We’re using our medical background to focus on the strange, baffling, and downright unsettling world of medical mysteries. We’re going to dig into unusual cases, diagnostic puzzles, unexplained symptoms, and medical misadventures. Our first three seasons covered a little bit of everything, including crime, conspiracy, mystery, and the occasional rabbit hole we probably shouldn’t have gone down. Those episodes aren’t going anywhere, so the archives remain open for anyone who likes their mysteries, a little more broad spectrum. But from season four on, the prescription is different. More medicine, more mysteries, more questions. So grab a drink, hit the follow, and tune in every Tuesday for a new episode. Hey, I welcome back to the three skiing queens. I hope you guys are liking our uh dropping two episodes a week. That’s been fun. Yeah, a little bonus bonus episode. Like a bonus and if you like to hear us all the time, guess what? Now we have a Patreon, right, Megan? Yeah, we do have a Patreon, so you should go check it out. You know, it has been sort of a hot week. I was just about to talk about the weather. The weather again, Megan. Come on. It’s not been a hot week, actually. I woke up and it was 40 degrees. I wasn’t gonna talk about the weather.
What are you talking about?
I was gonna say it’s been a hot week in like medical crime. Oh, oh. I was like, what are you talking about? Is it’s been chilly and it’s been glorious. I don’t I don’t know if the listeners understand how much I have to. I give these girls a look every time they start talking about the weather. It’s like an iPhone first date every time. No, I don’t think you understand the weather affects my moods so much. And Colleen too, right? Colleen. Yeah, exactly. I feel the opposite. I feel like it’s already feeling dark all the time. No, no, I love it. Like I love it. So like the feeling of the cold air on my cheek. Last few weeks, it has still been dark, but I left for work in the morning. Well, daylight savings is coming, and then the sun starts going. Is daylight savings actually coming? Do we know? I can’t keep track. I thought it was that weekend. Yeah, but we were getting rid of it, you know. It hasn’t passed in the sun yet. You guys gotta follow.
Okay.
Okay, we’ll do. Okay. She’s just trying to watch her friend. Although, are the farmers upset? Because that’s the thing, that’s who it affects, right? The farmers. But does it really affect them? It’s just I don’t think they’re still getting the same amount of hours. We already have all these states that don’t participate, right? Uh Arizona. It’s just like one.
Yeah.
And states and countries. It’s not two. I don’t think it’s the whole state. I think it’s just a couple cities. It’s Arizona. Well, anyway, what I was trying to say before we went on another weather tangent is that it’s been a hot week in medical news, right? Yeah. Gypsy’s husband died. Well, mysteriously. Gypsy’s baby daddy. Oh, sorry. Died. The plague. There’s a Russian plague. There’s a Russian plague. I swear, if if another is if it’s COVID 2.0, I’m leaving care. I am getting out. I can’t do it anymore. Uh, and then I think there, you know, we’re still kind of getting trickle updates about uh Lindsay Clancy, right? And then the hot topic that we’re gonna cover today is the death penalty and Krista Pike’s failed execution. Oh, she’s survived. I personally have gotten a lot of messages asking us to cover this. So I mean I’ll tell you what, I got opinions. But before we get into it, so is it time for our drink check drink check? So for today’s drink check, we are drinking apples. Yes. It’s so good made in the instant pot. This is I don’t even know. I hadn’t even said it out loud to Megan, but I was like, in my brain, I was like, I’m so craving this. And then we then I showed up and Megan had it ready. And I was like, How did she know? Burn it alive. I mean, well, the apples were about to go bad, so I had to do it. Although I will say that I mixed it up with a little of Kate’s favorite wild turkey 101. And Colleen was Colleen was like, didn’t you have caramel vodka last year? That was I do. It’s downstairs. Caramel vodka. This is fantastic what I’m bringing right now. But I just remember the caramel vodka. That took it to another level. Yeah. Well, I have some caramel vodka downstairs, and there’s probably another batch of hot apple cider. So we’ll do that. Heck yeah. We’ll do that later this week. Cheers! And let’s get into it. Disclaimer: the views, opinions, and commentary expressed on this podcast are those of the hosts and guests, and do not represent the view or opinions of our employers, organizations, or professional affiliations. Colleen. Yes. Picture this.
Okay.
A woman has been sentenced to death. She is strapped to the gurney at Riverbend Maximum Security Institution. She has already given what she believes are her final words. The lethal injection begins. And then the first dose doesn’t kill her. So they administer another. And she still doesn’t die. This is exactly what happened to Krista Pike, who, following two injections of pentobarbital, remained alive and could be heard breathing and snoring. She was eventually removed from the prison by ambulance. So tonight we’re talking about Krista Pike, the convicted murderer who became one of the most infamous women on American Death Row and last week survived her own execution. Isn’t she the second woman on death row? I’m pretty sure she was the first one that was sentenced. Aileen was before. No, I think the drama is that she was 18 when she committed a crime. So she’s the youngest put on death. Oh, youngest. That’s what I knew it was. There are currently 45 women on death row. But how many have been committed in like so I know Krista didn’t die, but how many were actually killed? Just Aileen, right? 18 women. Oh, never mind then. Okay. Since 1976. But obviously, if we go back to, you know, you’re like the witch troms? Yeah. If we go back to colonial times, uh 576 women have are estimated to have been executed since the first rec recorded instance in 1632. So any thoughts before we get into it? Well, my immediate thought was they didn’t have a good IV. Yeah, I feel like I think that’s obvious. We’re gonna talk about it. I’m confused. Why didn’t they just give it IM? Why you gotta put an IV? Well, here’s my question: like, why couldn’t we just get a centralized? Yo, you’re gonna spend all the money on a death row case, you’re gonna spend all the money to actually get the paperwork process for death, and you’re not gonna get a central line. Yeah, or get a pick one or something, but we’re gonna be using pentobarbital instead of the old combo. These are all such good questions that I have in my notes. So immediately your question is well, why don’t we just have a central line? And then why are we using pentobarb and not the old, the old-fashioned anesthesia, paralytic potassium chloride? I want to know who put the IV in. Well, I don’t have the exact person because it’s all actually very concealed to protect them, which is why they have these curtains. Like they close the curtains, they do their work, and then when the curtains open, there’s no one in there because they don’t want anyone they’re in another room. They don’t want anyone to know who put it in. But I did look into like what kind of certification and what kind of criteria do they make one comment.
