Tag Archives: Science

GILBERT PAUL JORDAN—THE “BOOZING BARBER” SERIAL KILLER

A5The term “serial killer” makes us think of hi-profile monsters like Ted Bundy, who beat and strangled his victims, or the Zodiac Killer, who shot most with a gun. There’s Clifford Olson who used a hammer. Jack The Ripper who liked his knife. And Willie Pickton who drugged his ladies, cut them apart with an electric Sawzall, then fed their pieces to his pigs.

By nature, serial killers follow a specific Modus Operandi—an M.O. peculiar to their wares. Some strangle, some shoot, some smash, and some slash. But the most unique and unsuspecting method of serial killing I’ve heard of came from Gilbert Paul Jordan, aka the “Boozing Barber”, who got his victims comatose drunk then finished them off by pouring straight vodka down their throats. He intentionally alcohol-poisoned at least nine women—possibly dozens more.

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Gilbert Jordan was a monster from the 1980’s operating in the Down Town East Side of Vancouver, British Columbia, Canada. Today, the skid row DTES of Vancouver is still one of the most dangerous, crime and drug-ridden inner cities of the world. In the DTES, the most popular drug of choice is still alcohol—ethanol as it’s known in the coroner and toxicologist world.

A6Jordan was born in 1931 and started a crime career in his twenties by kidnapping and raping a five-year-old aboriginal girl. He beat the charges and went on to commit more sexual assaults including abducting a woman from a mental institute and raping her, too. Jordan bounced in and out of jail. He continued to prey on the helpless and downtrodden, especially alcoholic women from the First Nations culture. Gilbert Jordan, himself, became a raging alcoholic and consumed over fifty ounces of vodka per day.

Jordan learned barbering skills while in prison. Between jail sentences, he set up a barber shop on East Hastings Street in the heart of Vancouver’s DTES, being a regular fixture in the seedy bar scene. He blended easily and was not at all intimidating—short, stocky, balding, with thick glasses.

Jordan was a well-known mark for buying vulnerable aboriginal women drinks and he’d take them from the bars to his barber shop or a room which he kept in a derelict hotel. Here they’d party till they passed out. It’s estimated that hundreds of women binge drank with Jordan during his spree from 1980 to 1987.

Overdose deaths in the DTES were common.

A7The majority were intravenous drug users, many having a lethal toxin level amplified with mixed use of ethanol. It’s still that way today. But overdose deaths from ethanol consumption alone are rare. Usually, heavy drinkers reach a blood-ethanol limit where they pass out—long before ethanol effects shut down their central nervous system. The few deaths from ethanol alone are almost always caused by an unconscious victim aspirating on vomit—not from reaching a lethal blood-ethanol-content. A BEC of 0.35% (35mg of ethanol per 100 milliliters of blood) is considered the start of the lethal range. Note that 0.08% is the standard for drunk driving.

During Jordan’s run, there were increasingly suspicious amounts of aboriginal women deaths from shockingly high BEC. They included:

  1. Ivy Rose — 0.51
  2. Mary Johnson — 0.44
  3. Barbara Paul — 0.47
  4. Mary Johns — 0.76
  5. Patricia Thomas — 0.51
  6. Patricia Andrew — 0.79
  7. Vera Harry — 0.49
  8. Vanessa Buckner — 0.50
  9. Edna Slade — 0.55

A8When Edna Slade was found dead in Gilbert Jordan’s hotel room, and it became apparent Jordan was the common denominator in many similar deaths, Vancouver Police put Jordan under surveillance. From October 12th to November 26th, 1987, VPD observed Jordan “search out native Indian women in the skid row area of Vancouver and take them back to his hotel room for binge-drinking”.

VPD officers listened from outside Jordan’s door and recorded him saying phrases like “Have a drink. Down the hatch, baby. Twenty bucks if you drink it right down. See if you’re a real woman. Finish that drink. Down the hatch, hurry, right down. You need another drink. I’ll give you fifty bucks if you can take it right down. I’ll give you ten, twenty, fifty dollars. Whatever you want. Come on, I want to see you get it all down. Get it right down.

