Tag Archives: Suicide

WHAT REALLY KILLED ROBIN WILLIAMS

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On August 11, 2014, entertainment genius Robin Williams took his own life inside his Paradise Cay, California home near San Francisco. The coroner initially ruled that Williams, age 63, died by suicide—asphyxia by hanging antecedent to, or caused by, clinical depression. However, when the final autopsy results were in, an entirely different picture played out. Robin Williams was in the advanced stage of a somewhat common, but almost always undiagnosed, brain disease called Lewy Body Dementia or LBD.

As Williams’ window, Susan Schneider Williams who now represents the Lewy Body Dementia Association, stated, “The disease was a terrorist in my husband’s head. Any way you look at it, the presence of Lewy bodies in his brain took his life. Depression was only a symptom. Unfortunately, we as a culture don’t have the vocabulary to discuss brain disease in the way we do about depression. Depression is only a side effect of LBD—it’s rooted in neurology. His brain was literally falling apart, and not one thing could be done about it.”

Lewy Body is a strange term. We’ll examine where that name came from, what exactly LBD is, what causes it, and how this always-fatal disease can be managed in its three progressive stages: early, mid, and late. But first, let’s have a brief look at this remarkable man’s achievements. Perhaps “remarkable” isn’t a powerful enough word for Robin Williams.

Robin McLaurin Williams was born on July 21, 1951, into an average American family. But from an early age, there was nothing average about him. He showed a God-given gift for improvision comedy and acting. By the early 1970s, Williams was in high demand as a San Francisco-based stand-up comedian, and he went on to be one of the funniest funnies of all time.

Few can forget many of Robin Williams’ outstanding character roles. He got his television start in Mork & Mindy and went on to film. Popeye. Hook. Good Will Hunting. Dead Poets Society. Good Morning Vietnam. The World According to Garp. World’s Greatest Dad. Night at the Museum. The Birdcage. Moscow on the Hudson. Jumanji. And, of course, Mrs. Doubtfire.

Williams also did voice-overs in Aladdin, Robots, and Happy Feet. He won numerous awards—six Golden Globes, five Grammys, two Primetime Emmys, two Screen Actors Guilds, and an Oscar for Best Supporting Actor. As well, Williams won the Cecille B. DeMille award in 2005.

Robin Williams had his struggles through life, though. He was addicted to cocaine and alcohol which set him into fitful mood swings. He was in and out of rehab for years. However, by 2010 he was stable and substance free, except for therapeutic prescriptions issues to combat what was thought to be clinical depression.

It was not. Robin Williams had an undiagnosed brain disorder. A disease that was only discovered after his death and was verified by brain sectioning at his autopsy. What was suspected to be Alzheimer’s or Parkinson’s in the last year of his life turned out to be Lewy’s Body Dementia—a condition under the general dementia umbrella and an extremely deadly disease.

You’re likely wondering what this weird name is and what it entails. Rather than me paraphrasing the information, let’s go to the best source available. No, not Wikipedia or ChatGPT.  It’s the website of the Lewy Body Dementia Association, and here’s what it says:

Lewy body dementia (LBD) is the 2nd most common type of progressive dementia after Alzheimer’s disease. The name comes from a discovery by Dr. Friedrich Lewy in the early 1900s of abnormal bodies or deposits of alpha-synuclein proteins in areas of the brain that can only be verified through an autopsy. These bodies alter the production of dopamine and acetylcholine that are vital neural transmitters.

LBD is not a rare disease. It affects more than a million people in the United States alone. Because LBD symptoms may closely resemble other, more commonly known disorders like Alzheimer’s and Parkinson’s disease, it is widely under-diagnosed.

LBD is an umbrella term for two related diagnoses:

  • A person with dementia with Lewy bodies will develop dementia and other LBD symptoms, one of which may be changes in movement, like a tremor (parkinsonism).
  • With the other form of LBD, people will present first with changes in movement, leading to a Parkinson’s disease diagnosis; over time many will develop dementia years later. This is diagnosed as Parkinson’s disease dementia.

