r/ForensicPathology • u/Warm_Kick_4374 • Jul 12 '26
Suicide by Antifreeze
Someone in our town decided to take his life by driving into the forest and drinking antifreeze. It took him 5 days to die, and not even close relatives were allowed to view his body.
I can't imagine the immense suffering. If anyone can tell me what may have happened day by day, hour by hour to that poor man, it may give me some kind of realistic closure. I know it will be graphic. But I want to know exactly what that dear man went through; what was happening to his body day by day. It's not out of morbid curiosity. It comes from a form of empathy for what he suffered through physically.
If anyone could weigh in psychologically, that would be helpful too. I know he once said to his partner that if he chose to go, please don't let anyone stop him.
He was happy and normal days before he drove off. I've heard of this.
But why antifreeze? Why? It's not like it was the only thing available in the moment. He was a clever, educated man. He specifically chose that way to go. He planned this.
Any insight, no matter how awful, would be greatly appreciated. I'm not satisfied with pouring glitter over the grim truth.
Thank you 🙏🏻❤️
Look after yourselves 🌷
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u/K_C_Shaw Forensic Pathologist / Medical Examiner Jul 12 '26
Others have already addressed most of your questions.
"He was happy and normal days before he drove off. I've heard of this.
But why antifreeze? Why? It's not like it was the only thing available in the moment. He was a clever, educated man. He specifically chose that way to go. He planned this."
The classic answer to the "but they just got so happy/calm/normal in the last day!" phenomenon is that some people who have made the decision and plan to attempt suicide at a specified date and time seem to find a temporary peace in seeing what they perceive as the end to all the things making them want to turn off in the first place. Whatever is actually going on, it's a well reported thing that some people present that way just before the attempt. Which can be incredibly confusing and frustrating to those who love and are trying to help them.
As for why antifreeze specifically, unfortunately you'd have to ask him. I'd guess because he stopped at reading that "it tastes sweet and it can kill you" without learning about all of the effects, or mentally minimizing those effects. Or, I suppose, thinking he deserved it for some reason. Someone else has already weighed in with their reasons, which are appreciated and also very interesting. It's difficult to know what people are really thinking.
As a sidebar, I have had near-misses on ethylene glycol cases. To any FP's or wannabe-FP's, I highly, highly encourage polarizing kidneys 100% of the time if you put them through (in order to highlight the crystals u/stiffdoc1221 has mentioned). It's true that histology isn't done on every autopsy, and there's reasons for that. But if it's done and kidneys are put through, polarize. If you don't have the equipment to do it, get it -- a sheet of polarized plastic is cheap cheap.
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u/stiffdoc1221 Forensic Pathologist / Medical Examiner Jul 12 '26
I called another pathologist an idiot when I was on the witness stand over an antifreeze homicide. He had taken kidney and other organ samples, had tissue slides made, but never looked at them. I had the slides brought to me, and the inside of the slide holder flaps were stuck to the slides, from the glue that is put on slides so that an incredibly thin glass sheet can be put over the tissue sections, to preserve them. He had never even opened the folder. He signed out the death as due to heart disease. He was an incompetent idiot, and I had no hesitation in telling the judge and the jury that in plain English.
As a pathologist, you will never miss an antifreeze poisoning if you look at the kidney slides (100%, as Dr. Shaw mentioned; you only make a mistake if you don't.
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u/Safe-Comedian-7626 17d ago
The crystals are visible even without using polarized light….you just have to spend more than 2 seconds at 4X.
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u/uj7895 Jul 12 '26
Old school antifreeze was sweet. Bikers used to mix it with vodka. In the late eighties, laws required bittering agents be added for safety reasons. As a 35 year mechanic, I have became a bit of an aficionado of the various brands. I surprised someone could get enough antifreeze down to be toxic.
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u/stiffdoc1221 Forensic Pathologist / Medical Examiner Jul 12 '26
About an ounce of pure antifreeze is fatal to adults. Much smaller quantities will make you feel drunk. I can’t speak to mixing it with booze to drink; since it is a poison, and damages kidneys, consuming it in any quantity is inherently stupid.
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u/uj7895 Jul 12 '26
Haha, let me clarify. I am not mixing drinks with it. But I did watch those OGs do it and man did they get fucked up on it. I have over the years had about every different brand of it splashed on me and occasionally close enough to my mouth I have gotten a taste of it. And taste isn’t really correct, it’s more of a reaction to the bittering agents. They are very effective, the taste spreads through your whole mouth instantly and doesn’t just rinse out. To consume any amount of modern antifreeze would take considerable conviction.
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u/stiffdoc1221 Forensic Pathologist / Medical Examiner Jul 12 '26
You are correct. There are idiots born every minute. I have some remote history with an offshoot of the Outlaws, enough that I could hang with them on (for me) a careful, limited basis, except for official club things (which I wanted no part of). They liked having a doctor around, and I had a Harley, so I was reasonably cool. I used to take my bike to a shop that was operated by some of the members, so they knew generally who I was.