Uh-huh.
I don’t want to make light of it. You may make many, but to be the one to put the IB in it. Yeah, that’s embarrassing. Or maybe not so embarrassing, but like the guilt. Okay, hold on. Do you know what she did? Brutalized a girl. She tortured a girl and then killed her. It I don’t give one shit. It’s like karma’s a bit. I’m with you. It would, I would be in embarrassed, Colleen. If I put in an IV and that was my one job and infiltrated, I’m gonna tell you it was obviously not a Corpsman. Okay.
Yeah.
If that IV was a good IV, she’d be dead. Well, let me tell you about the IV. I’m gonna tell you about all of these things. But first, let’s get into Kate’s passionate feelings here. Yeah. I’m gonna tell you who Krista Pike is. And before she had this failed execution attempt, her execution was already very controversial. But we’re gonna give you all the facts so you can decide for yourself. So Krista Pike was born in 1976 in West Virginia, and she did have a rough childhood. She was born with fetal alcohol syndrome, and as a toddler, her grandmother’s partner sexually abused her like repetitive repeatedly.
She just knew she was gonna have a bad background.
When she started school, a teacher asked the class to draw a picture of what she did at home, and she drew a demonic man with large genitalia. And despite teachers reporting the incident, she was not removed from the home. Then at age eight, she was raped by a neighbor. She reported it to her mother, who did not believe her, but she ended up developing an infection at school. So her teacher reported it. That attacker was prosecuted, but he pled to a uh pled guilty to a reduced charge. At home, she allegedly faced physical abuse and neglect, and she has attempted suicide when she was just 12 years old. At 15, she was put on probation for breaking into a community center to steal candy, but violated probation and was sent to a juvenile evaluation center, which I had to look, I was like, is this juvenile detention? It sounds like it’s more short-term than juvenile detention. You’re not supposed to go for very long. And it’s you get sort of like a lot of clinical testing and behavioral assessments and interviews to determine why a youth is acting out and develop a plan to keep them out of, you know, oh, the system. Again, it’s usually a pretty short stay, but and you get released based on a point system. So you earn points for good behavior, you lose points for bad behavior. She ended up staying for 16 months because she kept losing points for infractions. So that was like very uncommon. It’s a very long stay. She was released at the age of 17 in March of 1993. And by then she had earned her GED. She was like a teacher’s assistant in the program, and she entered the Knoxville job corps hoping to become a nurse. It was around this time that she was also reportedly raped again by a stranger on the side of the road, and he was never caught. While in the job corps, she met boyfriend Tederrill Ship, as well as Colleen Slemmer. So Krista Pike believed that 19-year-old Colleen Slemmer was interested in her boyfriend, 17-year-old Tederyl Ship. On January 12th, 1985, with the help of friend Shidola Peterson, Krista and Tadaryl lured Colleen to a park near the UT campus and beat and tortured her, with Pike delivering the final fatal blow. Slemmer was beaten, cut with a box cutter, and tortured for 30 minutes before being killed. Also with the butcher’s knife. A pentagram was carved into her body, which Ship eventually admitted to being responsible for. Pike took a fragment of the victim’s skull. The next morning, two UT employees found the body and called police. In the meantime, Krista was bragging to her job core classmates about what she had done and showing off the piece of skull. Showed it off like a trophy. Yes, her life is up until the point before she decided to take someone’s life. That is very sad and very unfortunate. But you can choose to make better decisions. The reason why she killed someone is because she thought that girl liked her boyfriend. That’s a good reason to kill somebody. She’s clearly not competent. Well, so I’m in the middle, I’m kind of in the middle of you two here. I think she had a terrible upbringing. And this is kind of what starts making her lawyers are arguing all these facts is like what makes her eventual her eventual sentencing controversial. Uh and she was a juvenile, but I also am and I’m like, but she seems to lack any way she’s competent. But the problem is that she doesn’t like suddenly turn it around as as she hits 26 in that frontal lobe development. Okay. So because Chris is out there bragging and showing off this piece of skull, she gets arrested within 36 hours. So Pike, Ship, and Peterson all arrested. Peterson received six years probation in exchange for testimony. So they charged her with accessory after the fact, and she testified against both Pike and Ship. When searching Ship’s dorm, they located satanic paraphernalia, including a satanic Bible, an altar, and a hexagram earring and a hat pin. Ship claimed to investigators that he had not planned to kill as a satanic offering, but only considered Slemmer a sacrifice after. Pike also confessed to the murder, but claimed that she did not lure her with the attempt to kill her just to fight her to get her to stay away from her boyfriend. It should be noted, not that it matters, because even if Colleen was into Ship, like that’s not an excuse to kill her, but everyone’s like, there was zero evidence. None of the classmates believe that Colleen liked this guy. So it was like really for nothing. This was this whole thing was stupid. Adding more than that. Yeah. So Peterson pleads guilty to accessory after the fact, as I said, gets six years probation. Despite confessing, you know, to the police, Pike and Ship both plead not guilty, but were found guilty of first-degree murder and conspiracy to commit first-degree murder in separate trials. And this is where things get controversial because she was 18 at the time of the crime and her boyfriend was 17. So he was charged as an adolescent and sentenced to life with the possibility of parole. He’s already eligible for parole. He came up before the board and was not approved because of the severity of this crime. So he remains in jail. But the question is like, we’re talking a matter of months. Was a matter of months supposed to make her more kind of culpable in this crime? So she gets sentenced to death row. She’s the youngest woman sentenced to death row in modern history. At the time of this execution, she was the only woman on Tennessee death row. Okay, but 18-year-old men can be charged with statutory rape for a 17-year-old female. So how does that change anything? I’m not discrediting that she committed a crime. It’s a crime, a heinous crime. She’s also clearly not a well person. To be committed to