Marlowe Direct

can you introduce yourself to the members of the jury

my name is dr grey Marlowe

what do you do for a living, dr Marlowe?

I am the founder and principal medical consultant of Marlowe sports and medical consulting

what does being a principal medical consultant entail?

I provide expert medical consultation for cases involving athletic overexertion and athlete safety protocols

how long have you been in this position

10 years

what education do you need for this kind of medical consulting?

I completed my medical doctorate at Bay Ridge in ‘98. I am a board certified physician in sports medicine, and I completed a fellowship in forensic pathology

do you know why you’ve been asked to court today?

yes. I am here to testify to my findings on the cause of the death of Rob Armstrong

did you use a method?

yes

what did your method entail?

I conducted a comparative analysis based on the results of someone named Dr. Hartley. as a part of that analysis, I reviewed a number of documents

what documents did you review?

from dr. Hartley’s examination, I reviewed their autopsy report, toxicology report, and their CV. from my own examination, I examined the body and my own toxicological samples. 

Is this a reliable method?

of course

and did you reliably apply it to the facts of the case?

yes

was that information sufficient to come to your conclusions?

yes

and were you able to come to those conclusions within a reasonable degree of scientific certainty?

yes

you mentioned that you compared your results to those of someone named dr. Hartley. what did they determine in this case?

dr. hartley determined that oxalic acid inhalation caused hypoxia, which caused Mr. Armstrong to drown whilst diving

do you agree with their conclusion?

not entirely, I agree that mr. Armstrong ultimately drowned, but I disagree on what caused him to drown. specifically, I disagree about the interpretation of calcium oxalate crystals, the cause of disorientation, and the cause of hypoxia. 

did anything about dr. Hartley’s expertise influence your opinion?

no, i’ve actually got a great deal of respect for dr. Hartley given their immense experience in the field of poison detection, in their professional work they do tend to focus on poison. 

and did they find poison in this case?

they did, that oxalic acid I referenced earlier is one of the rare poisons Dr. Hartley studies, and in this case, some of the elements that they attribute to poisoning, I was able to attribute to more environmental factors. 

you mentioned three points of contention. i’d like to walk through them one by one. let’s start with calcium oxalate crystals, do you agree that this was attributed to poison?

[frown and shake head] no, I do not

why don’t you believe that the calcium oxalate crystals were attributed to poison?

there are other things which could cause calcium oxalate crystals to form in the body

what other things could cause that?

calcium oxalate crystals are fairly common in unpoisoned folks, actually. dehydration can cause crystals forming, which would make sense for someone who had been overexerting themselves. otherwise healthy folks who’ve eaten foods that are high in oxalate, like spinach or chocolate, present with calcium oxalate crystals. they also present in folks who have early stages of kidney stones, or are taking certain medications. 

now that we’ve talked about those crystals, i’d like to talk about the next point of contention, hypoxia. for those of us who do not know, what is hypoxia?

this is simply when the body does not have enough oxygen to operate properly. this lack of oxygen can be fatal, as it was in this case. 

do you agree with Dr. Hartley that hypoxia was caused by poison?

no

is there anything else that could exacerbate hypoxia?

when you are taking quick, shallow breaths, because you are physically exhausted - say, from heavy physical activity - you’re not breathing in enough oxygen. That can cause hypoxia. 

could exhaustion have caused hypoxia in this case?

again, considering how strenuous Mr. Armstrong’s circumstances were, it definitely could have. 

how about that next point of contention, disorientation? Do you agree with Dr. Hartley that this was attributed to poison?

I don’t agree with that one, either.

What did you determine?

I determined that Mr. Armstrong displayed a gradual loss of control of his motor function and navigation abilities. 

what does this gradual decline tell us?

[mime a sine wave] that gradual decline is consistent with exertional hypoxia 

what is exertional hypoxia?

that is what happens when an individual is deprived of oxygen due to intense physical activity, such as running or carrying something heavy, and their exhaustion slowly builds up until judgement and coordination begin to decline

is this consistent with oxalic acid poisoning?

a gradual decline? no, it’s not.

what would oxalic acid poisoning show?

you’d see a rapid behavioural shift 

so could the disorientation have been because of exhaustion?

yes

with all that in mind, what is your conclusion in today’s case?

whilst dr. Hartley was correct that Mr. Armstrong drowned, it is impossible to rule out that this might have been exhaustion rather than poison