On four occasions during the surveillance, police intervened and remove the comatose victims to the hospital.

A9Gilbert Jordan was convicted of manslaughter in the death of Vanessa Buckner. The prosecution used similar fact evidence from the other eight identified deaths. He was sentenced to fifteen years imprisonment. This was reduced to nine years on appeal and he served only six. When Jordan was paroled in 1994, he went right back to the business of stalking alcoholic aboriginal women. He was being watched by VPD and immediately sent back to prison for parole violation and an additional sexual assault. He served out his sentenced but was released in 2000, again returning to a life of chronic alcoholism and serial predation.

Gilbert Jordan, the Boozing Barber, died of the disease called alcoholism in 2006.

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Ethanol, or ethyl alcohol, has been used by humans for thousands of years for its relaxation effect of euphoria and lowering social inhibitions. Drinking ethanol is widely accepted around the western world and is an enormous economic force.

A12Ethanol abuse is a contributing factor in untold tragedies.

Despite ethanol’s popularity as a social interactor, the medical pathophysiology considers any amount of BEC to be clinically poisonous. Ethanol is metabolized by the liver at a rate of about 50 ml (1.7 fluid ounce) per 90 minutes. That’s like two beers or one 9-ounce glass of wine every hour and a half. Drink more than you can absorb and you’ll get drunk. Wake up still drunk and you’re hung-over.

A13The acute effects of an ethanol overdose vary according to many factors. The body mass and tolerance to the drug are primary as is the rate of consumption. Ultimately, acute ethanol poisoning depresses the body’s central nervous system, causing the respiratory system to shut down and the victim asphyxiates.

These are the average symptomatic presentations of ethanol poisoning in relation to BEC:

  • 02 – 0.07% — Intoxication and euphoria
  • 08 – 0.19% — Ataxia (loss of body control ), poor judgment, labile mood
  • 20 – 0.29% — Advanced ataxia, extremely poor judgment, nausea
  • 30 – 0.35% — Stage 1 anesthesia, memory collapse
  • 35 – 0.39% — Comatose
  • 40 +             — Respiratory failure, sudden death

A14In my time as a police officerthen as a coronerI attended lots of deaths where ethanol was a contributing factor. Very few were acute ethanol poisoning deaths, though. Many were mixed drug overdoses, especially mixing booze with prescription pills. Then there were suffocating on puke cases, suicides while pissed, fatal motor vehicle crashes driven by drunks, and violent homicides done during ethanol-fueled anger and inebriation.

Don’t get me wrong. I’m not slamming the social use of ethanol. I’ve been around the booze scene my whole life and still enjoy decent wine and good scotch, although I’ve never had a taste for beer.

A15I grew up in a socio-economic environment where rampant alcoholism was common. It was accepted. Grant RobertsonI worked with Grant in my teensGrant was proud of his breathalyzer certificate proving he was caught behind the wheel at a 0.44% BEC. True story. I saw the paper. Grant was a die-hard—a chronic alcoholic with forty years of practice. I don’t think Grant ever went below two-five.

As a young cop, I brought an old guy in for a blow. I couldn’t tell if he was drunk but he’d caused a minor car accident and slightly smelled of liquor. Legally, I had to demand a breathalyzer test. He pushed the needle to a 0.36% and I’ll never forget the breathalyzer operator’s remark “You’re no stranger to alcohol, are you?

People have different tolerances to ethanol. And different physiological responses.

A16I’ve worked with cops who were drunk on duty, seen judges half-cut on the bench, had my pilot pass out before time to depart, and I’ve woken in places unknown. I’ve had countless laughs, spent way too much money on time pissed away, and have stories from nights in the bars.

But I still can’t get clipped in my buddy Dave’s chair without thinking of Gilbert Paul Jordan, the “Boozing Barber” Serial Killer of the Down Town East Side of Vancouver.

