On this day in 1977 at approximately 2:30 PM the King Rock ‘n Roll was found dead on a bathroom floor at Graceland, his mansion in Memphis, Tennessee. He had not been seen since around 6 AM, right after he finished playing racquetball.
This was a death that reverberated around the world because Elvis Presley was a world icon. The most recognizable name and perhaps the most recognizable face on the planet.
The autopsy revealed no evidence of trauma or stroke or a heart attack or anything else that would cause a 42-year-old man to suddenly fall dead. Then the toxicology reports returned. These reports have been the subject of controversy and discussion for over 30 years now.
The investigation into The King’s death led to Dr. George Nichopoulos, the original “Dr. Feelgood.” He wrote prescriptions for Elvis for many years and some estimates indicate that he gave Elvis over 10,000 doses of downers, uppers, and narcotics. Seems that Michael Jackson found similar physicians.
The toxicology report indicated that Elvis had significant amounts of Ethinamate (a short-acting sleeping pill taken for insomnia), Methaqualone (Quaalude), codeine (a narcotic), and barbiturates (a class of tranquilizer) as well as smaller amounts of chlorpheniramine (an antihistamine), meperidine (Demerol), morphine (a narcotic) and Valium (a benzodiazepine tranquilizer) in his bloodstream. The question that remains is whether this pharmacological soup directly killed Elvis or did he simply have a cardiac arrhythmia and all of these drugs had little or no role in his death?
This may sound like a simple determination but in fact it is quite difficult and it is problems like these that perplex the medical examiner and the forensic toxicologist on a daily basis. Narcotics, sedatives, tranquilizers, and even antihistamines, when combined, can lead to treacherous results. Though the levels of none of these medications found in Elvis’ body, taken by themselves, would have resulted in death, the combination might very well have. These types of medicines tend to be additive and cumulative. Since narcotics and tranquilizers and sedatives all have depressing effects on the brain’s respiratory center, it is possible that this combination caused Elvis to stop breathing, collapse, and die. It is also entirely possible that his heart simply stopped due to a cardiac arrhythmia and these medications had little or nothing to do with it.
This is not an uncommon problem in forensic investigations. The determination that must be made is whether the drug or the combination of drugs was sufficient to cause death in and of themselves, or did they contribute to the death, or were they simply incidental findings and had nothing to do with the death. These are very difficult problems to resolve since each individual reacts to medications and combinations of medications differently. Maybe what Elvis took was too much for his system. Maybe he was used to these drugs and they had little effect on him. We will probably never know the answer to this question.
The same dilemma was part of the investigation into the death of Kurt Cobain, a death that was ruled suicidal but might very well might have been something more sinister. Also, these types of questions are coming to the forefront in the investigation of the death of Michael Jackson. Stay tuned.