death, you have to be able to comprehend that. I don’t believe that this person is healthy enough to actually comprehend anything. I think she needs to be committed to a psych ward for life. You don’t just take a piece of a patient’s or a person’s skull and like brag about that without knowing, like, without comprehending the repercussions. She’s unwell. While in prison, she was diagnosed with PTSD and bipolar disorder. And her lawyers argue that the system had failed her as a child, which it did. We can all agree that I think if she’s really being assaulted and she’s getting report, it’s getting reported by teachers and nothing and they’re keeping her in the same location. That is a failure by the system. Her later appeals argue that her trial lawyers inadequately presented mitigating evidence concerning severe childhood sexual abuse, and that became part of decades of litigation over whether the death sentence should stand. So for her part, Krista Pike claimed that she was mentally ill, and it wasn’t until she was diagnosed and treated for PTSD and bipolar in prison that she was really able to comprehend what she did. Okay. That’s off fine and well, and maybe I would give that to her. Except that in prison she was not a model citizen. In 2001, she and another inmate attacked Patricia Jones, who was incarcerated for her own murder conviction and attempted to strangle her with a shoelace. In recorded prison phone calls, Pike bragged that it was premeditated and that she would have finished the job if she had 30 more seconds. She claims that Jones had been taunting her for years about the electric chair and called her degrading name. So I think it’s safe to say if she’s like, listen, I got mental health treatment, I’ve worked through my issues, I now know what I did is wrong. I would maybe buy into that, except at the same time you’re trying to kill another person. She needs to be in a sideboard. That’s what I don’t understand why she didn’t have a psych workout. Okay, so like every serial killer in the world goes to a psych instead of prison because they’re all mentally ill. I think people don’t do these crimes without some form of trauma and illness like impacting their brain as a child. Well, she’s a direct example. This goes back though to the debate that everyone was having during Lindsay Clancy, also, like devil’s advocate here, right? If you’re to argue that way, then we should say that that Ted Jeffrey Dahmer Jeffrey Dahmer should have just been put in a psych ward. I don’t believe in the death row. Like in death, you don’t think you don’t think they should be in prison? I think they should be in prison or in some form of controlled environment. But like, I don’t believe they need to be killed. But did she have a full-sight workup? She did. That’s what she’s saying. So when she was failed as a child, she goes to jail, she was in psychiatric care in the jail. She’s diagnosed with P T S D. She’s PTSD, she’s diagnosed bipolar, she’s medicine. And she tries to kill another person. She’s therapized. She tells everyone that she now is a rational human being and she recognizes she has insight now into what she did. And this is all part of her, like, you know, plea with her lawyers to get off death row. And then she turns around and tries to kill someone else, and she nearly succeeds. And then brags about it again. Yeah. So I think it’s safe to say she wasn’t all that reformed. She was found guilty of attempted murder, and she had 25 years added to her sentence. Then in 2012, the Tennessee Bureau of Investigations and the Department of Corrections foiled an escape plot in which a 23-year-old correctional office at the women’s prison and the 34-year-old boyfriend of then 36-year-old Krista Pike were conspiring to break her out. So, as I mentioned, Krista Pike’s lawyers were attempting to get her death sentence commuted to life without parole, arguing all the reasons we’ve kind of just discussed. And then other issues they raised included Tennessee’s lethal injection protocol and Krista Pike’s individual medical conditions. That’s sort of the background on Krista Pike. And now I’m gonna shift gears here and talk about the actual lethal injection process. Okay. How it is supposed to work. There are currently 27 states that allow capital punishment. And all of those allow lethal injection as a method of execution. You guys touched on earlier the three drug cocktail, right? Mm-hmm. When they would use an anesthetic or sedative to induce unconsciousness, then a paralytic to paralyze the skeletal muscle. So this is pretty much what we do when we intubate a patient, right? You give them anesthesia first, they don’t feel anything, and then you paralyze them so they can’t fight you when you’re trying to help them, or in this case, you know, they can’t breathe. And then you give them, inject them with uh a drug, which is usually potassium chloride, to disrupt electrical activity within the heart, leading to cardiac arrest. So in theory, this should really be a painless and not traumatic for the people watching, and like just goes to sleep, and that’s the end of it. I will say though, that if we were still doing this, my biggest fear, I’ve never even had surgery, but this is what I fear of getting waking up, of being paralyzed, but not sedated because paralysis does not equal sedation. You can feel everything. You’re gonna say and you can’t do anything about it. Yeah, can’t communicate. I mean, why do they need a paralytic? Like, why can’t they just heavily sedate someone and then just just inject potassium chloride? I think it’s also all the people who are watching this in the audience. Yeah, because when people go into cardiac arrest, it’s not comfortable to watch. So, anyway, the three drug cocktail was already criticized to begin with before we even went away with it, right? And then we have like the issue of drug makers, they don’t want their meds to be associated with execution. So it became very hard for like the DOC to obtain the medications necessary for these executions. So now we have drug shortages, and uh as a result, these some states, including Tennessee, transitioned to a single drug protocol. And the most commonly used drug in the single drug protocol is an overdose of the sedative pentobarbital. Isn’t pentobarbidol an old drug? It’s been around for a while, though. We still use it. What’s older phenobarbidol or pentobarbidol? One of them is like a second generation. I think phenobarbital is older than pentobarb, but isn’t phenobarb like more recommended? Well, phenobarb, you can give as like a low-dose pill because it lasts a long time. That’s what we use for alcohol withdrawal. You’re right. Phenobarbadol was 1904, and then pentobarbadol was 1930. So they’re both old. But pheno is older. Well, I kind of feel like after all of this now, pentobarbital is gonna be like propofol after