ARE YOU INTELLIGENTLY DESIGNED?

A4I never came away from an autopsy without reflecting on the marvelous design of the human body. I don’t know how many autopsies I attended over the years as a cop and a coroner. Lots. It’s not something you score. But I always looked at postmortems as a scientific—almost spiritual—systematic exercise in examining human design. 

They’re twelve major systems in your anatomy—all interlinked to ensure your survival. Remove any system (except maybe your reproductive one) and you’ll die. And these systems go about their intermingling business—day after day—year after year—without you having to consciously think about operating them.

Think about it.

A11All that’s required to live is a bit of maintenance and, when things go wrong, modern medical science usually knows how to patch you up. Today’s medical practitioners can replace your organs, your limbs, your hair, your eyes, your nose, and your teeth.

But what modern science doesn’t know is how all this came to be.

A5I’m going to do some edited plagiarism from William  A. Dembski, of the Access Research Network, who wrote on intelligent design. The idea has been around since the ancient Greeks, who did some pretty deep thinking about where they came from and where they were going.

Some of it was explained by mythology, some by theology, and some by analogy. But the central question—did something intentionally design us—remains unanswered today.

Personally, I think there’s a force of infinite intelligence at work. A force we’re not capable of truly understanding, comprehending, or explaining.

Design theory—also called design or the design argument—is the view that nature shows tangible signs of having been designed by a preexisting intelligence.

The most famous version of the design argument can be found in the work of theologian William Paley who, in 1802, proposed his “watchmaker” thesis. His reasoning went like this:

A12“In crossing a heath, suppose I pitched my foot against a stone, and were asked how the stone came to be there; I might possibly answer, that, for anything I knew to the contrary, it had lain there forever. … But suppose I had found a watch upon the ground, and it should be inquired how the watch happened to be in that place; I should hardly think the answer which I had before given would be sufficient.” 

To the contrary, the fine coordination of all the watch parts would force us to conclude that it must have had a maker—that there must have existed, at some time, and at some place or other, an artificer or artificers, who formed it for some purpose. We’d struggle to comprehend its construction and designed its use, just as we’ve struggled to understand ourselves.

A13Paley argued we can draw the same conclusion about many anatomical objects, such as the eye. Just as a watch’s parts are all perfectly adapted for the purpose of telling time, the parts of an eye are all perfectly adapted for the purpose of seeing. In each case, Paley argued, we discern the marks of an intelligent designer.

Although Paley’s basic notion was sound and influenced thinkers for decades, Paley never provided a rigorous standard for detecting design in nature. Detecting design depended on such vague standards as being able to discern an object’s “purpose.” Moreover, Paley and other “natural theologians” tried to reason from the facts of nature to the existence of a wise and benevolent God. They tried to prove God from the perception of perfect products.

All of these things made design an easy target for Charles Darwin when he proposed his theory of evolution. 

A16Whereas Paley saw a finely-balanced world attesting to a kind and just God, Darwin pointed to nature’s imperfections and brutishness. Although Darwin had once been an admirer of Paley, Darwin’s own observations and experiences—especially the cruel, lingering death of his 9-year-old daughter Annie in 1850—that destroyed whatever belief he had in a just and moral universe.

Following Darwin’s widely-accepted theory of evolution, the notion of design was all but banished from biology.

A17Since the 1980s, however, advances in biology have convinced a new generation of scholars that Darwin’s theory was inadequate to account for the sheer complexity of living things. These scholars—chemists, biologists, mathematicians, and philosophers of science—began to reconsider design theory. They formulated a new view of design that avoids the pitfalls of previous versions.

Called intelligent design (ID), to distinguish it from earlier versions of design theory (as well as from the naturalistic use of the term design), this new approach is more modest than its predecessors. Rather than trying to infer God’s existence or character from the natural world, it simply claims that “intelligent causes are necessary to explain the complex, information-rich structures of biology and that these causes are empirically detectable.”

