How Did Elvis Die?
‘Elvis was probably an addict,’ his doctor admits—but did those prescriptions kill him?
Shortly after 2 p.m. August 16, 1977 Ginger Alden, awaking from a long day’s sleep, walked into the bathroom adjoining the palatial master bedroom of Graceland and discovered that Elvis Presley was dead at 42. It was a seismic event and a national tragedy. To cope with it, to capitalize on it, in some cases as if to deny it, his former retinue and his most fanatic fans have pored over his effects hungrily for relics and talismans, turning his death into a macabre sideshow. Kidnappers have tried to steal his body from its grave. Fortunes have been made in retrospective schlock and dime-store Presleyana. Dozens of relatives and “friends” have published increasingly lurid accounts of his life. One old retainer, security chief Dick Grob, recently tried to sell a book outline retailing the theory that Elvis was dying of cancer; now, reportedly, Grob says he made it up. Someone, presumably a vengeful fan, fired a shot at Elvis’ physician, Dr. George Nichopoulos, at a football game last year. One ghoul has tried to sell the vial in which Elvis’ last drug prescription was packaged. The price: $1,000.
Perhaps the most insistent consequence of Presley’s death has been the growing debate over how he died. On one side is the medical examiner of Memphis, arguing that the cause was (as his death certificate states) “hypertensive cardiovascular disease associated with atherosclerotic heart disease.” In short, heart attack. On the other side is an army of onetime associates, some of his fans and an ABC-TV news producer who attribute his death to dependence on a lethal combination of powerful prescription drugs.
Two weeks ago a state agency accused Memphis pharmacist Irving Jack Kirsch of filling over 200 narcotics prescriptions for the singer despite the fact that he “knew or should have known” that Elvis was a drug abuser. Last week in Memphis a state panel convened to hear charges that his personal physician, Dr. Nichopoulos, had prescribed a phenomenal amount of drugs for Presley—more than 5,000 narcotics capsules and pills alone—in the seven months before he died. On the stand, Nichopoulos confirmed for the first time that Elvis had indeed been a drug addict. Fueled by new information and theories unearthed by journalistic and official investigations, the mystery of Elvis’ death is today deeper than ever.
The controversy began virtually at the moment of his death, when Memphis ambulance attendant Ulysses Jones arrived at Graceland and a Presley staff member greeted him at the door with the news: “We think he’s OD’d.” A notation to that effect was entered on Presley’s admitting form at the Baptist Hospital emergency room. Toxicologists who studied Presley’s tissues isolated at least eight different barbiturates and narcotics—including Valmid, Quaaludes, codeine, Placidyl and phenobarbitol. According to ABC, the doctors who performed the autopsy personally advised Vernon Presley that his son had died of a drug overdose. But then, three days later, Tennessee’s Chief Medical Examiner Jerry Francisco signed and issued the official certificate, ascribing death only to coronary problems. “Elvis Presley died of heart disease, and prescription drugs found in his blood were not a contributing factor,” Francisco later stated categorically to the American Medical News. “Had these drugs not been there, he still would have died.”
Francisco has come under increasingly virulent attack in the two years since that finding. At least one of the 10 members of the autopsy team—and reportedly others—wanted to attribute Elvis’ death to “polypharmacy,” or a toxic combination of dangerous drugs. After a six-month investigation, Memphis-born ABC News producer Charles Thompson has also come to the conclusion that only drugs could have killed Presley. “He had in his system enough narcotics to kill almost anybody,” says Thompson, who somehow wangled a copy of the toxicologist’s report. “The quantity of drugs in the man was truly amazing,” marvels former Pittsburgh Medical Examiner Cyril Wecht, who was called on by ABC to examine the lab reports. New York Deputy Chief Medical Examiner Michael Baden agreed: “A street addict could not possibly take that amount of drugs and survive.”
Actress Linda (Hee Haw) Thompson, who lived with Elvis for years after his 1973 divorce from wife Priscilla, says he had been abusing prescription drugs since the 1950s. Reports from his old entourage confirm the fact that he was indeed hooked. “I have never seen a human being in my life abuse drugs like Elvis,” Presley’s stepbrother David Stanley recalls. “I am not talking about street drugs—I am talking about prescribed drugs. Some of the doctors were out for the almighty buck.” Adds former bodyguard Sonny West bitterly: “They called them ‘prescribed’ drugs, but he was addicted to them. He was taking narcotics shots—as far as I know in the muscles, not intravenously—of liquid demerol and stuff like that. He would use an excuse like a sprained ankle for taking Dilaudid; that’s the strongest pain medication you can get—they usually prescribe it for terminal cancer patients.”
