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When someone's heart stops, we instinctively hear one phrase:

"Start CPR."

But have you ever wondered where CPR came from—or what it's actually doing?

The truth is far stranger, and far more violent, than most people realize.

In this episode of The Cadaver's Lessons, we're tracing more than 4,000 years of humanity's attempts to reverse death. From rectal insufflation and tobacco smoke enemas to open-chest cardiac massage, mouth-to-mouth ventilation, defibrillation, and the birth of modern CPR, this is the incredible story of how medicine learned to fight death.

We also pull back the curtain on what CPR really looks like today. It isn't the clean, miraculous procedure portrayed on television. It often means broken ribs, prolonged resuscitations, heartbreaking decisions, and difficult conversations about survival versus quality of life.

📚 References

1. StatPearls. Cardiopulmonary Resuscitation. NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK470402/
2. Morrison LJ, et al. The History of Cardiopulmonary Resuscitation. 2025. https://pmc.ncbi.nlm.nih.gov/articles/PMC12637392/
3. Johns Hopkins Medicine. Extracorporeal Membrane Oxygenation (ECMO). https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/extracorporeal-membrane-oxygenation
4. Advances in Cardiopulmonary Resuscitation. 2025. https://pmc.ncbi.nlm.nih.gov/articles/PMC12225435/
5. Panchal AR, et al. 2020 Adult Basic and Advanced Life Support Guidelines. Circulation. 2020. https://pmc.ncbi.nlm.nih.gov/articles/PMC7787697/
6. Kleinman ME, et al. Adult Basic Life Support Focused Update. Circulation. 2018. https://pmc.ncbi.nlm.nih.gov/articles/PMC5964572/
7. ECG Waves. The Physiology of Cardiopulmonary Resuscitation. https://ecgwaves.com/topic/the-physiology-of-cardiopulmonary-resuscitation/
8. Brown Emergency Medicine Blog. The History of Resuscitation. 2022. https://brownemblog.com/blogposts/2022/1/21/the-history-of-resuscitation

   **This Reference List has been shortened to meet character limits for full referenced please visit the link at the top, thank you!

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What looks like a tragic drowning quickly becomes one of the most important forensic investigations in criminal history.

In May 1957, 31-year-old Elizabeth Barlow was found unconscious in her bathtub by her husband, Kenneth, a former charge nurse. At first glance, the scene appeared to be a heartbreaking accident. But an observant forensic pathologist noticed small details that didn't fit—a healthy young woman drowning in a household bathtub was unusual, and subtle clues at the scene raised more questions than answers.

As the investigation unfolded, an autopsy revealed Elizabeth had actually been eight weeks pregnant. Even more puzzling were signs that pointed toward severe hypoglycemia rather than a simple drowning. When investigators discovered tiny injection marks hidden on her body, the case took an extraordinary turn.

At a time when insulin was widely believed to be impossible to detect after death, forensic scientists embarked on one of the most ambitious toxicological investigations ever attempted. Using experimental techniques involving more than 1,200 mice, 150 rats, and 24 guinea pigs, researchers were able to recover measurable amounts of insulin from Elizabeth's tissue—an achievement that forever changed forensic medicine.

The evidence ultimately led to the conviction of Kenneth Barlow, a man who had previously boasted that insulin would make the perfect murder weapon because it disappeared from the body after death.

📚 References

1. Marks, V., & Richmond, C. (2008). Kenneth Barlow: The first documented case of murder by insulin. Journal of the Royal Society of Medicine, 101(1), 19–21. https://doi.org/10.1258/jrsm.2007.071002
2. TIME. (1957, December 23). Medicine: The imperfect crime. https://time.com/archive/6806417/medicine-the-imperfect-crime/
3. Murderpedia. (n.d.). Kenneth Barlow. https://murderpedia.org/male.B/b/barlow-kenneth.htm
4. Bathurst, M. E., & Price, D. E. (1958). Regina v. Kenneth Barlow. Medico-Legal Journal, 26(2), 58–70. https://doi.org/10.1177/002581725802600204

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Diabetic emergencies remain among the most dangerous—and most misunderstood—conditions encountered in medicine. In this episode of The Cadaver's Lessons, we explore the science, history, and clinical management of diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) while tracing the incredible evolution of diabetes care from the discovery of insulin to today's cutting-edge technology.

Learn how insulin transformed from crude animal extracts into genetically engineered human insulin, why electrolyte management can mean the difference between life and death, and how modern tools like continuous glucose monitors (CGMs), insulin pumps, and artificial pancreas systems are reshaping the future of diabetes treatment.

Whether you're a healthcare professional, student, or simply fascinated by medical history, this episode blends real clinical cases, pathophysiology, history, and ethics into one comprehensive discussion.

📚 References

1. Kitabchi, A. E., Umpierrez, G. E., Miles, J. M., & Fisher, J. N. (2024). Adult diabetic ketoacidosis. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK560723/
2. Pasquel, F. J., & Umpierrez, G. E. (2024). Hyperosmolar hyperglycemic state. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK482142/
3. Atkinson, M. A., Eisenbarth, G. S., & Michels, A. W. (2025). Type 1 diabetes. New England Journal of Medicine, 393(1), 34–48. https://pmc.ncbi.nlm.nih.gov/articles/PMC11745827/
4. Reddy, P., & Jialal, I. (2024). Biochemistry, metabolic acidosis. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK551568/
5. Heinemann, L., & Hompesch, M. (2018). Biosimilar insulins: Guidance for data interpretation by clinicians and users. Diabetes, Obesity and Metabolism, 20(11), 2543–2548. https://pmc.ncbi.nlm.nih.gov/articles/PMC6205949/
6. American Diabetes Association. (2022, January 11). The history of the wonderful thing we call insulin. https://diabetes.org/blog/history-wonderful-thing-we-call-insulin
7. Smithsonian Institution. (n.d.). Two tons of pig parts: Making insulin in the 1920s. National Museum of American History. https://americanhistory.si.edu/explore/stories/two-tons-pig-parts-making-insulin-1920s
8. American Chemical Society. (n.d.). Insulin. National Historic Chemical Landmarks.