Michael Jackson. Like Pentobarbital does have indications. Yeah. Yeah. What do they use it for, Kate? Status epilepticus. Yes, we use it. Uh it’s a big drug in the neuroICU, uh neurocritical care. And now it is used, it can, you know, be used as like an anesthetic in low doses. The big uses I see for it, Stanis epilepticus, that has already failed treatment. So it’s like oh, this is like the patient is yes, the patient has already been having seizures. They’ve not stopped seizing. You have already intubated them and put them down for dick for days with propofol and ketamine and versed and nothing is stopping their seizures. Then we try pentobarbital. And so pentobarbital acts on the GABA receptors, which is the same thing that the way propofol and versed and alcohol work, right? And inhibit nerve transmission. So we will use pentobarbital to pretty much, in like layman’s terms, practically like cease brain activity. Like they’re on an EG, titrated up, and you are just kind of limiting the brain activity to let everything cool down and to stop the seizures. And so when you do that, the dose, you load them with 15 megs per kig, and then you start a drip of about one megs per kig per hour, which is important when we compare doses. Okay. So we would say that for a 100-kilogram person, a 220 pound, 220-pound person, they’re going to get a gram dose of pentobarbital. It’s also used for sedation, 100 milligrams of IV for sedation. But again, if you’re going to use this, the patient has a breathing tube in. Again, whenever we use pentobarbital in the hospital setting, there’s a breathing tube in doing all of the work of the breathing. And there is cardiovascular monitoring because they are on medications to keep their blood pressure up and all of that. We also use it for ICP management when a patient has has, again, failed all other treatment. These are patients we have standing up in the bed and we’ve done all the therapies to minimize the pressure in the brain in order to prevent them from progressing to brain death. And so then we do petrobatol. This is how it is used clinically. Okay. For lethal injection, they use a five gram dose. It’s given over about 15 minutes. 5,000 milligrams. So a much, much higher dose. Is it just thought to kill them faster? Well, I think you want to be make sure that you’re sure. Yeah. Yeah. And then here’s why. So the pentobarbital before her as an execution drug was already controversial because a known side effect of pentobarbital, we see this even when we use it therapeutically at lower doses, is pulmonary edema. And they’ve done autopsies on patients who have had pentobarbital and they have pulmonary edema. Pulmonary edema is when is what we call water on the lungs. Yes. That’s when the lungs fill up with blood. This happens because the capillary endothelial cells and the alveolar membranes, so the everything, the vessels just kind of leak in the lungs, right? It’s like you’re drowning. Yeah. So that’s the concern is if they give punch barbital to patients and they’re not fully unconscious, their tongue falls back, obstructs their airway. That the negative pressure of trying to overcome the tongue obstruction is going to exacerbate that that pulmonary edema. And so the lungs are going to fill with fluid. And are these people being executed having a sensation of drowning? Because they’re kind of promised a painless death. And that’s that’s traumatic, right? I guess we should just bring back the guillotine. Well, what’s a painless death? The other update was the Fort Hood shooter. He’s gonna be executed by firing squad. Yeah. Yeah. Fire ring. The whole point of multi-the three drug usage of using the paralytic was for the audience to not have to watch anything. Yeah, I mean, I think it also does chop people’s sense. It does get a component also of like, I mean, it’s stop, it halts your the paralytic is gonna halt your breathing. Yeah. So I think it is gonna contribute to your death. It like halts your breathing and the potassium stops your heart, so it happens much quicker. I do, I’m sure that there’s an element of let’s make this prettier for the people who are watching, also. Yeah. As the different administrations have changed, there have been a lot of back and forth about the death penalty and and how we should use it. So prior to Trump’s first term, there had sort of been like a halt on executions. It wasn’t, they weren’t banned, it wasn’t a law. It was just sort of this like, we’re gonna take a pause. Okay. No one was really getting executed. Trump came back, he resumed death penalty, and during his first term, the federal government used pentobarbital for 13 executions. The Biden administration took over. They continued executions, but they stopped the use of pentobarbital because there was, again, very mixed recommendations about whether pentobarbital was causing pain and suffering. And then when Trump came back, they reauthorized pentobarbital. So so the reason that Trump brought it back is because lawyers for the DOC were arguing that inmates are unconscious in under a minute after administration. And their concern is like if we stop doing this and we go find a new cocktail, like the last cocktail you guys had concerns about, right? Red off the Penta Barbara to do something else. You guys are gonna have concerns about that. And there’s a higher risk of having like violent reactions and delayed death as we’re getting more comfortable with the new cocktail. So that was the argument. That’s why I came back. That’s all the background that leads us to this specific event. Do you guys have anything to add before we jump into what happened on September 30th? My questions going into it are what the protocol is for ensuring a good Ivy line, what the protocol is in prepping the patient, how many people are part of that process, and what are the double checks. And my question is why is she a full code? My assumption is because she has to be killed with the protocol. I have a lot of answers for your questions, Colleen, that I’m gonna get into. I don’t really have a great answer for you, Kate, because the problem is that the policy ends. Ends. Yeah. It’s like it’s like they don’t they don’t die with the first injection, do the second injection, and then it that’s just the end of it. And so I think there was a lot of standing around for an hour here. I’m absolutely shocked they took it in closing. That’s crazy. Pike’s execution was scheduled for 10 a.m. on September 30th, but there was some frantic last-minute litigation, and the Federal Appeals Court temporarily stayed the execution. Krista Pike’s lawyers were arguing that her medical conditions, specifically, she had essential thrombocytosis. What’s that? For the listeners? Clotting. High platelets. Kind of like microclot, very high platelet count microclots. And that she had very small, hard-to-find veins, which, in