SOLVING THE 5,000-YEAR-OLD MURDER OF “OTZI THE ICEMAN”

A7In 1991, the mummified body of a 5,000-year-old murder victim was discovered in melting ice at a rock-gully crime scene high in the Italian Otzal Alps. Nicknamed “Otzi”, the estimated 45-year-old man and his possessions were incredibly well preserved. His skin, hair, bones, and organs were cryopreserved in time, allowing archeological researchers a phenomenal insight into human life in the Copper Age.

The frozen-in-time corpse also gave modern science the opportunity to forensically investigate and positively determine how Otzi The Iceman was killed.

A44On a sunny September day, two hikers were traversing a mountain pass at the 3210 meter (10,530 foot) level and saw a brown, leathery shape protruding from the ice amidst running melt-water. Closely examined, it was a human body which they thought might be the victim of a past mountaineering accident.

They reported it to Austrian police who attended the following day and quickly realized they were dealing with an ancient archeological site. A scientific team was assembled and, over a three-day period, the remains were extracted and taken to the Institute of Forensic Medicine in Innsbruck.

B9Such an incredibly valuable find soon led to a jurisdictional argument between the Austrian and Italian governments and an immediate border survey was done, finding Otzi had been lying ninety-two meters inside of Italian territory. Italy gained legal possession of the body and artifacts, however in the interests of science and history, everything was kept at Innsbruck until a proper, climate-controlled facility was built at the South Tyrol Museum of Archaeology in Bolzano, Italy, where Otzi the Iceman now rests.

Many, many questions arose. Who was he? Where did he come from? How long ago did he live? And, of course, what caused his death?

Technological advances over the past twenty-five years have answered some questions surrounding Otzi’s life and death and surely the next twenty-five will answer more. This, so far, is what science knows about the Iceman.

A6Otzi was found lying face down with outstretched arms in a protected, rock depression near the Finail Peak watershed at the top of the Tisenjoch pass which connects two forested valleys. The trench measured 40 meters (131 foot) long, between 5 and 8 meters (16–26 foot) wide, and  averaged 3 meters (10 feet) deep. For millennia, this area was covered by glaciers which, by the end of the twentieth century, had receded.

Four separate scientific institutes conducted C-14 radiocarbon dating on Otzi, equivocally agreeing he came from between 3350 and 3100 BC — more than 5,000 years ago. This was the oldest-known preserved human being; far older than the Egyptian and Inca mummifications or the corpses found pickled in peat bogs.

A8Something exceptionally unique about Otzi was that he was a “wet” mummy—an almost unheard of process for a cadaver of this age where humidity was preserved in his cells, unlike the intentional dehydration processes used in Egypt and Peru. As well, Otzi was perfectly intact and not dissected or embalmed by a funeral ritual. His entire body achieved a state of elasticity and, although shrunken, remained as in the day he died including vital clues stored in his digestive tract.

Researchers felt Otzi must have been preserved through a chain of coincidences. It was evident that no damage had been done by predators, scavengers, or insects so it was obvious that the body was covered by snow and/or ice immediately after death. Secondly, the gully lay perpendicular to the main ice flow, allowing the grinding action of the glacier to pass overtop. Thirdly, exposure to air and sunlight was only a brief period before being found by the hikers.

It was vital Otzi remain frozen to avoid an irreversible decomposition and remain intact to preserve his historical significance. This gave researchers limited ability to examine the cadaver as would be done in a conventional autopsy.

B3A thorough external exam was done in 1991 along with Xray radiography images. Notable was a cut to the back of the right hand which showed early signs of healing as well as breaks to the left ribcage, which had healed, and breaks to the right ribs which were fresh at the time of death. A depression in the skull was thought to be caused by the weight of ice compression and analysis of the only remaining fingernail found that the Beau-Reil Lines, which are like rings on a tree trunk, showed significant stress to his immune system in three periods—16, 13, and 8 weeks before death.

A46Other factors told of Otzi’s failing health—understandable for a 45-year-old in the Copper Age who’d then be considered elderly. He suffered from tooth decay, gum disease, and worn joints. What shocked the researchers were the amounts, designs, and placement of tattoos on Otzi’s body. There were 61 separate markings, all made by incisions and insertion of charcoal—not ink as has been used by other cultures for centuries. The locations were consistent with known acupuncture points as practiced for pain relief thought to be discovered by the Chinese two thousand years after Otzi’s existence. It seemed these markings were therapeutic, rather than symbolic.