Like I said, I never came away from an autopsy without a scientific and spiritual reflection on the marvelous design of the human body.

What do you think? 

Have you been intelligently designed?

WAS MARILYN MONROE MURDERED?

A1No movie star lived on after death like Marilyn Monroe. She was far more than a bleached-blonde bombshell with a voluptuous frame and a lusty voice—she intuitively knew her craft. Born in poverty as Norma Jean Mortenson (aka Baker) to a mentally unstable mother, Marilyn Monroe rose to Hollywood glamor, fame, and idolization beyond what few ever reached. Tragically, by the time she died at age thirty-six, her performing career had spiraled into the same abyss her personal relationships and head space were already in.

MM10Marilyn Monroe was found dead in her Beverly Hills bed at 3 a.m. on Sunday, August 5, 1962. The scene suggested nothing suspicious—no foul play, that is—and the toxicology results from her autopsy proved she’d succumbed to a lethal dose of prescription drugs. The coroner ruled her death as “probable suicide” but, like the deaths of other uber-celebrities, many mumbled murder. Monroe’s death was reinvestigated in 1992 by the Los Angeles District Attorney who came to the same conclusion—“probable suicide”.

In today’s coroner-speak, “probable” is not in the official vocabulary. Neither is “possibly”. Everywhere in the civilized world, coroners are mandated by legislation to rule a manner of death as being in one of five categories: natural, homicide, accidental, suicide, or undetermined. Now, fifty-four years later, an impartial look at Monroe’s case facts indicate her manner of death should not be ruled as a suicide.

But was Marilyn Munroe actually murdered?

A7On the day of her death, Marilyn Monroe was in the company of many people, none of who reported any immediately implied threat or perceived action from Monroe that suggested an imminent danger of suicide, nor any behavior that was outside of her already troubled mental state of manic highs and depressive lows. She’d a history of emotional instability that, today, would likely be classified as Bipolar II Disorder and she was under the continual care of a general physician and a psychiatrist. Monroe was no stranger to prescription pharmaceuticals, specifically anti-depressants and sleeping pills, but she was a relatively light alcohol drinker.

Marilyn Monroe had a difficult year in 1961. She worked very little due to health issues. Besides her emotional imbalance and substance dependency, she underwent surgery for endometriosis (uterus ailment) and a cholecystectomy (gall bladder removal), then suffered a painful attack of sinusitis. Her stress level soared from a lawsuit with 20th Century Fox where they sued Monroe for breach of contract—her erratic behavior led to delays in filming, disputes with cast and crew, then finally a stop of production.

A14On Saturday morning, August 4, Marilyn Monroe met with her official photographer and discussed an upcoming Playboy deal, then kept a massage appointment, a meeting with her publicist, talked with friends on the phone, and signed for deliveries for her house renovation. She was visited by her psychiatrist, Dr. Ralph Greenson, in the late afternoon for a scheduled therapy session. Greenson left around 7 p.m. and reported no alarming behavior, however he ensured that Monroe’s housekeeper, Eunice Murray, would be staying overnight.

Marilyn Monroe retired to her bedroom around 8 p.m. The last person to have contact with Monroe was actor Peter Lawford who invited her to a Hollywood party. He reported that in their phone conversation Monroe sounded tired—sleepy—as under the influence of drugs. After their call, Lawford became alarmed and phoned back to the house where he got Murray. She assured him everything was fine with Monroe.

A22At 3 a.m. on Sunday morning, Eunice Murray woke and noticed light coming from under Monroe’s bedroom door. Sensing something not right, Murray tapped on the door. There was no response so she tried the handle and found it locked, which she stated was unusual.

Now alarmed, Murray phoned Dr. Greenson who instructed her to go outside and look through the bedroom window. She did and observed Marilyn Monroe lying facedown on the bed, covered in a sheet, and clutching a telephone receiver in her right hand.