As time passes, people with both diagnoses will develop very similar cognitive, physical, sleep, and behavioral symptoms. The earliest symptoms of dementia with Lewy bodies and Parkinson’s disease dementia are different, but both are due to the same underlying biological changes in the brain.

LBD is a multi-system disease and usually requires a comprehensive treatment approach with a collaborative team of physicians and other health care professionals like occupational, physical, or speech therapists. Early diagnosis and treatment may extend your quality of life and independence. Many people with LBD enjoy significant lifestyle improvement with a comprehensive treatment approach, and some may even experience little change from year to year.

For a more in-depth explanation of Lewy Body Dementia disease, here’s a trip to the medical research department at Johns Hopkins University:

Lewy Body Disease (LBD) is a complex and often misunderstood neurodegenerative disorder that affects millions of individuals worldwide. Characterized by the accumulation of abnormal protein deposits called Lewy bodies in the brain, LBD poses significant challenges to both patients and caregivers. In this article, we delve into the neurological aspects of LBD, exploring its development, detection, effects on the human body, and its associated symptoms.

Development of Lewy Body Disease

Lewy Body Disease primarily affects older adults, typically manifesting after the age of 50. While the exact cause of LBD remains unknown, researchers believe that a combination of genetic, environmental, and lifestyle factors may contribute to its development. Genetic mutations, particularly in genes associated with the production and clearance of alpha-synuclein protein, have been implicated in some cases of familial LBD. However, most cases of LBD occur sporadically without a clear genetic link.

Neurological Pathology

At the core of LBD pathology is the abnormal accumulation of alpha-synuclein protein, forming Lewy bodies within neurons. These protein aggregates disrupt normal cellular function and communication within the brain, leading to widespread neurodegeneration. Areas of the brain particularly affected by Lewy bodies include the substantia nigra, which plays a crucial role in movement control, and the cerebral cortex, responsible for cognitive functions.

Detection and Diagnosis

Diagnosing LBD can be challenging due to its overlapping symptoms with other neurodegenerative disorders such as Parkinson’s disease and Alzheimer’s disease. A comprehensive medical history, neurological examination, and a battery of neuropsychological tests are often employed to assess cognitive function, motor abilities, and psychiatric symptoms.

Brain imaging techniques, such as MRI and PET scans, may reveal characteristic patterns of brain atrophy and dysfunction associated with LBD. Additionally, a definitive diagnosis of LBD can only be made post-mortem through the examination of brain tissue for the presence of Lewy bodies.

Effects on the Human Body

Lewy Body Disease has profound effects on both motor and non-motor functions, significantly impacting quality of life. Motor symptoms include bradykinesia (slowed movements), rigidity, tremors, and gait disturbances resembling those seen in Parkinson’s disease. Non-motor symptoms encompass cognitive impairment, hallucinations, fluctuations in attention and alertness, sleep disturbances, autonomic dysfunction (such as orthostatic hypotension and urinary incontinence), and psychiatric manifestations like depression and anxiety.

Treatment and Management

While there is no cure for Lewy Body Disease, various treatment strategies aim to alleviate symptoms and improve patients’ quality of life. Medications targeting dopamine levels in the brain, such as levodopa, may help alleviate motor symptoms. Cholinesterase inhibitors, commonly used in Alzheimer’s disease, may improve cognitive function and psychiatric symptoms in some LBD patients. Multidisciplinary approaches involving physical therapy, occupational therapy, speech therapy, and psychological support are essential for managing the diverse array of symptoms associated with LBD.

Takeaway

Lewy Body Disease presents a complex clinical picture characterized by the interplay of motor, cognitive, and psychiatric symptoms. Understanding its neurological underpinnings is crucial for early detection, accurate diagnosis, and effective management of the disease. Ongoing research efforts aimed at unraveling the molecular mechanisms underlying LBD pathogenesis hold promise for the development of targeted therapies that can ultimately improve outcomes for individuals living with this challenging condition.

I’ll jump back to the Lewy Body Dementia Association for the diagnostic symptoms of the disease.