Despite examination by many leading experts, no exact cause of Otzi’s demise was determined and it was speculated this old man may have fallen, injured himself, then succumbed to the elements. That was until new technology was developed.

A47One of the great challenges was to examine Otzi endoscopically—that is to look internally at his organs. Special high-precision titanium instruments were invented—steel probes that were inserted through tiny incisions in Otzi’s back. Using computerized navigational aids, the tools were guided to exact spots were evidentiary samples could be taken. This was recorded with a hi-definition camera and an entire 3-D map of the mummy’s thorax and abdomen was made.

Lung and digestive tract contents told a time-of-year travel story through the presence of thirty different pollens which entered Otzi’s body by the food he ate, the water he drank, and the air he breathed.

A48Most pollens were from trees and indicated he ingested them during a bloom in the late spring or early summer. The locations and digested states of different pollens in different sections of the stomach and intestines showed Otzi had made a climb from the valley floor to the top of the pass where he died within a twenty-four hour period. Pollens in the lower gastrointestinal tract were identified to low elevation trees and pollens in the upper GI were from higher elevation species.

So, it was known that Otzi had left the populated valley and headed for high country where he met his death. Speculation rose that he might have been fleeing some danger.

A3This theory strengthened in 2001 when new Xrays identified a small, flint arrowhead in Otzi’s left shoulder which was missed ten years earlier. A close examination of Otzi’s back revealed a two-centimeter slash and established the arrow’s path. He’d been shot from a rear and lower position.

In 2005, Otzi was put through a high-resolution, multi-slice CT scanning machine which enlightened the arrow wound. Clearly, the arrowhead had caused a one-centimeter gash in Otzi’s left subclavian artery which is the main circulatory pipeline that carries fresh oxygenated blood from the heart to the left arm. Such a serious tear would have caused massive internal bleeding and rapid death—probably within two minutes.

A49The CT scan showed something else. There was serious bleeding at the base of the brain which corresponded to the depression in Otzi’s skull. He’d suffered a serious head injury right at the time of death. With the cause of death now certain to be from a violent act of homicide, the prime question centered on the circumstances of how all this went down.

Researchers felt the answer may lay in the Iceman’s possessions.

A50Among the artifacts found on and around Otzi’s body were a copper ax, a flint dagger, a quiver with twelve blank arrow shafts and two completed arrows with stone heads. There was also winter clothing and supplies to support wilderness survival.

This speaks to motive, for if robbery was behind Otzi’s murder, it’s certain that the perpetrator(s) would have made off with these valuables. Glaringly missing was the shaft of the fatal arrow, especially in light of Otzi’s quiver arrows being perfectly preserved.

A51Egarter Vigl, a leading archeological expert on the Iceman, believes that the assailant tried to pull out the fatal arrow to destroy evidence, only to snap off the arrowhead inside. Vigl was quoted in the archeology magazine Germani, “telltale markings in the construction of prehistoric arrows could be used to identify the archer much in the way modern ballistics can link a bullet to a gun. The killer yanked out the arrow to cover his tracks. For similar motives, the attacker did not run off with any precious artifacts that remained at the scene, especially the distinctive copper-bladed ax; the appearance of such a remarkable object in the possession of a villager would automatically implicate its owner of the crime.”

I’d have to agree with Mr. Vigl, and I’d like to add an observation of my own.

A33In the hundreds and hundreds of dead bodies I’ve examined as a cop and a coroner, I’ve never seen a cadaver with its arms outstretched in a hyperextended position like how Otzi the Iceman was found. This is absolutely unnatural and shrieks to me that someone placed the arms in that position after death.

I think it’s safe to speculate on what might have happened and here’s what Otzi’s crime scene evidence suggests to me.

A52The day before Otzi’s death, he was in a physical altercation down at the village on the valley floor where he suffered the cut hand and possibly the broken right ribs. This caused him to pack up and flee, climbing to the elevated pass where he was overcome by his attacker(s) and shot with the arrow from behind and below. This wound would have put Otzi into hemorrhagic shock and he would have quickly collapsed and internally bled out. Following his collapse, the murderer(s) went up and caved-in the back of Otzi’s head to finish him off.

