Clinical Case Studies


Re: An Autoerotic Death [NSFW]

The 72-year-old actor(David Carradine [from kung fu])was found dead in a Thai hotel room closet in an intricate web of ropes -- one around his neck, another around his genitals and the two tied together, according to Thai authorities.

Sex experts say that Carradine's advanced age suggests that he may have been a lifelong practitioner of the secretive and dangerous practice, one that can go fatally awry.

Los Angeles Superior Court documents of Carradine's divorce put online by The Smoking Gun show that his most recent ex-wife, Marina Anderson, accused the actor of "deviant sexual behavior which was potentially deadly." The alleged behavior wasn't described in the court documents.

Also known as hypoxyphilia, the practice is a sub-category of sexual masochism that involves reducing the oxygen supply to the brain while masturbating to achieve a heightened orgasm.

'Fine Line' Between Euphoria and Death

"There's a fine line between the state of hypoxia [lack of oxygen in the brain] and death, and it's in that state that a person becomes highly aroused and it's what allows them to orgasm," said Eli Coleman, chair of the sexual health department at the University of Minnesota.

"People usually have safety nets and no intention to die, but something often goes wrong in their calculation," he told "Maybe a stool or something they are standing on somehow slips away."

The Federal Bureau of Investigation estimates there are between 500 and 1,000 such deaths in the United States annually, mostly among young men. Many more may be falsely ruled as homicides or suicides.

Auto-erotic asphyxia often starts in adolescence, which is why many of the deaths associated with the practice are among young adults. But, the practice is not unknown among girls, according to Coleman.

Because it is practiced alone, AEA is particularly dangerous. It is a compulsive activity that can also escalate, as may have been the case with Carradine, said Coleman.

"We know very little about the people who practice this," he said. "Most of what we know is from those have accidentally died."

Auto Erotic Asphyxia Often Ruled Suicide
Forensic experts often rule these deaths as suicides, but the evidence often suggests otherwise: the body is naked, there are pornographic materials and perhaps even semen present.

"It's tragic for families because no one has any suspicion of what is going on," said Coleman. "Usually it's a carefully guarded secret."

Such was the case with Michael Hutchence, the late lead singer of the superstar Australian band INXS, whose death in 1997 was ruled a suicide.

The singer was found naked, hanging from his leather belt in a Sydney hotel room with pornographic literature at his feet and no suicide note.

Hutchence's wife spoke publicly of their kinky sex life and his desire to try AEA, and a British documentary eventually concluded that was the case.

According to research by Stephen Hucker, forensic psychiatrist from the University of Toronto who is one of the foremost experts in the field, the practice is not entirely modern.

Sexual Practice Dates Back Centuries

Stone statues dating back to 1,000 AD suggest it was known to the ancient Mayans in Mexico. The Marquis de Sade, whose name was given to the practice of sado-masochism, described it in his 1791 novel, "Justine."

The more common ways of carrying out the practice are self-hanging, strangulation, choking, suffocation and techniques to restrict breathing movements. Self-hanging is the most common method observed among fatal cases, according to Hucker's Web site, Forensic Psychiatry

"Fatalities resulting from AEA practices occur with a frequency of about one per million of the population per year in North America though it is important to note that this figure is based on studies of cases that have been recognized as AEA or Hypoxyphilia," said Hucker.

Usually a rope or ligature is the method used to strangulate the oxygen supply, but others may be present as part of the person's own sexual ritual. Plastic bags and more complicated apparatuses may also be used.

Sex therapists regard this as a paraphilias -- or a socially unacceptable sexual practice. It is often associated with forms of anxiety and depression, though not suicidal thoughts.

Auto Erotic Asphyxia Evokes Shame
Few who seek help because of the shame, which fuels a cycle of guilt, anxiety and then release.

"Many look pretty normal underneath but when they are accelerating this need for a very intense high, what they are doing in medicating some state of dysphoria or unease," said Coleman. "And because it is rather unusual and there is a lot of stigma around masturbation to begin with, the guilt and shame become part of a repetitive cycle of obsession and compulsion."

Teens often discover the practice on their own, rather than learning it from others. Its sensations are similar to the "choking game" played by young children, who get a thrill from the dizziness created by holding their breath.

Divers have also reported a "high" from oxygen deprivation, according to Coleman. "For some people that may be pleasant or something associated with sexual arousal."

"This has been around long before the Internet.We have no idea how they would discover this," said Coleman. "It's not something they learned. It was a puzzlement and we concluded they were learning it on their own."

"We can only start to piece this together from people who have actually survived," he said.

Carradine May Have Practiced for Years

Coleman, who did not consult in the Carradine case, speculates that many, like the actor, have practiced AEA for years.

"It becomes for them a fetish kind of thing and that is what it really takes for them," he said. But often their activities escalate in risk for the thrill, resulting in accidents.

But in the case of teens, accidental death often happens because they are inexperienced in the practice. "For those who have done it a long time, they know the limits and are pretty careful."

Coleman said people, particularly young teens, need to learn about the dangers of AEA.

"There are a lot of things on the Internet and we have no idea how this is impacting people," he said. "We are certainly concerned that [the Carradine case] might lead to an increase."

"We need to educate people about the risks rather than shield people from the information," he said. "A lot of people are engaged in this activity and they don't know the risk."

Carradine's ex-wife Anderson also said in divorce documents that her "pleas for him to get counseling" were ignored.