Motor Symptoms

  • Bradykinesia (slowed movements)
  • Rigidity (stiffness)
  • Tremors (usually less prominent than in Parkinson’s disease)
  • Gait disturbances (shuffling gait, balance problems)

Cognitive Symptoms

  • Fluctuating attention and alertness
  • Memory loss
  • Executive dysfunction (problems with planning, organizing, and problem-solving)
  • Visuospatial difficulties (problems with spatial awareness and perception)

Psychiatric Symptoms

  • Hallucinations (visual hallucinations are particularly common)
  • Delusions (often related to the hallucinations)
  • Depression
  • Anxiety
  • Apathy
  • Irritability or aggression
  • Sleep disturbances (REM sleep behavior disorder, vivid dreams, acting out dreams)

Autonomic Dysfunction

  • Orthostatic hypotension (drop in blood pressure upon standing)
  • Urinary incontinence or urgency
  • Constipation
  • Erectile dysfunction (in men)

Other Symptoms

  • REM sleep behavior disorder (acting out dreams physically)
  • Sensitivity to neuroleptic medications (may worsen symptoms)
  • Changes in sense of smell
  • Difficulty swallowing (dysphagia)

Note that not all individuals with LBD will experience all of these symptoms, and the severity and combination of symptoms can vary widely from person to person. Additionally, symptoms may fluctuate over time, with periods of relative stability interspersed with episodes of worsening symptoms. Early recognition and management of these symptoms are crucial for improving the quality of life for individuals living with LBD.

Detecting and verifying Lewy Body Disease (LBD) involves a comprehensive approach that combines clinical evaluation, neurological assessments, and diagnostic tests. Here’s a breakdown of the steps involved in the detection and verification process.

Clinical Evaluation

  • A thorough medical history is obtained from the patient and their caregivers, focusing on the onset and progression of symptoms.
  • A neurological examination is conducted to assess motor function, cognitive abilities, and psychiatric symptoms. This may include assessing gait, muscle tone, reflexes, coordination, memory, attention, and mood.
  • Careful observation of symptom patterns, including fluctuations in cognition and alertness, visual hallucinations, and motor symptoms resembling Parkinson’s disease.

Diagnostic Criteria

  • LBD is diagnosed based on established clinical criteria, such as the consensus criteria proposed by the DLB Consortium or the McKeith criteria.
  • These criteria outline the characteristic features and diagnostic markers of LBD, including cognitive fluctuations, visual hallucinations, Parkinsonism, and rapid eye movement (REM) sleep behavior disorder.
  • Criteria may also specify supportive features, such as neuroimaging findings and autonomic dysfunction, which further support the diagnosis of LBD.

Neuropsychological Assessment

  • Neuropsychological tests are administered to evaluate cognitive function, including memory, attention, executive function, and visuospatial abilities.
  • These tests help quantify cognitive impairment and track changes over time.

Neuroimaging Studies

  • Magnetic resonance imaging (MRI) and positron emission tomography (PET) scans may be performed to assess brain structure and function.
  • MRI may reveal patterns of cortical atrophy and changes in brain volume associated with LBD.
  • PET imaging with radiotracers targeting dopamine transporters or amyloid plaques can provide additional evidence supporting the diagnosis and differentiate LBD from other neurodegenerative disorders like Alzheimer’s disease.

Cerebrospinal Fluid Analysis

  • Lumbar puncture may be performed to analyze cerebrospinal fluid (CSF) biomarkers associated with LBD, such as levels of alpha-synuclein protein and markers of neuroinflammation.
  • While not routinely performed, CSF analysis can provide supplementary information to support the diagnosis of LBD in some cases.

Genetic Testing

  • Genetic testing may be considered in cases of familial LBD or when there is a strong family history of neurodegenerative diseases.
  • However, genetic testing is not typically performed as part of routine diagnostic evaluation for sporadic LBD.