their argument, would make the state’s lethal injection protocol tortuous and unsafe. I’m sorry. She had this before they trained her. The lawyer is arguing this before the day of the execution. They are a diagnosis known beforehand. Yes. Not discovered afterhand. Yes. So she is supposed to be executed at 10 a.m. Her lawyers are appealing to the federal appeals court. They stay the execution. They say, You’re not being executed at 10 a.m. Pause while we consider this. Okay, good question. What would thrombocytosis have to do with damage to the endothelium of the vessels? It can cause rapid needle clotting. Yeah. And then you can have vessel inflammation and quote blown veins, which they actually asked, you know, at first they’d been like, we don’t think she should be executed, we think she’d be executed. On the day of the execution, they’re like, okay, we agree with execution, but we don’t want her executed by lethal injection because she has small, hard-to-find veins. She has a history of being a difficult IB stick, and calling it for you. They wanted a different execution method. That evening, the Supreme Court ruled six to three that the execution would proceed. Who gets the pick the method? I don’t know. I don’t know if it’s like each state, I don’t know if there was an alternate alternative method. Sometimes when I read about it, it makes it seem like the prisoner gets the pickup, they get killed. The patients that we hate putting IVs in in the hospital are like patients who have who’ve had a lot of sticks. So medical conditions that require them to have frequent sticks. So cancer patients, dialysis patients, they have damaged vessels. And then when we deal with like IV drug users and that kind of thing, they usually don’t have any good veins left. And I was thinking about the patients who get executed. A lot of them probably do have some substance abuse history. And these are the people that are dying by lethal injection, you know? That’s that is that is a challenge. Yes. Okay, so the how the method is decided. They have one, a default state law. So each state with the death penalty specifies a primary method, and which is most commonly lethal injection. Then Colleen’s right, the inmate has a choice. So in few states, death row prisoners are given a lethal right, a legal right to pick their execution method, and they would be choosing between lethal injection, electrocution, and a firing squad. And then the fallback options, the state’s primary method is like not available due to drug shortages, like the lethal injection. The state can dictate a backup method, like an electrical chair, nitrogen hypoxics, or a firing squad. At the very end, I have a couple quick other failed attempts. Oh wow. Hanging. Hanging is still on there, kept on the books in very rare historical statutes as an extreme backup, though virtually unused in modern practice. So the Supreme Court says proceed by lethal injection. The team, okay, the team spent nearly an hour attempting to establish a peripheral IV. That’s what I’ve been calling it right then. With at least seven needles. That’s ridiculous. At one point, Krista Pike herself offered guidance of where they could try. That is ridiculous. One needle was bent in a 90-degree angle when it was removed. Oh, a hip bone. Quick timeline here, okay? Because again, they get witnesses. There’s a viewing room of like loved ones, you know, the mother of Colleen of viewing this. In another room, there’s like reporters. Okay. So we have seven reporters who are observing this. And then in the middle, there’s this room and there’s curtains. So again, the goal is to not see any of the people who were kind of part of this. So they’ll close the curtains, open them, and there’s speakers so they can hear what’s happening in the room. Then there’s a separate room that’s concealed where the medical providers are waiting. So at 7:27 p.m., the curtains open to the viewing room and Pike was seen strapped to the gurney with an IV. The warden asked if she had last words. Someone asked what her last words were, right? According to one of the reporters in the viewing room, she said, I’m going to leave this world the way I spent most of my life, and that is with love. She said she loves the people who were angry with her as much as she loves people who are on her side. And she said, quote, I’m at peace and I’m ready to go. Another reporter claimed that she said she was ready to be free and that this was a happy day. And then at 727, the pentobarbital started flowing. So again, they’re going to get five grams over 15 minutes. And it sort of sounds like it’s sort of like when you take a patient to MRI and you have like the pump in in a different room with the providers because everyone’s hiding from the magnet. Yeah. And then the tubing goes into the room to the patient. At 7:34 p.m., she started reporting discomfort. So again, according to the reporters who were present, they described this. So she said, My arm feels like it’s about to burst open. She was crying. She said, one spot is really throbbing. Three minutes later, she took four separate significant breaths, large enough to where you could see her body rising at points, sort of on and off the gurney. At 7:39, she lifted her head and looked at the IV in her arm. And the reporter said that she was kicking her feet this whole time. They had to keep like covering her back up with a blanket. Now, again, it’s a 50-minute infusion, but the DOJ lawyers were arguing to the administration, you know, when they brought this back that within a minute they’re unconscious, right? Right. Obviously, not in this case. 741, we know that the first infusion completed because they have this like secret code. A staff member puts a rock on the windowsill. It’s like a golf ball-sized rock. And that marks the completion of the drug injection. And traditionally, that starts a five-minute mandatory countdown or waiting period before medical personnel enter the room and check the vitals and confirm the death. So they get their 15-minute infusion, a rock gets placed so that everyone knows that the infusion is complete. And then five minutes later, they close the blinds and they confirm death. They’re not like on a heart monitor and you don’t see the core. I know I’m like, a rock, a rock is the is the sounds like a freaking Broadway show. And the theaters open and the theaters close, and the audience is on one side. Witnesses reported that her jaws were moving at 7.43. At 7.44, she took a deep breath and was kind of incomprehensibly speaking. She was yawning. And apparently reporters are like, oh, they’re looking at each other like uncomfortable. Like, what is happening right now? Right. At 7.46, she’s still alive and she’s snoring. They close the curtains and at 7:49, they reopen. And so we assume at this point a second dose of pentabarbital has