Several readers have commented on my original blog post “The Taconic Parkway Crash” about the possibility that Diane Schuler experienced a rare medical complication called ‘Auto Brewery Syndrome’ and that this condition may have led to her erratic behavior, elevated blood-alcohol level, and also account for her apparent lack of history of ‘alcoholic behavior.’ So, let’s take a look at the evidence for and against this theory and I welcome any further comments and thoughts regarding this sad case.
What Is Auto Brewery Syndrome?
Auto Brewery Syndrome (also sometimes referred to as Gut Fermentation Syndrome) is a rare medical condition in which the stomach, or gut, produces an excessive amount of ethanol after eating a meal high in carbohydrates. This sudden production of ethanol causes a spike in the affected person’s blood alcohol content (BAC) and symptoms mirror those of someone highly-intoxicated: dizziness, erratic behavior, slurred speech, irritable bowel syndrome, belching, chronic fatigue, dry mouth, disorientation, and hangovers. The condition occurs in both children and adults.
Auto Brewery Syndrome appears more common in Japan than in the United States however, even in Japan, cases of the condition are exceedingly rare. The condition is diagnosed when a person reports the symptoms to a medical doctor and their BAC comes back elevated in the absence of any alcohol consumption. Treatment includes diet management to reduce sugar and carbohydrate intake as well as increasing the good bacteria in the gut with supplements such as probiotics.
The Evidence That Diane Schuler May Have Experienced Auto Brewery Syndrome
- This condition would account Diane’s apparent lack of prior alcoholic behaviors. Others in her life do not report seeing her drink alcohol to excess. A private investigator hired by Diane’s widower said he could find no relative who had ever observed Diane drinking heavily or being intoxicated.
- Auto Brewery Syndrome would account for Diane’s rapid behavioral escalation
- It is possible Diane ate a carb-heavy meal at the McDonald’s stop and we know she ordered an orange juice which is high in sugar.
- The condition of Diane’s liver at autopsy was found to be in the normal range suggesting a possible lack of long-term alcohol abuse.
- Diane did not appear drunk to witnesses at most of her stops along the way (McDonald’s, the gas station). Whatever happened must have taken place suddenly.
- Diane did not have a known history of perpetrating child abuse, attempting suicide, or acts of violence against others.
The Evidence That Diane Schuler Did Not Experience Auto Brewery Syndrome
- An empty vodka bottle was found, smashed, in the mini-van wreckage. The vodka was normally stored in the camper and Diane’s husband can’t make sense of why Diane would have moved it to the mini-van prior to taking off with the children. It appears Diane specifically moved an open bottle of vodka from the camper her husband was driving to the mini-van she was driving — but, why, if not to drink it along the way? The mini-van had a trunk. Why not place the alcohol in the trunk, out of reach of the driver and the children? No mother wants to get pulled over with a van full of children and an open container if she’s not drinking. It’s tough to think of another explanation for this behavior.
- Vodka is a common drink of choice for later-stage alcoholics as it’s scent is easier to mask and the alcohol concentration is higher than other beverages. It is also clear which makes it easier to swap in place of other drinks such as water or to mix in with other liquids such as a protein shake or tea. The fact that vodka was the alcohol of choice present says something, I believe.
- Diane had the equivalent of 10 shots of alcohol in her bloodstream and an additional 10 shots of undigested alcohol in her stomach at the time of autopsy. I would be curious to know if the ethanol produced by Auto Brewery Syndrome appears the same in the stomach as 10 undigested shots of vodka. My understanding from what I have read on the subject is that Auto Brewery Syndrome produced ethanol — which is a gas — and that Diane had a liquid in her stomach. While both the ethanol and vodka might produce the same physiological effects, it appears a coroner would be able to determine on autopsy whether someone had undigested vodka in their stomach or not.
- Diane had risk factors for being a closet alcoholic: a traumatic childhood, perfectionistic and controlling tendencies, a high-powered career, the public presentation of the illusion of domestic perfection, an opposite work schedule as her husband — a primary adult who would be able to actually monitor any alcohol use
- An absence of liver damage at autopsy does not mean Diane was not abusing alcohol. It just means that, if she was, it had not damaged her liver yet. Diane was relatively young, at 36-years old. If she was a closet alcoholic, we don’t know how long prior to the car crash her drinking may have begun.
