Lab technicians were playing Elvis music in the background. From somewhere outside the lab, people could be heard crying.
"People were just sobbing. It was a sad, sad moment," says Dr. Noel Florendo, a pathology intern assigned to help perform the autopsy of the 42-year-old man on the table at Baptist Memorial Hospital.
Florendo says he and another intern followed instructions from his former professor, Dr. Jerry Francisco, as they began the postmortem on the biggest legend in music history. Elvis Presley, the world's first rock star, had outraged much of America at first, and controversy was about to follow him to the grave.
In 1961, Francisco had become Shelby County's first medical examiner. He was the last word in Memphis on how people died. A pathology professor at the University of Tennessee Center for the Health Sciences, he had helped train pathologists at almost every hospital in the region.
Francisco had "seen more dead people" than anyone else in the room, says Florendo.
Yet, what happened Aug.16, 1977, would become one of the most highly publicized cliffhangers since the deaths of the Romanovs in Russia, the disappearance of Jimmy Hoffa or conspiracy theories about a Marilyn Monroe murder.
Even now, Elvis' death could be classified as a medical "mystery," says Maurice Elliott, former vice president of Baptist Hospital and former chief executive officer of Methodist Le Bonheur Healthcare. Francisco would attribute the death to "cardiac arrhythmia due to undetermined causes," or, in layman's terms, a heart attack.
The rest of the pathology team suspected "polypharmacy." Elvis had a history of drug abuse, and most of those in the room did not see enough evidence of heart disease to justify calling the death a heart attack.
For Francisco, it was his second 15 minutes of fame. From his home in East Memphis, the 75-year-old retired pathologist says he had worked in relative anonymity for years until the 1968 assassination of Dr. Martin Luther King Jr.
Francisco, who signed the death certificate, had no trouble convincing the world of the cause of that death. A rifle shell penetrated King's face just to the right of his mouth.
"The bullet never left his body," says Francisco.
Nine years later, it was Elvis on the table. Francisco was "absolutely shocked" at the world's reaction. A fan of "all sorts" of music, including classical and opera, he was not a fan of Elvis and knew no Elvis song to pick a favorite.
Francisco had grown up in the small West Tennessee town of Huntingdon, the son of a cotton ginner and a mother who spent most of her life as a housewife before being appointed city recorder. Francisco loved organic chemistry and the life of an academician. He was now being offered $10,000 by a tabloid TV show for photographs from the Elvis autopsy.
When the autopsy was done, it was inconclusive.
"There was no way they could have ruled it was polypharmacy on the day of the autopsy because the (toxicology) results weren't back," says Florendo.
Other members of the autopsy team and others present in the room, including Maurice Elliott, say there was also no way the death could be dismissed simply as cardiac arrhythmia. Nevertheless, Francisco held a news conference after the autopsy announcing that Elvis had died of "cardiac arrhythmia due to undetermined causes."
In 1991, Dr. Eric Muirhead, retired pathology chief of Baptist Memorial Hospital, took the first official shot at Francisco. Muirhead, who had remained quiet for 14 years, says he had been "muzzled" into silence by hospital attorneys and later had not wanted to be engulfed in global publicity.
Muirhead, who has since died, says Elvis "was a drug addict. We knew he was a drug addict because he had been at Baptist to be treated for that."
He says Francisco pre-empted every other member of the autopsy team, announcing the heart-failure theory to the world.
"We were appalled that he made that announcement. There were eight other doctors there who disagreed with him."
Dr. Thomas Chesney, now pathology director of Baptist Hospital and of Pathology Group of the Mid-South, was present at the autopsy and says Francisco's conclusion "was unprovable one way or another. You can never go wrong with that diagnosis. One hundred percent of people have something that goes into an abnormal rhythm before they die. It's what leads up to the state that is the question. I don't think that to say someone died of arrhythmia is a very satisfactory answer."
After the initial autopsy, tissue samples were sent to laboratories around the country. Independently, they confirmed high levels of more than 10 drugs, some at near-lethal doses, in Elvis' body. Even then, Francisco stuck by his heart-failure ruling.
Chesney says the drugs, mostly sedatives, were at sublethal levels.