started. Because in the protocol, if the first one fails, you repeat with the second dose. They use the same item. Um, I tried to look into that. It sounds like she had damage to both arms, so I have to assume that they one IV. Yeah. That they have two IVs. Yeah. At 754, she let out a loud grunt, lifted her head up, her mouth opened, and snoring began again. And this is when her right arm apparently started to look purple and began to blister. Just before 756, her body lifted off the gurney again, both her head and her legs sort of like in a V shape almost. At 801, Pike let out a heavy sigh. The rock is placed back on the window. So now we’ve had the second dose completely infused. We’ve had 10 grams infused. And four minutes later at 8.05 p.m., her body flexed as she gasped for air, and the curtain was abruptly drawn for a second time. The witnesses and everyone are hanging out in this room with curtains, just look at each other. They said they had no clock, only one of them had a watch. They kept being like, hey, dude, how long has it been? How long has it been? They’re trying to track what’s going on. It was 50 minutes. They said they could hear on the microphone her snoring and her breathing until 8.53 when the microphone cut off. And then the warden asked all the witnesses to leave. As they were leaving and they were talking to the press, EMS arrived at 9.15, and at 9.28, the ambulances with police escorts left the prison. So that is how it went down. So I think, yeah, it sounds pretty clear. I don’t know anyone who could survive 10 grams of pentobarbital if it was actually infusing. This sounds very clearly, right? Like infiltrated IVs. She did get all the medication. Her arms are burning, she’s blistering. So that sounds like an infiltrated IV. Correct? You guys agree? Without like reports are coming out now that are kind of confirming that. But I think any healthcare professional who heard the story immediately was like, Yeah, we know what happened, right? Right. And everyone knows too. It’s like when you treat a patient in the hospital and you give a med and it doesn’t work, the first thing you do is like check your IV AIV and switch ID. Check your check your connections, make sure everything’s connected. Yeah. Start at the patient, look at the IV in her arm. Yeah. Is it dangling out? Well, sometimes you have IV lines, like IV pumps that will be like beeping because it’s hard to, you know, infuse. Infuse. Yeah. Yeah. But I guess then there’s then, well, yeah, then there’s sometimes that your IV infiltrates and then their whole arm is just feeling fluid. And this, you know, you just don’t know. Yeah. Which if she blistered that fast, that’s kind of what I assume happened. And I think one of the big side effects of pentobarbadol is like necrosis. Like it can cause necrosis. If I’m getting put to death, I’m asking them to just put a central line in me. Okay. Numb me up and put a central line in and make sure the med goes in. So I’m like, why are they not doing that? Yeah. If you are going to purposefully kill somebody, do it efficiently. Uh I looked into this. I was like, why did this patient not get a central line? Why do they not put central lines in? Maybe that’s what the Supreme Court could have said. Like, hey, we hear you that you’re a tough stick. So central line. There are states that allow for central line placement if a good peripheral cannot be obtained. And Tennessee is one of those states. Centraline, again, guys, is a is an IB that goes into a much bigger, it’s placed by a provider. It’s a it’s a much larger IB that goes into a much larger vessel. So we usually put them in in the neck or uh under the clavicle or rarely in the groin. And it goes in in the and it’s got a much longer catheter, so it kind of trickles down into the heart. So we use that in the hospital to give a lot of medications that are too caustic to give peripherally, like a regular IB. Again, it’s more invasive, and there are risks of like infection, which in this case, who cares, right? Pneumothorax, I guess, would be the big risk of dropping a lung, but I feel like that’s a very low risk if you have someone who’s doing it appropriately, like who is experienced. What does it mean to have a cycle line versus just a regular peripheral IV? Is that they’re going to get the medicine? Yes. There’s no responsible doubt it’s getting into their system. I wonder, is it you would need like an X-ray machine to confer replacement? Is that like an extra cost that they would don’t do? Or you could do with use it with old, you could do with ultrasound mics. Well, if they’re willing to spend all the money on the appeal process on just funding for death row in general, why can’t they fund or why can’t they pay for an ultrasound? Yeah. So anyway, Tennessee is a state that allows central line placement if the peripheral access cannot be obtained. And again, we already know she met criteria. They tried seven times and they couldn’t get an ID. You know what probably happened? They’ve probably said she needs to die today. Now I know why, but I think I might have buried that lead for the end. The peripheral IVs, again, we don’t know who places these because it’s all very hush-hush. But there is a Tennessee Department of Correction IV team that is authorized to place these. Under standard state execution protocols, the team consists of trained prison staff and contracted individuals whose specific medical credentials are kept anonymous by law. So we don’t know if they’re RNs, well, medical assistants. Typically, it’s a physician, a physician’s assistant, a registered nurse, a paramedic, or an EMT. So anyone who is currently licensed, certified, and qualified within the United States insert IVs, which I’m gonna be honest though, like if I’m on death row and I’m getting a central one, give me a doctor. Okay. But I’m getting peripheral IV, I think I want the EMT, maybe, you know, the nurse, the again, I want the EMT. Yeah, an EMT or like an ER nurse. Yeah. Someone who, some a labor and delivery nurse. Those girls can get some IVs. They did not attempt to place a central line in her case. And what I try, I’m trying to figure out why that is. And all I can think is because there was a subcentraline drama previously this year in Tennessee with a different execution, which I’ll get to later. So I’m not sure if they just like didn’t want to deal with that drama or what happened. Her lawyers had asked for a central one to prevent vein rupture, and the judge had ruled it was unnecessary. So again, what we know is that her arms have reportedly become markedly swollen, burned, and blistered. An anesthesiologist retained by her defense believes the findings are consistent with pentobarbital leaking from improperly positioned IVs into surrounding tissue rather than reaching the circulation in the intended concentration, which again, we all