Multidisciplinary Evaluation

  • A multidisciplinary team approach involving neurologists, neuropsychologists, geriatricians, psychiatrists, and other healthcare professionals is often utilized to ensure a comprehensive assessment and accurate diagnosis of LBD.
  • Verification of LBD relies on the integration of clinical findings, diagnostic tests, and adherence to established diagnostic criteria.
  • Given the complexity and variability of LBD presentation, accurate diagnosis and ongoing monitoring are essential for effective management and supportive care.

Treatment Options

  • LBD is a multi-system disease and typically requires a comprehensive treatment approach, meaning a team of physicians from different specialties, who collaborate to provide optimum treatment of each symptom without worsening other LBD symptoms.  ​
  • A comprehensive treatment plan may involve medications, physical, occupational, speech or other types of therapy, and counseling.

Medications

  • There are many treatments that can help with the symptoms; all medications prescribed for LBD are approved by the Food and Drug Administration to treat symptoms in other diseases, like Alzheimer’s disease and Parkinson’s disease.
  • These medications can offer symptomatic benefits for cognitive, movement, sleep, mood and behavioral changes in LBD.
  • There are not yet any medications that slow or stop the progression of LBD.

Cognitive Symptoms

  • Medications called cholinesterase inhibitors are considered the standard treatment for cognitive symptoms in LBD.
  • These medications were developed to treat Alzheimer’s disease. However, some researchers believe that people with LBD may be even more responsive to these types of medications than those with Alzheimer’s.
  • These drugs sometimes help control behavior problems and hallucinations as well.
  • Another medication that may be helpful is memantine (Namenda).

Movement Symptoms

  • Movement symptoms may be treated with a Parkinson’s medication called carbidopa/levodopa (Sinemet), but if the symptoms are mild, it may be best to not treat them in order to avoid potential medication side effects.

Visual Hallucinations

  • If the hallucinations are not disruptive, they may not need to be treated. However, if they are frightening or create challenging behavioral changes, a physician may recommend treatment.
  • Cholinesterase inhibitors are sometimes effective in treating hallucinations and other psychiatric symptoms of LBD. In addition, newer ‘atypical’ antipsychotic medications may be tried.
  • Most LBD experts prefer quetiapine or clozapine when treatment is necessary for safety or quality of life concerns.
  • Caution is required to find the lowest effective dose in this situation.
  • A newer medication, pimavanserin, was approved to treat psychosis in Parkinson’s disease; results from another clinical trial of this medication in people with dementia and psychosis are pending.
  • While older ‘traditional’ antipsychotic medications such as thorazine and haloperidol are commonly prescribed for Alzheimer’s patients with disruptive behavior, these medications may cause severe side effects in those with LBD.
  • For this reason, older traditional antipsychotic medications like haloperidol should be avoided.

WARNING: Up to 50% of LBD patients treated with any antipsychotic medication may have a severe reaction, such as worsening confusion, heavy sedation, and increased or possibly irreversible parkinsonism. If severe fever or muscle rigidity occurs, contact your doctor immediately; you may have a potentially life-threatening condition that is treated by stopping the medication.

REM Sleep Behavior Disorder (RBD)

  • RBD can be quite responsive to treatment, so your physician may recommend a medication like melatonin and/or clonazepam.

Medication Side Effects

  • Speak with your doctor about possible side effects.
  • The following drugs may cause sedation, motor impairment, or confusion:
  • Benzodiazepines, tranquilizers like diazepam and lorazepam
  • Anticholinergics (antispasmodics), such as oxybutynin and glycopyrrolate
  • Older antidepressants
  • Certain over-the-counter medications, including diphenhydramine and dimenhydrinate.
  • Some medications, like anticholinergics, amantadine, and dopamine agonists, which help relieve parkinsonian symptoms, might increase confusion, delusions, or hallucinations.

Surgery and Anesthesia

  • Be sure to meet with your anesthesiologist in advance of any surgery to discuss medication sensitivities and risks unique to LBD.
  • People with LBD often respond to certain anesthetics and surgery with acute states of confusion or delirium and may have a sudden significant drop in functional abilities, which may or may not be permanent.
  • Possible alternatives to general anesthesia include a spinal or regional block. These methods are less likely to result in postoperative confusion.
  • If you are told to stop taking all medications prior to surgery, consult with your doctor to develop a plan for careful withdrawal.