Greenson arrived at approximately 3:20 a.m., broke the window with a fireplace poker, and climbed in. Immediately he could tell Monroe had been dead for some time and it was pointless to call an ambulance or attempt resuscitation. Greenson phoned Monroe’s physician, Dr. Hyman Engelberg, who arrived at around 3:50 a.m. Engelberg examined Monroe by removing the phone receiver and rolling her over, officially pronouncing death. At 4:25 a.m. they notified the LAPD.

MM2The attending detective agreed with the two doctors that there was nothing to indicate foul play and the death was most likely a drug overdose. The detective photographed the scene and recorded the “pill count” of the pharmaceutical vials on Monroe’s nightstand. Dr. Engelberg noted a vial containing twenty-five capsules of the barbiturate Nembutal that he’d prescribed two days earlier was empty. Vials with other prescriptions appeared in order including one containing the sleeping sedative Chloral Hydrate.

Marilyn Monroe was autopsied on the morning of August 6 by pathologist Dr. Thomas Noguchi who would later be known as “Coroner To The Stars” for his many postmortem exams on celebrities. His original autopsy report is on the public record and can be downloaded. Click Here.

A20Noguchi is very clear in his report and many subsequent interviews that he found no evidence of physical trauma—specifically needle marks—on Monroe’s body. Based on his observations and those of Drs. Greenson and Engelberg regarding Monroe’s rigor, livor, algor, and palor mortis conditions, he felt reasonable to estimate her time of death between 8 and no later than 10 p.m. the previous night. Noguchi found no natural cause of death and waited for the toxicology report before forming his final conclusions.

The tox screen was done by the LA County Coroner’s laboratory and released on August 13. The results concluded  Monroe’s blood contained 4.5 milligrams (percent) of Nembutal and 8.0 milligrams (percent) of Chloral Hydrate. Her liver contained 13.0 milligrams (percent) of Pentobarbital. Blood ethanol (alcohol) was absent.

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Noguchi was satisfied the combination of Nembutal and Chloral Hydrate levels in Monroe was sufficiently high to cause her death through respiratory and central nervous system failure and he knew the Pentobarbital stored in her liver was simply indicative of someone who had long exposure to barbiturates and developed a “tolerance”. Noguchi certified the cause as “acute barbiturate poisoning due to ingestion of overdose” but he was reluctant to rule the classification as “suicide”. Though Noguchi was certain no evidence existed to suggest the death was an intentional homicide, he was uncomfortable with there being no clear evidence that Monroe intended to take her own life.

There were no immediate threats, no suicide note, no warning behavior, and not all the Chloral Hydrate pills were consumed, not like the Nembutal.

A23It might be an accidental OD, Noguchi thought, and he was troubled by the fact Monroe had been prescribed the amounts of Nembutal and Chloral Hydrate at the same time—her physician had to have known they’d be lethal if mixed a large quantity.

Noguchi was under pressure—political pressure, if you will—from the elected Chief Coroner of Los Angeles County to shut down media speculation that there might be more to Monroe’s death than a sad case of a despondent star intentionally extinguishing her light. The Chief and Noguchi reached a temporary compromise that they’d say Monroe’s death was a “probable” suicide.

A21Noguchi didn’t go so far as to insinuate negligence by Monroe’s caregivers might be the smoking gun, yet he requested a “psychological autopsy” to investigate Marilyn Monroe’s mental state leading to her death. Without clear evidence of an intentional suicide, the pattern of Monroe’s behavior was crucial in corroborating a suicide rule.

