robin Williams suffered.
I would say he went from zero to a hundred over a period of maybe a minute, maybe two minutes, who knows?
It was a protracted amount of time that he went from getting from zero to a hundred strength units.
What I'm talking about is like in a chance fracture, the force necessary to break bones.
In a chance fracture, you go from zero to a hundred like that in an automobile crash.
I mean, it just is instantaneous force applied, massive force applied very shortly over time.
And that's what I mean when I say that's the force required to break bones, especially multiple bones.
Now, hyoid bone is something that could be cracked with the gentle application of pressure.
I'll grant that because it's close to the surface.
It's got a unique shape.
But the cervical vertebrae, the neck bones, I can't imagine a scenario where someone is just putting the force on their neck, going from zero to 100.
I mean, Unless the force was enough to literally cause them to be partially decapitated, I can't imagine enough force applied over time in order to break bones, the cervical bone, the spinal column.
Let's say the spinal column.
It's a tough cookie.
It takes a lot of abuse.
It takes a lot of force to break that thing.
Here's the thing, too. This is...
Arguably the biggest question in America at the moment because there were so many people who were shocked by Epstein's sudden and it seemed pretty mysterious death.
So if there were legitimate reasons, legitimate explanations and so on, wouldn't they just release everything as quickly as humanly possible so that people could stop asking all of these questions?
They could nip all these conspiracy theories in the bud and they could get the information out in front of experts or people who know a lot about it like yourself.
The fact that there's been no press conference, I think.
The fact that the autopsy is all, you know, kind of hearsay.
The fact that we don't have the data and we can't cross-examine the coroner and so on.
This also, to me, adds to the suspicious nature of what is going on.
Because, you know, sunlight's the best disinfected.
You want to turn the lights on and get as many minds looking at this as possible so that explanations can be achieved.
But the fact that it's all so murky and hidden is not exactly putting these fires out.
Well, you know, Rudy Giuliani, I think it was him that I saw the other night giving a great talk about this, and he pointed it out.
He said, there's not much to investigate.
I mean, it was a jail cell. It was one guy.
It was a few minutes' time.
They should have this investigation.
It's not going to be another Ken Starr or Robert Mueller thing.
I mean, this should be wrapped up very, very quickly as far as investigation goes.
So, yeah, it's been almost a week, or I guess it has been a week now.
Why are we not hearing this thing coming out with oodles and oodles of news, oodles of reports and investigative findings?
I don't know. That's a great question.
Alright, so listen, I really, really appreciate you getting us up to speed on this, and I just wanted to point out as well that you have a great blog and other places.
How can people find what it is that you're doing on the web?
Well, I'm trying to change healthcare by changing the way Americans and other people think about healthcare, so I have a site called Healthcareonomics.
That's my blog. I have a YouTube channel at Healthcareonomics, and I'm on Twitter at Healthcareonomics, and Parlay, or Parler, as people call it.
I just followed you last night, Steph.
It's all healthcare-onomics.
That's what I'm trying to do.
I've written a couple of books about healthcare and health insurance.
People should check them out if they want to get the scoop on how to save money on those.
All right. Well, we'll put links to all of that below.
I really do appreciate your insight and thoughts on this, and I hope that we can get you back on if and when the actual coroner's report sees the light of day.
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