I don’t think this happened in the gully. I’ve looked at the scene photos and can’t envision how Otzi could have been shot from below in that tight gully, which is what the forensic evidence clearly shows on the arrowhead’s track through the body—even if Otzi were bending over.

A53No, I suspect Otzi was shot elsewhere, dragged by the arms, dumped in the gully with all his possessions, rolled over to remove the arrow, and then covered with ice and/or snow to hide the crime.

After 5,000 years, the answers to “By who?” and “For what reason?” are unlikely to be known—despite what future technology might bring—and the murder of Otzi the Iceman will always remain a really cold case.

*   *   *

For a fascinating look at the entire Otzi story, including exceptional photos, visit the official website www.Iceman.it at the South Tyrol Museum of Archaeology in Bolzano, Italy. Click Here

THE EXCRUCIATING DEATH OF MISTER RED PEPPER PASTE MAN

A17“Sounded like someone was skinning a live cat,” the neighbor told us. She sniffed, wiping her eyes. “Then loud crashing and banging, then… everything went quiet. I waited a while, didn’t hear nothing more, so I went and checked and found him dead on the floor.” 

I was in my first year of coroner understudy and shadowing my mentor, senior coroner Barbara McCormick. We were in the kitchen of a tiny suite on the poor side of town, standing over this skinny, old guy who was in a semi-fetal position with one arm wrapped around his abdomen and his other hand clutching his throat. I’ll never forget his wide-open eyes or the gritting grimace of teeth—the expression of excruciating pain etched in a cold, deathly stare.

“Heart attack or brain aneurysm, Barb?” I asked, ready to flip a coin. I was new to the coroner service, but no stranger to dead bodies after a career as a homicide cop. There was zero sign of foul play at this scene and my experience told me people only drop dead from one of these two natural events.

A19Barb was bent over, starting the head-to-toe examination that coroners do before removing a body for a thorough autopsy back at the morgue. “Wouldn’t bet on either.” Barb was trying to pry his jaw for a look down the throat. “Check his color. Blue-gray. He’s asphyxiated. I’m thinking he might have choked on something but, for the life of me, I don’t know how he could let out a curdling cat-scream if something was stuck in his yap.”

While Barb was messing with his head, I snooped around. It was typical digs for a single pensioner—a bachelor suite crammed with junk. Empty booze bottles and overflowing ashtrays testified to a lifestyle that suggested he should be dead of something by now. I checked for meds, which was routine. The pathologist would want to know what was likely in his system and the toxicology lab would want it for sure.

A20I found the usual pill vials indicating treatment for coronary and respiratory ailments that heavy drinkers and smokers all have. The place was relatively clean, although cluttered, and didn’t reek of garbage and bodily waste like most of these places do. I saw a part-eaten sandwich on the table and a freshly cracked beer—seemed like the old boy was doing lunch when violently seized by the death monster and taken down hard to the mat.

Barb stood up, looking puzzled. “I have no idea. Should be an interesting postmortem.” We finished photographs, bagged the man, then stretchered him out to the transport van and drove him off to the morgue.

We’d recorded his personal details, which is part of a death investigation, but his real name never stayed with me. Most are like that. In the death business it’s not a good idea to get too close to your clients, but some you never forget because of how they checked out.

A15It’s normal—in black humor behind the scenes—for coroners to name their files by earned handles. I’ll always remember Capn’ Crab Bait, Voltage Vern, Methlab Mikey, Arachnoid Ann, Lawn Tractor Guy, Tarzan of the Caterpillars, Freight Train Ference, The Krosswalk Kidd, The Drill Sergeant, Pole Dancer, Cats-Sup, and… as long as I live… I’ll never forget The Electric Carving Knife Lady.

And, it came to pass, I’ll also never forget the dead little man we’d just rolled into the cooler. 

Next morning my favorite pathologist, Dr. Elvira Esikanian, was on the roster to autopsy our guy from the kitchen floor. I loved dealing with Elvira. She’s Bosnian with a wicked sense of dry humor and an equally wicked curriculum vitae, including exhuming mass graves for the UN and serving in some of the busiest morgues around the world where she’d often do a dozen different cuttings per day.