This statement was issued by LA County Chief Coroner Theodore J. Curphey. It’s an addendum to Noguchi’s final autopsy report:

“Following is the summary report by the Psychiatric Investigative Team which assisted me in collecting information in this case. The team was headed by Robert Litman, M.D., Norman Farberow. Ph. D., and Norman Tabachnick, M.D.:

‘Marilyn Monroe died on the night of August 4th or the early morning of August 5th, 1962. Examination by the toxicology laboratory indicates that death was due to a self-administered overdose of sedative drugs. We have been asked, as consultants, to examine the life situation of the deceased and to give an opinion of the intent of Miss Monroe when she ingested the sedative drugs which caused her death. From the data obtained, the following points are the most important and relevant:
Miss Monroe suffered from psychiatric disturbance for a long time. She experienced severe fears and frequent depressions. Mood changes were abrupt and unpredictable. Among symptoms of disorganization, sleep disturbance was prominent, for which she had been taking sedative drugs for many years. She was thus familiar with and experienced in the use of sedative drugs and well aware of their dangers.
Recently, one of the main objectives of her psychiatric treatment had been the reduction of her intake of drugs. This has been partly successful during the last two months. She was reported to be following doctor’s orders in her use of drugs; and the amount of drugs found in her home at the time of her death was not unusual.
In our investigation, we have learned that Miss Monroe had often expressed wishes to give up, to withdraw, and even to die. On more than one occasion in the past, when disappointed and depressed, she made a suicide attempt using sedative drugs. On these occasions, she had called for help and had been rescued.
From the information collected about the events on the evening of August 4th, it is our opinion that the same pattern was repeated except for the rescue. It has been our practice with similar information collected in other cases in the past to recommend a certification for such deaths as a probable suicide.
Additional clues for suicide provided by the physical evidence are:
(1) the high level of barbiturates and chloral hydrate in the blood, which, with other evidence from the autopsy, indicate the probable ingestion of a large amount of drugs in a short period of time;
(2) the completely empty bottle of Nembutal, the prescription for which was filled the day before the ingestion of drugs; and
(3) the locked door which was unusual.’

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Now that the final toxicological report and that of the psychiatric consultants have been received and considered, it is my conclusion that the death of Marilyn Monroe was caused by a self-administered overdose of sedative drugs and that the mode of death is probable suicide.

– Theodore J. Curphey, M.D. Chief Medical Examiner-Coroner for the County of Los Angeles, August 13, 1962.”

There’s that word “probable” again.

A24In my time as a police officer and coroner, I’ve attended many drug overdose deaths. Some were clearly suicides, backed-up by threats and notes. Some were accidents by misadventure, usually mixed with alcohol. And some were undetermined—not shown to have a definite intent by the decedent to take their own life.

I’d say some of the undetermined deaths were probably suicides—if I could say it. But a coroner doesn’t have the legal option to say “probably”. There’s a long-held  court ruling called the Beckon Test that states a death can only be classified as a suicide if it can be determined that the individual knew the consequences of their actions would end in death and intentionally carried them out. There is a high standard of proof required for a finding of suicide as the ruling states:

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“In most legal cases the test to be satisfied is a balance of probability. But a determination of suicide can only be made where there is clear and convincing evidence. There is to be a presumption against suicide at the outset and one must be certain beyond a high degree of probability that the death was a suicide. Where one cannot be absolutely certain, the death must be classified as undetermined.”

Based on my death investigation experience, there are three points about Marilyn Monroe’s suicide ruling that bother me.

First, in all the polypharmacy overdoses I’ve seen where suicide was obvious, the deceased downed the whole darned stash.

A30In Monroe’s case, Dr. Engelberg prescribed her 50 caps of 500 mg Chloral Hydrate on July 31 as a refill for a previous Chloral Hydrate order on July 25. She was taking 10 per day. At her death scene, there were still 10 Chloral Hydrate caps left in her bedside vial. 40 were gone and, at a rate of 10 per day from July 31 till August 4, the pill count is right in order.

In the toxicology world, the effects of drugs are rated on a range scale of Therapeutic, Toxic, and Lethal. In the Lethal range, the substance is given a value called LD50 where it’s expected that 50 percent of the population would be expected to die from the drug’s effect at a certain point based upon the drug’s milligram blood content per the kilogram weight of the person.