Attempts by ABC News to reach Anderson for comment were unsuccessful.
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Re: An Autoerotic Death [NSFW]

Yea, and I recall all the bad press that guy from Hogans Heros got and I think all that happened was that they found a few sex toys and magazines in his trunk after he died... Looks like they will have to dig a little deeper these days to pronounce someone a "post mortem freak"... LOL

But thats not the worst... At least those folks aren't around to have to answer to their stone tossing peers. Can you imagine the shit that EMTs find folks associated with on some of the 911 calls today. The secrets they must hold. I know there has GOT to be some good phone video I am the start of for extended chuckles SOMEWHERE>... LOL

I cant help but think that all these folks doing this are improperly searching that old "pass out trick" feeling associated with constricting the blood to the head in certain physical conditions like everyone had done to them by a peer in their teens. And really fuking up. I also cant help but thinking the ones looking to be partially suffocated ARE THE REAL DEAL into sickness. What these pictures DO NOT depict is the horror associated with this death process. Most dont realize it aint like in the movies and you just strangle someone to death and toss em aside and its over. Most likely that results in a natural restart. Could you imagine with these folks bodies came back around for another attempt at air, or 10 of em, all the cajouling/convusing/unconscious jerking around. Must be just sadly gruesome. But not as bad I imagine if EMTs found em jeking around like that but brain dead all ready. Really sad...

and I thought I was a perv. I'm looking a little more normal every day:D
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Michael Scally MD

Doctor of Medicine
Detail Of The Needle Inserted Into The Penis

Modelli ME, Rodrigues MS, Castro BZ, Correa RS. Self-induced fatal air embolism: accidental autoerotic death or suicide? J Forensic Sci 2013;58 Suppl 1:S261-3. Self-Induced Fatal Air Embolism: Accidental Autoerotic Death or Suicide? - Modelli - 2012 - Journal of Forensic Sciences - Wiley Online Library

Autoeroticism comprises behavior deviations aimed at producing sexual gratification through the manipulation of one's own body. The use of asphyxia and the induction of pain (masochism) are well-known examples. "Atypical forms" of such behaviors have appeared in the literature as isolated cases. Fatal air embolism is most common in women (causing abortion), being very rare in men (urethral trauma). The authors present a probable case of air embolism associated with signs of autoeroticism, instrumented by the delivery of air through a system formed by a compressor (typical of those used in refrigerators), a syringe barrel, a segment of latex tubing (tourniquet), and a needle, which was found inserted into the glans penis of an adult male. The hypothesis of accidental death was chosen due to the findings at the scene. The body was decomposing when found, which hampered the conduction of examinations.


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Michael Scally MD

Doctor of Medicine
Pellets in the Appendix
MMS: Error

An 8-year-old hyperactive boy was admitted to the hospital after having been found to have elevated blood lead levels, ranging from 17.4 to 27.4 ?g per deciliter (reference range, <10) over a period of 2 years.

An abdominal radiograph revealed large numbers of small, hyperdense foci in the right lower quadrant. The entire family reported that they regularly ate geese that were killed with lead pellets from a shotgun, and the children reported that they had been eating the pellets as part of a game to make them disappear.

The patient and his siblings underwent bowel washout. A follow-up radiograph of the patient revealed that pellets were still present in the gastrointestinal tract, in either the cecum or the appendix (Panel A). Laparoscopic appendectomy was performed.

The appendix weighed 27.5 g (normal weight, 4 to 5 g), measured 55 mm in length, and had an average external diameter of 7 mm with a wall thickness of 2 mm. A total of 57 lead pellets were recovered from the lumen (Panel B ).



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My god, I`m not only normal but subnormal after all.
Real men dont get fucked in the ass they stick lead shot up their what?


I did not know the appendix was a functional part of the digestive tract. At least in terms of where food or things swallowed could actually travel???


I did not know the appendix was a functional part of the digestive tract. At least in terms of where food or things swallowed could actually travel???

Yea, it has something to do with bile and liver function overflow. Its a one way street.


I did not know the appendix was a functional part of the digestive tract. At least in terms of where food or things swallowed could actually travel???

Me neither. Wow! Never ever heard of anything like that. I wonder where those go if you had your appendix removed?

Michael Scally MD

Doctor of Medicine
Pelvic X-Ray Depicting Radio-Opaque Foreign Body (Fork) Within Penis

Naidu K, Chung A, Mulcahy M. An unusual urethral foreign body. International Journal of Surgery Case Reports. An unusual urethral foreign body

INTRODUCTION Lower urinary tract foreign body insertions have a low incidence. The motives for insertion of a variety of objects are difficult to comprehend. This case warrants discussion given the great management challenge faced by the oddity and infrequency with which a fork is encountered in the penile urethra.

PRESENTATION OF CASE A 70-year-old man presents to the Emergency Department with a bleeding urethral meatus following self-insertion of a fork into the urethra to achieve sexual gratification. Multiple retrieval methods were contemplated with success achieved via forceps traction and copious lubrication.

DISCUSSION The presentation of urethral foreign bodies can vary widely, as can the type of object inserted. The most prevalent motivation for self-insertion of urethral foreign bodies is autoerotism. Motivations ought to be explored in light of possible underlying psychological or psychiatric conditions. The most appropriate surgical extraction technique can be guided by physical examination and imaging. Endoscopic removal is often successful, depending on the object's physical attributes and morphology. It is important to arrange appropriate follow-up, as late complications can occur such as urethral strictures.

CONCLUSION Psychological and surgical arms encompass the management plan. Foreign body retrieval is determined by its physical attributes and morphology with the aim to minimise urothelial trauma and preserve erectile function. Essentially, endourological extraction serves the primary means of retrieval. Cystourethoscopy is important to diagnose urothelial injuries and to ensure complete removal of foreign bodies following extraction.


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Michael Scally MD

Doctor of Medicine
Scrotal Calcinosis

Multiple confluent, dark-yellow nodules on the scrotum are most consistent with idiopathic scrotal calcinosis, a rare and typically benign disorder. Nodules are localized to the scrotum and are not associated with hormonal or metabolic abnormalities.



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