A21Although Elvira was exceptionally thorough, she was a go-to-the-throat prosector. She’d assess the circumstances, then head straight to the most likely cause.

“I’m suspecting an acute respiratory event,” Elvira stated. “Note the petechiae in the eyes.” She pointed to pricks of blood in his whites. “We normally see petechiae in cases of sudden and severe loss of oxygen, such as in strangulation, although on this man I see no sign of exterior trauma.”

We Y-incisioned the thorax/abdominal cavities and began removing organs.

A16“His lungs are clear, with the exception of tobacco effects.” Elvira had cross-sectioned them. “And his airway is unobstructed. This man did not choke, nor was he suffocated by fluid.” She examined the heart, which showed expected signs of advanced coronary artery disease. “And he did not suffer a heart attack.” Elvira placed the gastro-intestinal tract in a plastic tub and set it aside on her bench.

She proceeded straight to a cranial exam, inspecting for the tell-tale bleed of a cerebral hemorrhage. “Nothing obvious here.” Elvira put the brain in a stainless bowl. “You indicated this man was eating lunch when he expired.” She looked at me. I nodded. She reached for her plastic tub. “I’m going to examine the stomach.”

A22For most pathologists and coroners, digging in the digestive tract is the most unpleasant part of the job. It was no different with this man. Elvira incised the stomach and poured its contents into a clear, glass tray. She flipped on her magnifiers and bent a gooseneck light overtop. Immediately, she let out a wolf-whistle. “Look at this!”

To me, it was a messy slime-goo of chewed bread mixed with some rude and red, pasty substance.

To Elvira, it was the smoking gun.

A25I watched Elvira excise a culture, fix it in a slide, and examine it under her microscope. “Have a look.” She directed me to the eyepieces.

What I saw was a squiggling biological mass of sub-terrain aliens—looking out-of-this-world like agitated, animated, turquoise tampons breathlessly mingling in a magnified mess of greenish-gray snot.

I swear they had heads, horns, and hoofs.

Clostridium  Botulinum,” Elvira announced. “Botulism. I’m sure this man died from the deadliest food poison known.” 

Now, I’d heard of botulism. Everyone has. That’s why my mum would sniff the tin cans when she opened them and why she’d boiled preserves for four hours. But this was the first time I’d seen a real case of botulism.

A12“We won’t know the strain or the severity level until we get toxicology results but I can tell you, given how quickly this poor fellow expired, it must be an extremely toxic ratio.” Elvira went on. “What happens is the neurotoxin produced by the botulinum bacteria acts as a blocking agent preventing neurotransmitters from issuing instructions to the muscles. Once this poison hit his system, every nerve in his body would have felt on fire and he’d quickly fall into total paralysis. That would soon stop his lungs and he’d fall into a state of anoxia, or lack of oxygenated blood to the brain. He’d be conscious throughout and would feel everything… but would be unable to react.”

She glanced at the cut-open cadaver on her examining table. “What a positively excruciating way to die.”

A8Barb McCormick already had her digital camera out and was scrolling through shots from the scene. “This might be it.” Barb enlarged a photo showing the kitchen. Evident was a jar with its top off, containing a reddish substance.

Realizing the lethality of the situation and the danger to others, Barb and I immediately went back to the apartment. There, on the counter, was a jar of red pepper paste with a label indicating it originated in China and was far past its expiry date. A tag showed it’d been purchased at the Dollar Store.

Cautiously, we peered inside.

And—I’m here to tell you—that red, peppery, pasty scum was actually moving.

A26It took over a month for the toxicology results to come back. They proved positive for Botulinum toxin—Type E—and the dosage was staggering.

Toxicology measures the presumed lethal dose of a substance in digital units of LD50/ (mg/kg) which translates to the Lethal Dose (LD) required to kill half of the tested laboratory animals in a controlled volume and time.

The LD for Botulinum toxin is 0.00001. Our red pepper paste man’s reading was over 0.02000—two thousand times the amount needed to kill a human being.