- Diane had high levels of THC, the active agent in marijuana, in her system at the time of her death. Reports indicate that she could have smoked as recently as 15-minutes prior to the crash. There is no such thing as Auto Cannabis Syndrome — we know Diane smoked marijuana prior to, or during, the car trip with the children. This behavior would be consistent with someone who also drank alcohol prior to, or during, the car trip.
- Diane purchased an orange juice at the McDonald’s stop — a mixer which is often used to chase vodka.
- Diane’s stomach contained 180ml of grey fluid “with no pills or fragments” in it at the time of her autopsy. There is no mention of food particles or remnants in her stomach. Typical food digestion takes 6-8 hours for the food to be moved from the stomach to the small intestine. Diane purchased food at 10:30am. Only 3 hours later, she was dead. There should have been food in her stomach at autopsy if the Auto Brewery Syndrome theory is to be believed — it would be a high-sugar/high-carbohydrate meal that would induce the elevated ethanol level; and, yet, she had NO food in her system. No food in Diane’s system would be consistent with a person attempting to get as buzzed as possible as quickly as possible on alcohol.
- If Diane did have Auto Brewery Syndrome, it appears this was the first incident of its kind, which would be stunningly inopportune. No one witnessed Diane behaving erratically or in an intoxicated manner in the months and years prior to the crash. Diane never sought medical help for a bizarre onset of symptoms. How crazy-unfortunate would it be if the first time Diane experienced an onset of sudden and severe Auto Brewery Syndrome is also during a brief drive home with a mini-van loaded with children (and an open vodka bottle and THC in her system)? If the Auto Brewery Syndrome was caused by consumption of liquids, I would imagine Diane would have needed to imbibe a ton of orange juice — more than the one serving she got at the McDonald’s.
- Diane was very, very angry. Multiple witnesses on the Taconic Parkway describe Diane as staring straight ahead, with an intent and determined look on her face. She was harassing and honking at other drivers and driving in a generally aggressive manner, appearing at times to be inciting a crash or altercation with other drivers. Of course, this could be attributed to her intoxicated state — but, we can’t rule out that Diane was just pissed. Perhaps at something Danny said or that she learned just prior to leaving the campground.
“The more assumptions one has to make, the less likely the explanation.”
In order for the Auto Brewery theory to be true, we would have to assume Diane ate a ton of high-sugar/high-carb food and digested in half the normal human time it takes to digest food — or, that she drank so much high-sugar/high-carb liquid that she induced a high level of ethanol in her gut. We would have to assume that this was her first incidence of Auto Brewery Syndrome or that she’d never experienced it this acutely before. We would have to assume that as Diane started feeling woozy — which should have been alarming if she hadn’t been drinking — she did not call her family members for help or indicate to anyone that she was feeling off. We would have to assume that the high THC levels in Diane’s system and the opened vodka bottle found under a seat in the mini-van are irrelevant. That’s a lot of assumptions.
In order for the closet alcoholic theory to be true, we would have to assume that Danny was in denial about Diane’s behavior or simply unaware of it due to the fact that they were essentially ships in the night with their work schedules. This is pretty much all we would have to assume as the vodka bottle, BAC levels, THC levels, orange juice, and lack of food in her stomach all indicate that Diane was drinking heavily that morning with the intention of getting wasted.
The Monster We Know
We all want to believe no one could possibly be this much of a monster. We want to believe that most incidents of murder and dismemberment occur at the hands of just a dozen serial killers rather than accepting the more-likely possibility that there are hundreds, if not thousands, of one-off killers out there — our neighbors, selectmen, school teachers — lone individuals who did something one time, so horrible in their lives, and then worked hard to cover up their singular transgression.
It feels comforting to believe that if we could just identify the one monster, we can conquer it. But, what if there are so many monsters we can barely keep up? And, what if those monsters are our own mothers, our favorite aunts?
What are your thoughts? Please post in the comments.
Link to autopsy report: http://www.autopsyfiles.org/reports/Other/schuler,%20diane_report.pdf
Link to original blog post: