Keogh agreed that night with his wife to take an extensive leave from work effective immediately, as they considered options.
But part of him stayed on the job. At home that afternoon, Keogh scribbled down some work-related financial numbers on a piece of paper. His wife found them weeks later while sorting through his papers.
Other than writing a few checks for household bills, no one knows what Kevin Keogh did on the last morning of his life after his wife left for work.
One thing he didn't do became a telltale sign for his wife, though after the fact.
"I didn't know until later that he'd quit watering his cactus," she says. "That was a big deal. He really loved those plants."
About 1,000 people attended Kevin Keogh's funeral at St. Theresa's Catholic Church on East Thomas Road.
He was cremated, and Mrs. Keogh scattered his ashes last August 26 in his native New York.
Early in 2005, city manager Fairbanks announced that an independent audit of Kevin Keogh's financial dealings on behalf of the city had found nothing amiss, not a penny unaccounted for.
So (and this never had been even a fleeting concern for anyone who knew Keogh) it wasn't as if he'd been stealing from the city or, more benignly, had become slipshod with taxpayer funds.
In early 2005, Mrs. Keogh asked CIGNA for life-insurance benefits from her late husband's policy with the City of Phoenix.
City executives are covered under a policy that calls for a one-time payout of 175 percent of the deceased's annual salary, or more than $300,000 in Keogh's case.
If CIGNA deems a death accidental, it's supposed to kick in another 175 percent, though that wasn't relevant in Keogh's case.
But exclusions written into the policy include no payouts in instances of suicide, which was the official manner of Keogh's death at the time.
In her March 2005 letter to CIGNA, Karlene Keogh explained why she felt Maricopa County's suicide ruling had been off-base.
She mentioned that Dr. Hsu who'd performed the Keogh autopsy and signed the death certificate recently had phoned her.
Mrs. Keogh said Dr. Hsu had expressed disappointment over having had to call it a suicide.
"She said she never calls anyone," Mrs. Keogh wrote, "but in this case she felt compelled to because she felt badly about what happened to Kevin and me and all the press.
"She said that seizures cannot be detected in an autopsy. She could not change the report and had to leave suicide on [it]. . . . However, she did tell me several times that she was absolutely certain that something horrible happened to Kevin. She said, 'It's likely he was hallucinating.'"
Dr. Hsu no longer works at the Medical Examiner's Office, and could not be reached for comment. But she never did amend the death certificate.
A few days before last Christmas, Karlene Keogh opened a discouraging letter from Sheri Leister, an accident claim specialist for CIGNA. Leister said CIGNA was rejecting Mrs. Keogh's application for life-insurance benefits for two reasons:
The first was the exclusion of benefits to survivors whose loved ones have committed suicide.
The second was another clause that seemed to say, even if worms in Keogh's brain actually had compelled him to kill himself, too bad.
Interestingly, CIGNA agreed with Mrs. Keogh that the worms had led to his death and that was another reason, Leister wrote, it wasn't going to pay up.
Leister explained that, because Keogh had become infected more than a year before he died, too much time had passed.
"As the findings indicate that Kevin Keogh's actions, caused by disease, directly resulted in his death," Leister wrote, "we have concluded that he did not suffer a covered loss."
Karlene Keogh immediately decided to appeal CIGNA's findings.
Dr. Philip Keen long has been known as a straight talker, which may have cost him his job last summer as Chief Medical Examiner (he's still working as an assistant examiner).
Keen calls it like he sees it, even when his opinion runs counter to what prosecutors, police and the county Board of Supervisors would like to hear from him.
The doctor says it's not unusual for families to question the manner of a loved one's death, especially a suicide. But it is quite unusual, he says, for anyone at the county's Forensic Science Center to amend a death certificate.
"We have to be convinced that the new information out there really is compelling," he says. "But I always will check into whatever anyone presents."