*   *   *

A27It’s been a few years since the red pepper paste case and I thought I’d review the pathology around Botulinum toxin. Here’s a quote from a paper by the World Health Organization on the medical process of how botulism works on the human body:

To understand the role of Botulinum toxin, it is necessary first to understand how the brain initiates a muscle contraction as it is in this process that Botulinum toxin intervenes.
Muscles are connected to the brain by the nervous system which is a complex network of neurons – these are long cells that can pass information using either electrical or chemical signals. Chemical signals pass between neurons and muscles through synapses, which are specialized connections linking cells. The chemicals that are used to pass these messages are called neurotransmitters.
A30In the case of a muscle contraction, the chemical signal is passed using a neurotransmitter called acetylcholine. This sits in the neuron in a vesicle, a small bubble surrounded by a membrane, until it is required. When the neuron receives a message from the nervous system to initiate a muscle contraction, the acetylcholine is released from the vesicle and passes through the synapse into the muscle fiber.
To achieve this, the vesicles need to be transported to, and fuse with, the neuron membrane that adjoins the synapse between the nerve and the muscle. This process is controlled by a group of proteins called the SNARE complex.
A29The three main proteins involved are Syntaxin (which connects to the nerve membrane), Synaptobrevin (which connects to the vesicle) and SNAP-25 (which helps the other SNARE proteins link up). These proteins join together to cause the vesicle to move to the nerve membrane and fuse with it. The acetylcholine can then be released across the synapse and pass into the muscle. This then triggers a chain of events that causes the muscle contraction.
Botulinum toxin prevents the release of acetylcholine through the synapse.
Botulinum toxin is produced by a bacterium called Clostridium Botulinum. This bacterium is associated with causing botulism, a rare but deadly form of food poisoning.
A33Botulinum toxin is exceptionally toxic but, when purified and used in tiny, medically controlled doses, it can be used effectively to relax excessive muscle contraction and is now commonly used in cosmetic surgery.

Hmmm… BOtulinum TOXin… BoTox. 

A23The same gruesome stuff in the red pepper paste that painfully killed our old man is commonly stuck into people’s faces to make them look younger and pretty.

I’m sure, for the most part, BoTox injections are perfectly safe. But… if you’re thinking of cosmetically shedding some years, remember the Excruciating Death of Mister Red Pepper Paste Man.

ELVIS PRESLEY — WHAT REALLY KILLED THE KING

A10Elvis Presley suddenly dropped in the bathroom of his Graceland mansion on the afternoon of August 16, 1977. He was rushed to Baptist Memorial Hospital in Memphis, Tennessee, pronounced dead, then shipped to the morgue and autopsied the same afternoon. Three days later, the coroner issued Elvis’s death certificate stating the cause as “hypertensive cardiovascular disease with atherosclerotic heart disease” — heart attack for short.

However, toxicology results soon identified ten pharmaceutical drugs in Elvis’s system with codeine being ten times the therapeutic level. This started accusations of a cover-up and suggesting conspiracy theories of a sinister criminal act.

Pushing forty years after, modern medicine and forensics took a new look at the Presley case facts and indicated that something entirely different from a heart attack or a drug overdose really killed the King of Rock & Roll.

A14Hindsight being twenty-twenty, let’s first look at how death investigations should be conducted.

Coroners are the judge of death and it’s their responsibility to establish five main facts surrounding a death. (Coroners are not to assign blame.) In the Presley case, the facts determined at the time were:

Identity of Deceased — Elvis Aaron Presley.

Time of Death — Approximately 2:00 p.m. on Tuesday, August 16, 1977.

Place of Death — 3754 Elvis Presley Boulevard, Memphis, Tennessee.

Cause of Death — Heart attack.

Means of Death — Chronic heart disease.

A27There’s a distinct difference between Cause of Death and Means of Death. Cause is the actual event. Means is the method in which death happened. Examples are cause being a ruptured aorta with means being a motor vehicle crash, or cause being massive cerebral interruption with means being gunshot wound to the head.

Once the facts are known, it’s the coroner’s duty to classify the Manner of Death. There are five universal classifications:

  • Natural.
  • Homicide.
  • Suicide.
  • Accidental.
  • Undetermined.

A19Elvis Presley’s death was ruled a natural event, thought at the time as being an acute cardiac event from existing cardiovascular disease. If the coroner determined Elvis died from a drug overdose, the ruling would have been accidental. No one ever claimed it was suicide or homicide.