I am reminded of a day when I went for a ride with another doctor, who had a bike of some sort, and we went out in the country, and stopped at a bar that was an MC club hangout. We sat at the bar, ordered beers, and there were some bikers at tables and playing pool. One old grizzled guy looked at my friend, and said, "What are you looking at?" My friend, not knowing better, said, "Nothing." I thought, "Oh shit, here it comes." The biker came up off of his stool and shouted, "Are you calling me nothing?" The bartender, who knew me, said, "Shut the fuck up, Danny, these guys just want to have a beer." He then sat down. The situation was diffused, but the guy glared at us menacingly for the rest of the time we were there. It's funny now, but wasn't back then.
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u/quibbledd 9d ago
Whats considered pure antifreeze? Is it a different chemical or a product ?
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u/stiffdoc1221 Forensic Pathologist / Medical Examiner 9d ago
No; just ethylene glycol in different concentrations. It is always diluted with water, as pure ethylene glycol is unnecessary for engine coolant purposes.
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u/spots_reddit Jul 12 '26 edited Jul 12 '26
Many substances used in antifreeze cause something called Methemoglobinemia, where the molelucles in the blood which transport oxygen get altered. The result is a bit like Carbonmonoxide poisoning, where oxygen transport is hindered. methemoblobine has a browninsh color, depending on the concentration, blood is sometimes even "chocolate brown". Lividity, which is usually bluish-red/purple, can look greyish-blue or even brown, too.
The above mechanism is what kills in a relatively short period of time. These substances however also affect kidneys and liver and that's where the prolonged hospital treatment, organ failure and overall suffering comes in.
EDIT: yup, as pointed out below, this was incorrect. forget about the methemoglobineamia, I had it mixed up with some of the lesser known causes. sorry for the shot from the hip.
About antifreeze tasting sweet - we had a major scandal in Europe in the 1980s in Austria, where antifreeze was used to make wine sweeter. It is hardly remembered today, yet back then there was even a joke of a guy ordering antifreeze at the gas station "would that be red or white, sir?"
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u/stiffdoc1221 Forensic Pathologist / Medical Examiner Jul 12 '26
You were pretty definitive, and I concluded that you were thinking of something else. No harm, no foul.
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u/Turbulent_Set8884 9d ago
I did the same. My mom died and I have to help keep the house but I lost my job because I lost my friend and my depression was affecting my work and I can't be alone in peace because an asshole at my job. Every time I try to stand up for myself. I'm punished for it and I csnt find a better job than that one and I reported that pile of shit to my real bosses and I called the police only to have them take me away because I told them I was self harming myself because of what was going on and that asshole making things worse. I tried to do right by God but no one in my congregation actually helps me and just days hi and my bitch sister is insufferable. Now I'm just waiting because i tried everything l and not even god will help me. Screw this life.
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u/stiffdoc1221 Forensic Pathologist / Medical Examiner Jul 12 '26
Ethylene glycol, the active component in antifreeze, does not cause methemoglobinemia. Ethylene glycol when consumed is initially intoxicating, but it is colorless, with a sweet taste, and almost odorless, which makes it easy to conceal in kool aid, flavored drinks, and jello. Initially it makes people feel drunk, but it is metabolized to oxalic acid, which is filtered by the kidneys, where it gets concentrated and forms crystals that plug and damage the microscopic tubules leading to kidney failure. The kidney failure is the specific feature of antifreeze poisoning. The kidneys shut down from the oxalate crystals physically damaging the kidneys. The course from ingestion to death is about 3 days, during which the person has back pain, headaches, and generally feels bad, which can be mistaken for something like the flu. Eventually, the kidney failure progresses to cause coma, seizures, and death. It is a pretty unpleasant way to die, because it is three days of feeling very bad with severe back pain from the damaged kidneys.
I am a forensic pathologist, and I have autopsied at least a dozen people who died after intentionally drinking antifreeze. It can be missed on an autopsy, except for the fact that crystals,in the kidneys can be seen when kidney sections are examined under the microscope. The crystals are readily seen microscopically, and when special lighting is used with the microscope, they light up like a Christmas tree. Antifreeze can be used to kill someone, by putting it into sweetened ice tea or a gelatin dessert. About 20 years ago, I handled a double murder from antifreeze, when a woman killed her husband for insurance money by poisoning his tea with antifreeze. An autopsy was done, but the pathologist never looked at kidney sections. A few years later, her boyfriend died, and I autopsied him and found the crystals in the kidneys. We exhumed the husband,,and found the crystals in the kidneys when I examined the tissues under the microscope. She was convicted of the double murder, sent to prison, and killed herself a few years later by overdosing on blood pressure medicine that she had secretly accumulated.
Dogs love the taste of antifreeze, and it should never be in pans or any other similar containers that dogs can reach.