autopsy report arrives with torrential down-pour

Yesterday, J's mother sent me a text to let me know the autopsy report had finally come in, confirming one of our many sad speculations that he lost his battle with addiction.  
I was sitting in my car when I read the message; the skies had opened and rain was coming down as if poured from buckets, mirroring the way I felt, having been brought back so close to his moment of death again. It felt as if I had just received that horrible phone call from his sister telling me that their worst fears had in fact come true and that he had died.

I broke down, sobbing uncontrollably, telling myself over and over again that it was my fault. It was my fault!
He would have never gone to that extreme had I not kicked him out that morning. I should have known better. How could I not know by now that he wasn't able to see through such empty words? How could I not know that he was going to catastrophize my anger and go into self-destructive mode? How could I NOT KNOW BY NOW that he wasn't going to be able to keep calm and re-approach when the B returns to normalcy?

A voice inside of me kept responding to my cries of guilt.
It's MY fault. It's MY FAULT!
-- No, it's not.
It's my fault! 
-- No, it's not.
It's my fault...
-- No. It is not.

When I was finally able to regain control, I drove to his mother's house to sit with her and read the report. Every part of his body was described in detail. What he was wearing, his scars, the weight and condition of all major organs, everything. Attached to the autopsy details was the toxicology report, which confirmed that he had cocaine and heroin, as well as excessive amounts of alcohol in his urine and blood.

The wording explaining the cause of death was so complicated that I decided to call the Medical Examiner to speak to her in person. The woman was incredibly patient. I asked her some questions two or three times just to clarify and double-check a particular detail. You could hear that she was truly sorry for our loss and told me how handsome he was. It's nice to meet people in a profession that aren't completely burned out and understand the importance of sensitivity in their line of work. Something I cannot claim of the staff we had to interact with when we went to identify J's body. That woman was awful. She was chatting on the phone with her friend as J's sisters and I stared at his dead body on a computer display on her desk. It was a miracle she wasn't chewing gum, filing her nails at the same time.

The medical examiner explained to me that the chronic drinking, possibly combined with drug use, had been slowly killing him and that this was probably an accidental overdose. That his body just couldn't take it anymore. She said it wasn't possible to tell whether he had been using (coke/heroin) all along or if it was just this day, but, she said, it didn't really matter, for the alcohol had done enough damage to the heart to compromise him. His heart wasn't in the state of a normal, healthy 36-yr-old. So, ultimately he died of heart failure due to probably chronic and acute alcohol and drug use. She said it was hard to diagnose precisely but that the cause of death was ultimately natural (i.e. it wasn't a violent crime) and that even if he hadn't used any hard drugs, the amount of alcohol he had in his blood and urine were poisonous (0.39 in some tissues. To illustrate the excessive level of this number, she compared it to the level one gets arrested for when driving under the influence: 0.08). She said that she sees many more deaths due to the effects of alcohol than to drugs.

And despite the fact that I now know he was already dying by continuing to drink, I feel responsible. I feel that he maybe wouldn't have reached the level that ultimately did him over hadn't it been for my last words to him that fatal day.

I wish there were an emoticon that would adequately describe the pain I feel, for my words always fall short to do so.