One principle of death investigation is to look for antecedent evidence—preexisting conditions which contributed to the death mechanism or was responsible for causing or continuing a chain of events that led to the death.

Another principle of death investigation is examining the triangle of Scene—Body—History. This compiles the totality of evidence.

Let’s look at the evidence in Elvis Presley’s death.

Scene

A18Elvis was found on his bathroom floor, face down in front of the toilet. It was apparent he’d instantly collapsed from a sitting position and there was no sign of a distress struggle or attempt to summon help. When the paramedics arrived, he was cold, blue, and had no vital signs. Rigor mortis had not set in so he’d probably expired within the hour. He was transported by ambulance to Baptist Memorial Hospital where a vain attempt at resuscitation occurred because “he was Elvis”. He was declared dead at 3:16 p.m. and was shipped to the morgue where an autopsy was promptly performed.

There was no suggestion of suicide or foul play so there was no police investigation. The scene wasn’t photographed, nor preserved, and there was no accounting for what medications or other drugs might have been present at Graceland.

Body

A12Elvis was in terrible health. His weight was estimated at 350 pounds and he was virtually non-functional at the end, being mostly bed-ridden and requiring permanent nursing care. He suffered from an enlarged heart which was twice the size of normal and showed advanced evidence of cardiovascular disease in his coronary vessels, aorta, and cerebral arteries—certainly more advanced than a normal 42-year-old would be. His lungs showed signs of emphysema, although he’d never smoked, and his bowel was found to be twice the length of normal with an impacted stool estimated to be four months old. Elvis also suffered from hypogammaglobulinemia which is an immune disorder, as well as showed evidence of a autoimmune inflammatory disorder.

Toxicology tested positive for ten separate prescription medications but showed negative for illicit drugs and alcohol. The only alarming pharmaceutical indicator, on its own, was codeine at ten times the prescribed manner but not in lethal range.

History

A11Elvis was born on January 8, 1935 in Tupelo, Mississippi and had a twin brother who died at birth. As a youth, Elvis was active and healthy which continued during his time in the army and all through his early performing stage when he was a bundle of energy. He began experimenting with amphetamines, probably to enhance his performances, but shied from alcohol as it gave him violent tendencies.

In 1967, Elvis came under the primary care of Dr. George Nichopoulos who was well-known to celebrities. Then, Elvis was 32 and weighed 163 pounds. His only known medical ailment was slightly high blood pressure, presumably due to his high-fat diet.

Also in 1967, Elvis’s health took a sudden turn with progressive chronic pain, insomnia, hypertension, lethargy, irrational behavior, and immense weight gain. Over his remaining years, Elvis was seen by a number of different doctors and was hospitalized a number of times, all the while resorting to self-medication with a wide assortment of drugs from dozens of sources.

A20Doctor Nick, as Nichopoulos was called, stayed as Elvis’s personal physician till the end and was present at the death scene, as well as during the autopsy. Doctor Nick concurred with the coroner’s conclusion that the cause of death was a natural cardiac event resulting from an arrhythmia, or sudden interruption of heartbeat, and agreed that Elvis’s death was not due to a drug overdose.

When the toxicology report  was released, it came with a qualifier:

“Diazepam, methaqualone, phenobarbital, ethchlorvynol, and ethinamate are below or within their respective ranges. Codeine was present at a level approximately 10 times those concentrations found therapeutically. In view of the polypharmacy aspects, this case must be looked at in terms of the cumulative pharmacological effect of the drugs identified by the report.”

A21Because the tox report appeared to contradict the autopsy report’s stated cardiac cause of death, a prominent toxicologist was asked to review the findings. His opinion was:

“Coupled with this toxicological data are the pathological findings and the reported history that the deceased had been mobile and functional within 8 hours prior to death. Together, all this information points to a conclusion that, whatever tolerance the deceased may have acquired to the many drugs found in his system, the strong probability is that these drugs were the major contribution to his demise.”

The Tennessee Board of Health then began an investigation into Elvis’s death which resulted in proceedings against Doctor Nick.

A22Evidence showed that during the seven and a half months preceding Elvis’s death—from January 1, 1977, to August 16, 1977—Doctor Nick wrote prescriptions for Elvis for at least 8,805 pills, tablets, vials, and injectables. Going back to January 1975, the count was 19,012.