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Marilyn Monroe’s autopsy report recorded her weight at 117 pounds or 53.2 kilograms. The Chloral Hydrate level in her blood was determined to be 8.0 milligrams (percent) based on her weight or 80 parts per million (ppm). Looking at my toxicology scale from my coroner days, I see that Chloral Hydrate has a Therapeutic range to 30 ppm and an LD50 value at 100 ppm, so Monroe was 20% under the Chloral Hydrate lethal bar.

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Looking at her barbiturate blood content from the Nembutal, it’s recorded to be 4.5 mg (percent) or 45 ppm. My chart says the barbiturate Pentobarbital, which is what’s in Nembutal, has a Therapeutic range to 12 ppm and an LD50 at 40 ppm. So Monroe was only 12.5 % over the average barbiturate lethal threshold, not taking into account that she was a very “tolerant” user.

However, the combination of Chloral Hydrate and Nembutal was deadly and this had to be known by Dr. Engelberg when he ordered Monroe’s prescription. This brings me to my second point.

A29A physician has a professional duty of care to their patient, especially when prescribing medication to a person with Monroe’s mental history. I find it irresponsible, actually negligent, that Dr. Engelberg failed to ensure Monroe no longer had Chloral Hydrate in her possession when he issued her a prescription for 25, 1500 mg caps of Nembutal four days later, knowing her supply of Chloral Hydrate wasn’t exhausted based on her prescribed consumption.

My third point deals with the “rescue” issue.

This very much applies to the Beckon Test. Intentional overdoses as attention-getting devices are common and always rely on the person’s backup plan that someone will intervene. This was part of Monroe’s previous overdose episodes as noted in the “psychological autopsy” report. And they referenced Monroe’s locked door as being unusual.

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I think the locked door issue is completely negated by the fact that Monroe was found with her telephone receiver in hand. This was stated by Eunice Murray, Dr. Greenson, Dr. Engelberg, and corroborated by the investigating detective who verified they reported this to him and suggested she was phoning for rescue—which was her pattern—but was overcome.

If I were the coroner ruling on the manner of Marilyn Monroe’s death, I’d be legally bound to consider how the facts apply to the parameter of categories.

MM1A natural cause determination is completely eliminated by the autopsy and toxicology evidence. Monroe clearly died as the result of a drug overdose.

Despite kooky conspiracy theories that Bobby Kennedy snuck in and injected Marilyn Monroe to cover up her alleged affair with President Jack or that mobsters Jimmy Hoffa and Sam Giancana knocked her off to keep from ratting them out, no sensible person can make a case that Monroe was intentionally murdered. But a homicide ruling doesn’t just apply to murder. The definition of homicide is “the killing of a human being due to the act or omission of another”.

I believe Dr. Engelberg was professionally negligent in his duty of care to Marilyn Monroe. He had to know—certainly ought to have known—that he was treating an emotionally unstable patient with a history of suicide attempts through polypharmacy. By giving Monroe a potentially lethal amount of barbiturates and not ensuring her chloral hydrate was gone, Engelberg effectively signed her death warrant.

However negligent Engelberg may have been, though, my suspicion falls far short of the burden necessary for establishing a homicide conclusion.

A3That Monroe accidently died from a self-administered overdose is a distinct probability but, again, the Coroners Act and court precedents won’t allow me the liberty to rely on probabilities regarding suicide. I have to come to a clear conclusion based on facts.

Setting aside the locked door and phone receiver in hand—these two negate each other—I must defer to one other glaring fact. There were still 10 caps of Chloral Hydrate left in her pill vial. Marilyn Monroe was a very experienced and tolerant prescription pill user. She knew exactly what she was taking, what their effects were, and she failed to down her whole darned stash which is always proof of a polypharmacy overdose suicide.

A4So deferring to the Beckon Test, I have to presume against Marilyn Monroe’s suicide from the outset and must be satisfied beyond a high degree of probability that her death was a suicide—I must be certain—and I can’t—because no clear evidence exists that Monroe’s death was an intentional act to end her own life. It may well have been an unfortunate, unrescued accident.

Therefore, I find Marilyn Monroe’s manner of death as Undetermined.