didn’t even get to review the charts. And that’s what we believe, right? You gotta be able to like do a practice run. Like, let’s practice putting an IV in you before your actual execution. Let’s practice and prove we can get an IV in you. So then if they know they need a central line, they can actually be prepared. Because how did that judge determine it wasn’t necessary? And so again, I would think this pentobarbital was probably mostly delivered to the soft tissue, which would explain delayed absorption, inadequate circulation concentration, tissue injury, and swelling and blistering. So Kate kind of talked on this. This the pentobarbital is a highly alkalotic lipophilic barbituate. Dumb that down. Well, it like Kate said, it’s gonna make it really caustic, right? And the infiltrating into the soft tissue alters its pharmacokinetics completely. So when it’s given intravenously, it’s immediate acting, it’s lethal. Uh, when it’s given kind of subcutaneously through this infrared IV, it’s going to be a much slower release sedative. So you’re going to have much more erratic and delayed circulation. It’s going to rely on kind of the passive capillary diffusion, all those little kind of, you know, blood vessels into the bloodstream instead of getting through like a big vein. Oh, it has a pH of 9.5, and in case anyone cares, uh, because of how caustic it is. And it has irritating vehicles like propylene, glycol, and alcohol. So this is what causes a local chemical irritation. You get burning, you get tissue inflammation. And uh again, having like this localized tissue injury is just going to further compromise the blood flow and like further delay your systemic absorption. Now you have sort of this um, again, this much slower peak level. So I think when we talk about later where she’s at now, it’s harder to kind of assess her long-term recovery because pentobarbital, when given intravenously, hangs around for a very long time. When we use it for ICP issues or seizures, we know, like if something happens, we can’t do brain death testing on this patient because we can’t believe that their exam is not being masked by the pentobarbital effects, right? It hangs around for many, many days. And now we’ve given this subcutaneously, so it’s gonna hang around for even longer. So I think it’s still gonna be a while before we really know, you know, how she although she was talking today. What’s frustrating to me is that like it’s all about them not having the contingency plan of it not working. So it’s like us in my mind, a central line is mandated for every lethal injection. Should be mandated. Tennessee has had some problems in the past, and they were was a recommendation made that they get like a farm, like right now, the only person they have to consult on this is the the rep, the drug rep. Okay. And they’re like, you should get like a pharmacist or someone to kind of oversee who could like maybe say these things, like, hey, God, but they didn’t do it. And after this, they’re like, Why’d you do that? And they’re like, Well, it was just a recommendation, it wasn’t a requirement. No, so that’d be pretty annoying. That is she has to be have like a hypoxic brain injury. She’s not gonna be normal. There’s no way that’s what I keep thinking. So um, before I get into the updates about her, I really quickly had just a handful of cases, like one-liners here, of other two survived their executions. Okay. Willie Francis in 1946 in Louisiana, he was 16 and he was sentenced to death by the electric chair.
16?
This is the 40s. Executioners had been out boozing the night before and showed up intoxicated. So they improperly set up the portable electrical chair and failed to ground the generator correctly. He convulsed and screamed, Take it off, I can’t breathe, but he didn’t die. He was taken back to his cell. His lawyers fought a second execution attempt, citing cruel and unusual punishment and saying that executing him again would violate constitutional protection. Supreme Court disagreed, and he was successfully executed the following year. Rommel Broom in Chasine, Ohio, the execution team couldn’t establish adequate IV access. They spent two hours and attempted 18 times before a vote. My execution. Gosh. But he never the like they couldn’t get an IV and then they were like, go back to your cell. Actually, yeah. So Ohio planned another execution, but then he died of COVID before that happened.
So that was that.
Doyle Ham in 2018, Alabama. He had terminal cancer, hep C. And as I mentioned, these are patients who have a really hard time getting IBs in, right? Like chronically ill people cancer patients. So his attorneys warned beforehand that IV access will be extremely difficult. Execution personnel attempted for roughly two and a half hours. A subsequent medical evaluation suggested his bladder and artery may have been punctured. I wondered if they tried to do like ephemeral line or something. I don’t know how else they were, you know, doing a peripheral near his bladder, which still, I mean, that’s still like real bad. I’m sure in your bladder is still hard to do, I think. Yeah. Um, he died of cancer in 2021. Thomas Creech in 2024 in Idaho. They attempted IV placement, couldn’t establish access. After an hour, they abandoned the execution and they went back to litigation again. It’s like the lawyers were like, is it constitutional to try again? It’s been stayed indefinitely uh while the courts decide if another attempt is cruel and unusual. And then Kenneth Eugene Smith in Alabama. Alabama tried to execute Smith by lethal injection in 2022. They couldn’t establish IV access before the death warrant expired at midnight. So they had to call it off. It was just, it was like 11:55, and they’re trying to get an IV in, and they’re like, can’t do it. So Alabama said, we got to try something else. And two years later, he was the first person in the US executed by nitrogen hypoxia. This is controversial as well. It is legal in five states. Since then, eight people have been executed via these means. But in execution gas, this sounds actually to me like a lovely way to go in theory. Okay. I’ve been in an altitude chamber, right? You just get sort of like if you’re in high high altitude and you lose pressurization, you get like hypoxic, but you don’t really know what you’re not like oxygen-starved, right? So you just kind of get loopy and euphoric, and then you eventually lose consciousness. And I was like, that actually sounds like a pretty good way to die. Except that’s not quite how it works when it’s done. The five witnesses from the press reported that um this particular patient, Smith, thrashed violently on the gurney for nearly 10 minutes before he died. Uh, because they’re they’re arguing that since they’re delivering this via a mask, like usually when you’re in an airplane or if you go into like uh an altitude