"The question was, if you have a certain level of a variety of different things on board is that going to have a cumulative effect? If each level is sublethal, will that combination of sublethal drugs become lethal?"
Muirhead and Elliott say Elvis' heart blockage was no more than 40 percent in one vessel.
"He didn't have enough to have a bypass," Muirhead says.
Florendo, now pathologist at Methodist Le Bonheur Healthcare, once was interviewed on the television show "20/20." He says he supported Muirhead's conclusion at the time.
"I was at Baptist, and he was my mentor," says Florendo, who says the competing theories devolved through the years into "a Muirhead camp and a Francisco camp."
His own loyalties are divided, he says.
"(Francisco) was the medical examiner after all. That was his prerogative."
In the 1991 book, "The Death of Elvis: What Really Happened," authors James P. Cole and Charles C. Thompson II exhaustively researched toxicology results and interviewed doctors, including Muirhead, off the record.
Cole, a former reporter for The Commercial Appeal, says, "Fundamentally, I just think Dr. Francisco was very mistaken about this. There was no cardiac pathology in the autopsy, and the records show that Elvis clearly died of an accidental drug overdose."
Francisco is just as adamant, his voice growing tense and urgent when Muirhead's argument comes up.
"He and I disagree violently," says Francisco.
He says Muirhead and Elliott's description of Elvis' heart blockage as moderate is wrong.
"There were no clots, but there was plaque with up to 50 percent narrowing in two major coronary vessels."
None of the drugs in Elvis' system nor any combination of them could have interrupted the electrical activity to Elvis' heart, he says.
"Because there were drugs, there was a population of people who wanted it be a drug death. I spoke the truth as I saw it," Francisco says.
As he was from his appointment in 1961 until he retired as medical examiner in 1999, Francisco remains the last word on Elvis' death:
"I was comfortable when I said it, and I'm comfortable with it now."
source: http://www.commercialappeal.com/
If there had been lethal amounts of so many sedatives wouldn't Elvis simple have fallen asleep and then never woke up?That's exactly what happened to Heath Ledger when he took a deadly combo of sedatives last January. He fell into a deep sleep and simply never woke up. We know that Elvis did not go that way. Lots of reports say that Elvis may have even stood up and even stumbled a few steps before falling and starting to crawl away.
By all accounts it was not a peaceful, painless death.
That is true. The 1994 review of the autopsy by Dr. Joseph Davis discussed this.Originally Posted by utmom2008
If there had been lethal amounts of so many sedatives wouldn't Elvis simple have fallen asleep and then never woke up?
Right...all of that is discussed in "Down At The End Of Lonely Street" as best I remember.I really enjoyed that book..for the most part I felt it to be entirely acccurate. I don't understand why it seems to be one that has been overlooked through the years.
It's one of those that I continue to pull off my shelf and re-read certain parts quite often.
Did it also mention the terrible condition of his bowels (leaking into his abdomen for what they believed to be months)?Right...all of that is discussed in "Down At The End Of Lonely Street" as best I remember.
Oh my gosh Jackie...not that I remember and I think something like that would have stayed with me.
I have a good friend whose hubs recently had prostate surgery. They removed the prostate, but the stitches leaked and all of his internal organs were "bathed" in urine. It made him extremely sick...having his abdomen fill with toxic poisons.
It was said by some medical people in the BBC documentary about Elvis' eating habits, I forgot the name. Several people who'd known Elvis as well as the undertaker and his staff who collected the body at the hospital, Nurse Cooke and Mary Jenkins were interviewed about stuff including his eating habits. The medical guy said about the autopsy that he would have died that year anyway because, well, the bowels had been leaking into his abdomen for quite some time as far as they could tell from the stuff they found in there and how it all - forgive the graphic description - stuck together. They were amazed that he was still alive and that he'd have to have been in considerable pain for quite some time. They also theorized that the aorta must have burst while he was trying to get bowel movement, which was harder than it would have been had his bowels been healthy......Oh my gosh Jackie...not that I remember and I think something like that would have stayed with me.
I have a good friend whose hubs recently had prostate surgery. They removed the prostate, but the stitches leaked and all of his internal organs were "bathed" in urine. It made him extremely sick...having his abdomen fill with toxic poisons.