These numbers might defy belief, but they came from an experienced team of investigators who visited 153 pharmacies and spent 1,090 hours going through 6,570,175 prescriptions and then, with the aid of two secretaries, spent another 1,120 hours organizing the evidence.

The drugs included uppers, downers, and powerful painkillers such as Dilaudid, Quaalude, Percodan, Demerol, and Cocaine Hydrochloride in quantities more appropriate for those terminally ill with cancer.

A23Doctor Nick admitted to this. His defense was because Elvis was so wired on pain killers, he prescribed these medications to keep Elvis away from dangerous street drugs, thereby controlling Elvis’s addiction—addiction being a disease.

One of the defense witnesses was Dr. Forest Torrent, a prominent California physician and a pioneer in the use of opiates in pain treatment who explained how the effects this level of codeine would have contributed to Elvis’s death.

Central to misconduct allegations was the issue of high codeine levels in Elvis at the time of death—codeine being the prime toxicological suspect as the pharmaceutical contributor. It was established that Elvis obtained codeine pills from a dentist the day before his death and Doctor Nick had no knowledge of it.

The jury bought it and Doctor Nick was absolved of negligence in directly causing Elvis Presley’s fatal event.

Continuing Investigation

A24Dr. Torrent was convinced there were other contributing factors leading to Elvis’s death. In preparation for Doctor Nick’s trial, Dr. Torrent had access to all of Elvis Presley’s medical records, including the autopsy and toxicology reports. Incidentally, these two reports are the property of the Presley estate and are sealed from public view until 2027, fifty years after Elvis’s death.

Dr. Torrent was intrigued by the sudden change in Elvis starting in 1967 and discovered that while in Los Angeles filming the movie Clambake, Elvis tripped over an electrical cord, fell, and cracked his head on the edge of a porcelain bathtub. Elvis was knocked unconscious and had to be hospitalized. Dr. Torrent found three other incidents where Elvis suffered head blows and he suspected Elvis suffered from what’s now known as Traumatic Brain InjuryTBI—and that’s what caused progressive ailments which led to his death.

Dr. Torrent released a paper titled Elvis Presley: Head Trauma, Autoimmunity, Pain, and Early Death. It’s a fascinating readrecently published in Practical Pain Management.

A25Dr. Torrent builds a theory that Elvis’s bathtub head injury was so severe that it caused brain tissue to be jarred loose and leak into his general blood circulation. This is now known to be a leading cause of autoimmune disorder which causes a breakdown of other organs. This was unknown in 1967 and Elvis went untreated. Side effects are chronic pain, irrational behavior, and severe bodily changes such as obesity and enlarged organs like hearts and bowels.

Today, TBI is a recognized health issue in professional contact sports.

A26With a change in mental state and suffering chronic pain, Elvis Presley entered a ten year spiral towards death. He became hopelessly addicted to pain killers, practiced a terribly unhealthy diet and lethargic lifestyle, and resorted to the typical addict’s habit of sneaking a fix wherever he could. This led to early coronary vascular disease and, combined with his escalating weight and pill consumption, Elvis was a heart attack ready to burst.

Recall that I used the term antecedent, like all coroners do when assessing a cause of death. Given Dr. Torrent’s observations—and all the facts compiled from forty yearsif I were the coroner completing Elvis Presley’s death certificate today, I’d write it like this:

Identity of Deceased — Elvis Aaron Presley.

Time of Death — Approximately 2:00 p.m. on Tuesday, August 16th, 1977.

Place of Death — 3754 Elvis Presley Boulevard, Memphis, Tennessee.

Cause of Death — Cardiac arrhythmia antecedent to hypertensive cardiovascular disease with atherosclerotic heart disease antecedent to polypharmacy antecedent to autoimmune inflammatory disorder antecedent to traumatic brain injury.

Means of Death — Cumulative Head Trauma.

A8Therefore, I’d have to classify Elvis’s death as an Accident.

There’s no one to blame—certainly not Elvis. He was a severely injured and sick man. There’s no specific negligence on anyone’s part and definitely no cover-up or conspiracy of a criminal act.

If Dr. Forrest Torrent is right, there simply wasn’t a proper understanding back then in determining what really killed the King of Rock & Roll.