For what it is worth I am not an ME. But I do have a pretty good working knowledge of the human body. Loss of consciousness is immediate when the cerebral cortex (sides of the head) is compromised. Not necessarily so when the frontal lobe is compromised. The base of the heart is actually at the top, the apex of the heart is near nipple line(for purposes of this post). The oblique (angled) stab wound to the superior vena cava is not a spouting wound like an artery would be. It caused some bleeding into the sac surrounding the heart (pericardium) which would affect the hearts ability to pump effectively. IMO, the cause for the largest amount of blood loss was from the jugular vein and carotid artery. Arteries spurt blood with every heart beat. As I mentioned in a previous post, without immediate intervention, complete blood loss would occur within 90-180 seconds. As the ME noted, there was a lack of hemorrhage in the frontal lobe. There could be varying reasons for that, but he had to draw a conclusion based on experience and knowledge of the human body. The amount of decomp unfortunately made things less clear in the debate over shot first or last. Had Travis only sustained the GSW, he in all likelihood would have survived. IMO