Last edited by Cherokee; 08-11-2008 at 03:12 AM.
I read that Elvis` death was a phenomenon called "Valsalva maneuver". It appeared that his lower intestinal system was clogged and distended with chalky- white, hardened fecal material. It said Elvis was in agony because he had not moved his bowels for some time. The downers he had taken over the years had paralyzed his lower intestinal system, causing chronic constipation.
The book "The death of Elvis" describes his last moments. It is very difficult to read but this is what it says. He was straining so hard to use the washroom that he increases the pressure in his belly. The pressure in his belly is higher than his blood pressure, which means he can`t pump blood. That means he has smashed the abdominal aorta and shuts down his heart. He`d feel his heart stop,and it would hurt just like an heart attack. He`d lose his breath and it would be just like somebody kicking him in the chest. He probably jumped up, taken a few steps and fell.
I know it is not nice to visualize .And again no one really knows if this is what happened. I prefer to picture Elvis as we remember him , handsome, having fun and singing his heart out.
I think Elvis was one of those people who had a high tolerance for pain and I'm sure the drug intake masked some of the pain he was feeling as well and that may have been part of the problem. Had he felt more pain, he might have realized he was in trouble and gotten help.
Diane
I thought this was the saddest thing i've read of the account of when he died and probably the most accurate...so sad. I've always thought the polypharmacy was it but its obvious they the prescriptions brought it all on.
it sure looked like a serious abdominal problem,drug enjoyment don't give anyone that belly,neither his weight was too much to give it that look..it wasn't weight..I 'm sure he had more than enough pain,but he didn't have a treatment other than medication(which is worse) for this problem and most probably a surgical operation was needed which wasn't easy to accept, for the conditions one has to deal with afterwards even if the operation is succesfull,specially while entertaining..yes it's amazing he performed till the end..he was amazing...
so sad to read really
It's hard NOT to imagine Elvis as perfect; how else could someone be THAT good looking, THAT talented, THAT generous & THAT charismatic
If the Aorta had burst, it would have been noted in the autopsy and it wasn't. And that would have been one of the causes of death that was listed. The speculation by people who have no expertise to me is irrelevant.
But millions of people die with out 100 percent conclusive reasons. The medical examiner is obligated to put something on the report(at the time) that he feels is accurate and dealing with the best case scenario possible. Any thing other than what is clearly seen can not be put down. In other words, deductive reasoning can be used but going further can put them in a precarious position. These are documents used in legal issues and with it being Elvis, caution would have been used.
One thing would lead to another. Had the medical examiner listed accidental drug induced death, then there would have been more and more legal situations. And he could have been sued.
Last edited by MissyM; 08-11-2008 at 06:09 AM.
This was not speculation by lay people, this was conclusions by medically trained people who were at the autopsy. They described the condition of his leaking bowels and the mess inside his abdomen AS THEY'D SEEN IT!
I agree,... for someone who brought us and millions so much joy and happiness..
I'm not saying that it was not there Cherokee. And I'd need to see it again and see the source as to who they were. Was it documented in the autopsy? If it was then it couldn't have been significant enough to have caused the death or they would have put that down as the cause.
What I'm trying to get at is this, there is always going to be conclusions made by people who were not responsible for making the scientific conclusion and signing of the legal document. Therefore their ideas to me anyway, hold no value. Not even the things said by those closest to him.
People die all the time of a cardiac arrthymia for no apparent reason or not conclusive reason. Elvis could have been having palpatation and just never knew what was going on.
IMO, the drug use is significant in that it messes up your whole system, and eventually will effect so much of it. But weather right then and there was the straw that broke the camels back, so to speak, I guess the medical examiner just could not say for sure.
I've read thay book also Kim, actually several times. It was part of my determination to find out what happened after he went into the bathroom. I try not to dwell on it....but it's so hard for me to think of someone like him..loved by millions...dying such an agonizing death. I would love to be able to say that he "never knew what hit him", but I don't think that's the case.
......I thought we were supposed to be discussing upbeat topics about Elvis
I don't think it is either. I'm such a light sleeper to, so sleeping through that as Ginger did must have been hard for her to deal with.
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