But West, too, was taking drugs, and so were Stanley and his two brothers and most of the other members of the “Memphis Mafia.” In the reconstructions, Graceland seems to have been a veritable drug emporium. Marty Lacker, a buddy since high school and the best man at Elvis’ wedding, had to leave the entourage after 20 years to detoxify in 1976. Others did the same, including Elvis’ three stepbrothers. The cost to Presley’s health was apparent—he reportedly fell into stupors with alarming frequency, was hospitalized for overdoses at least twice, and once in 1976 would have died if his father hadn’t given him artificial respiration. “Dr. Nick” testified in his own hearing last week that he brought in two psychiatrists specializing in drug addiction. Elvis saw them twice, according to Nichopoulos, then dismissed them because the idea of treatment by a shrink was anathema.
Presley’s drug problem worried those closest to him much more than the public ever guessed. “His death,” claims actress Thompson, “could have happened any number of times during the years I spent with him had I not been so acutely attuned to his habits and needs.” She finally moved out of Graceland a few months before Elvis died, fed up, she says, with his drug use. “When a person knocks himself out each night with sleeping pills, he is just as apt to fall asleep face down on the floor as he is to be safely tucked away in bed when the medication hits. For that reason, Elvis required an unfathomable amount of attention.” How could she leave him? “Elvis had a self-destructive vein,” explains Linda, “and I couldn’t watch him self-destruct.”
Vernon Presley was simultaneously so worried about his son’s habits that he hired two former narcotics agents to trace the source of Elvis’ supply. They named two doctors and a dentist, but by one account Elvis threatened to cut off his father’s $75,000 yearly salary if Vernon took any action. The problem, says Vernon’s ex-wife and Elvis’ stepmother, Dee, was simply that “there wasn’t a person in the world that would say no to him. If there was a woman or man strong enough, Elvis would be alive today.”
A few of Presley’s associates still maintain that he had no drug problem. They point out that Dr. Nichopoulos ordered all medication administered to Elvis by a licensed nurse and argue that his dosage was controlled. “A lot of the shots given to Elvis by his nurse were just saline solution,” insists last girlfriend Ginger Alden. “That was on Dr. Nick’s orders.” In her new book, Elvis: We Love You Tender, Presley’s stepmother, Dee, offers a wishful compromise. “It may yet be proven that Elvis was extremely ill,” she says, “and he had to take that amount of drugs to deaden the pain.”
The amount of drugs—and the reasons for them—were of paramount interest to the Tennessee Board of Medical Examiners as it began hearings this month. Dr. Nichopoulos was charged with dangerously overprescribing drugs not only for Elvis Presley but for 19 other patients as well (among them: his own teenage daughter, Chrissie, and rock legend Jerry Lee Lewis). Nichopoulos denies outright that he ever prescribed codeine or two of the three barbiturates found in Presley’s tissues. As for the most startling charge, that he prescribed 12,000 pills for Elvis in the 20 months before his death, Nichopoulos argues that those drugs were in fact intended for Presley’s entire road entourage, and were to be administered by a nurse under his direction. “Although I was not the only source of drugs available to Elvis Presley,” Nichopoulos states in his defense brief, “I did undertake as best I could from the time I became his personal physician to control his intake of habit-forming substances, and to keep him in good health and physically able to perform for his millions of admirers.”
A finding by the medical board that Nichopoulos was indeed a Dr. Feel-good will no doubt encourage the drug-death theory, but Medical Examiner Francisco believes that would be wrong. “Let’s look at the entire record upon which I base my decision,” was the way he put it to the medical journal. “The heart was enlarged to twice its normal size. There was severe coronary artery disease. His records showed a pattern of abnormal electrocardiogram readings. And he had a history of diabetes, depression, insomnia, overweight and blood pressure as high as 160/110. Then there was the circumstantial evidence,” Francisco continued. “His body was found in a flexed position, with a pressure point on the side of his head. Had he died of drugs, the body would have gone into a coma and been found in a comfortable resting position.” Finally, in defense of the heart-attack finding, Francisco notes the family’s history (Elvis’ mother also died of a coronary at 42), and points out that Presley rarely used alcohol, a common synergistic agent in OD deaths.
If the autopsy is ever made public—and ABC News is suing to obtain it—some significant new facts may be added to the dispute. But the deep and acrimonious dissension among doctors could also prove finally unresolvable—with Elvis’ death wrapped in impenetrable layers of medicalese.
That, according to Elvis’ uncle, Vester Presley, would be just as well. “We’re very sad over all this talk about Elvis—and it makes us feel very bad about the human race,” mourns Vester, 65, who still works as the gatekeeper at Graceland, as he has for 22 years. Elvis’ grandmother Minnie Mae, 90, and his aunt, Delta Mae Biggs, are the last inhabitants of the old mansion now, and they’re trying to keep the place just as it was on that August day. Elvis’ clothes still hang in his closet, the television over his bed stands ready for use, and the towels are in place in the bathroom where he died. The building has the air of a shrine. But these days the number of visitors to Graceland is way down—to about the same level as before Elvis died. That, too, is just as Vester thinks it should be. “Elvis was just a human being, just like everybody else,” the old man shrugs as he goes about his duty, guarding the gate at the big, empty house. Slowly, perhaps, even the King’s most obsessive followers will learn to accept that truth.