chamber, you’re in this enclosed area and everything around you is right, the pressure, your fishbowl on it. Correct. This these patients have a mask on, so there’s probably some leakage, and which they’re like, so first of all, now we’ve got leakage and we have witnesses, so that’s kind of putting them them at risk, but also it’s less insidious and it actually triggers the air hunger that that you don’t achieve in like an airplane. So it’s kind of not as painless as uh as thought. So that’s kind of a hot topic right now that people are debating. And then the last one I have happened in Tennessee just a few months ago. Tony Carruthers in May of 2026, he was supposed to be executed, but they were unable to place a peripheral IV. So he ended up getting a one-year reprieve, and he’s still going to be executed. This is, I think, what came out of their kind of review of this really pertains to what happened to Krista. So the on-call doctor, Dr. Fowler, was asked to place a central line because they couldn’t get a peripheral in him, which again is how the protocol is supposed to go. After an hour of failed central line placement attempts, they had to call off the execution. And when they investigated, it was discovered that Dr. Fowler had not placed a central line since 2013 when he worked in the ED. Okay. So I’m wondering if the way this went down is what impacted them not try to central line for Krista. So it went, it was investigated that he had not placed a central line since 2013 when he worked at an ED. He had only placed about a dozen in his career, which is crazy because usually you have to do like five to ten just to be like checked off for your credentials. You did five to ten observed procedures with someone watching you do this, and then it gets submitted to the hospital credentialing, and the whole little group powwows and reviews it and says, Okay, check they are capable of doing this procedure. So it’s like he probably did just enough to get credentialed, and that was it. And he currently has no hospital privileges. So what kind of anyway? This is the physician who was overseeing Krista’s case. Oh, so I’m wondering fire him after that. No, so I’m one no. So I’m wondering if how does he still have a job? The reason he didn’t do a central line is because it went so poorly last time, and so they didn’t want to go down that route. I’m so sorry. How does he still have a job? Or how is he still the person in charge of that? Sounds like there’s gonna be a lot of reform after this. That’s all I have. The quick update uh from today uh at the time of this recording, it’s been about a week since Tennessee gave Krista Pike those two doses. The Breaking Tube came out yesterday. She is awake and talking. I’m not sure how like articulate she is, you know. So the medical mystery isn’t whether she’s gonna survive, because that was the first question. Is she gonna survive this? The medical mystery is an idiotic system with core planning. Yes, and and the next question is should the state attempt to execute her again? Well, she’s still competent to be executed. I know. Well, we don’t know if she’s competent to be executed, we don’t know how much brain damage is done. I think too, all those other cases I listed, like those people they couldn’t get a peripheral IV, right? But no one had actually like received the drugs and then failed. So yeah, like why did they not stop for her? What got them to stop for the other people, but not her? And they must have they placed their IVs. Yeah, right. Yeah, they said, okay, we’ve got we’ve got trying some IVs. And yeah, I think the other thing I touched on, I think all this also what’s come out is just that that that we don’t know what happened for those 50 minutes, and then the curtains were closed and the witnesses left. But the protocol does not go beyond if they don’t respond, you may give a second dose, and then that’s it. So it was probably still out of everybody looking at each other. Oh shit. Why do we well? It sounds like that’s what was going on in the witness room, and then I guess in the separate medical room, they probably were I bet they were calling people.
How long did it take for them to actually start resuscitating her in any way?
I’m not even sure that they it was 50 minutes, they closed the blinds, they said please leave. And then 20 minutes later, EMS was there.
Right.
And they are the microphones were on for a while. It sounds like there was no sounds of like resuscitation. Sounds like there was a lot of like agonal breathing. It looks like they were when she die. And uh no, I bet they were in the other room watching in their private medical room, going oh shit and scrambling and calling people. Yeah, but but all we have is a guy who hasn’t has no privileges, who hasn’t really practiced for a while, and this is what he does. And we have no pharmacist because all we have to consult is the is the rep. And we have like a bunch of again, what’s wrong with healthcare, right? A bunch of non-medical people making the decisions, right, who aren’t, you know, at the bedside. So it feels rushed, or it feels more planned. And if you spend an hour getting a PIV, I personally would not feel confident in anything I place if it took me an hour to even try to get one. Rushed, they have they should have stopped decades to plan these, but yet they don’t have the appropriate contingency plan, don’t have the appropriate pharmacist, they don’t even have appropriate provider on board. I think the even more embarrassing thing is that in May, you already had this embarrassing moment. Exactly. And you’ve again had had five months you did nothing to get a better plan in place. That’s embarrassing, Tennessee. Guys, just a reminder, don’t forget to check out our Facebook and Instagram pages at Three Scheme Queens. That’s the number three scheme queens, all one word. We’re also on Reddit, same username. If you want to check out our website, go to three schemequeens.com and you can find links to our social media accounts, our BuzzSpour page, all of our episodes, additional content, and our contact page where you can engage with us and share any updates on the topics that we have discussed. Let us know how we’re doing and what you want to hear next. There are also opportunities to financially support us with links to buy us a cup of coffee and links to our merch store. As always, if you choose not to financially support us, we appreciate the follows, the downloads, the listens, the likes. Kate, what should the people do? Yeah, the people, they should take out their phone right now and text this to three different people if you think that they are gonna be interested in this case. And then scroll on down, leave us a five-star review, share it on your social media platforms, interact with us on our social media platforms. Yeah. See you guys next Tuesday. See you next Tuesday..