Other Types of Treatments

  • Lifestyle interventions include eating a healthy diet, exercising, and remaining socially active.
  • Physical therapy includes cardiovascular, strengthening and flexibility exercises, as well as gait training.
  • Speech therapy may improve low voice volume, poor enunciation, muscular strength, and swallowing difficulties.
  • Occupational therapy helps maintain skills and promotes functional ability and independence.
  • Music and aromatherapy may reduce anxiety and improve mood.
  • Individual and family psychotherapy may be useful for learning strategies to manage emotional and behavioral symptoms and to help make plans that address individual and family concerns about the future.
  • Support groups may be helpful for caregivers and persons with LBD to identify practical solutions to day-to-day frustrations and to obtain emotional support from others.

—   —   —

This might be a lot of cut & pasted material—some maybe repetitive—however I think it’s important to be aware of Lewy Body Dementia.

So far, LBD is incurable but somewhat manageable if detected early-on. Our population is aging. Today’s demographics represent an ever-increasing older population, and the numbers are that many of our folks and friends around us, including ourselves, will develop some form of a degenerative brain disorder like LBD which is what really killed Robin Williams.

THE SUDDEN (SUSPICIOUS?) DEATH OF U.S. PRESIDENT WARREN G. HARDING

One hundred years ago, on August 2nd, 1923, Warren G. Harding, the 29th President of the United States, suddenly died in a San Francisco hotel room. He was 57 years old. Immediately—due to no autopsy insisted upon by the ironclad demand from his wife, Florence Harding, and the fact that his body was embalmed one hour after death—suspicious rumors of foul play circulated. Conspirators came in many forms. Corrupt politicians, scandal cover-ups, quack physicians, and foreign operatives. But the most sinister accusation of all was Harding being intentionally poisoned by his wife.

The official cause of death released in press statements by the attending doctors was a “probable cerebral apoplexy”. In other words, President Harding had a stroke, a fatal brain event. There was no mention of any toxicity through poison nor any suggestion of a chronic cardiac condition, a heart attack.

Harding’s body was returned by train to Washington, DC, lay in state for two days, then was transported again by train to his hometown of Marion, Ohio where he was entombed in a marble crypt. His wife, Florence, died the following year of kidney failure and came to rest beside him. As the years passed, the truth of the Harding Administration emerged. It became known as America’s most scandalous presidency.

Extramarital lovers, illegitimate children, political corruption, cronies, bribes, payoffs, and even suicides emerged that painted a black mark on Harding’s history. The persistent suspicion of cover-up in his death failed to go away. Today, there’s a consensus as to what really happened in Harding’s death. We’ll get to that conclusion but, first, let’s look at who Warren Harding was, how he got to the White House, and how he came to die in that San Francisco hotel room.

Warren Gamaliel Harding was born on November 3rd, 1865—the year the Civil War ended—on his grandfather’s farm near Blooming Grove, Ohio. His father was a small-town physician with a small practice that earned little money. His mother was a devoutly religious homemaker with eight children to care for, including Warren who was the oldest. Harding was an average student but a very strong boy with even stronger work ethic.

Following grade school, Harding attended Ohio Central College graduating in 1882 with a B.S. degree (which grounded him as a later politician). Here he  gained experience editing and publishing the college paper. After college, Harding worked at various jobs such as a barn painter, a railroad laborer, and a horse team driver. It was in Marion, Ohio where Warren Harding got his first business break.

Harding had saved enough money to purchase a failing newspaper in Marion. He parlayed it into a profitable venture in which he wore all hats—reporter, editor, and publisher. These roles allowed Harding to get well connected and form the “Marion Gang” whom he nepotistically took with him through his political career, including placing some of these friends and allies in high-ranking service jobs in the United States federal government. That was to come back and haunt him.

In the late 1880s, Warren Harding met Florence Kling at a community dance. He became smitten with Florence who was the daughter of a banker and Marion’s richest man. Amos Kling did not approve of Warren Harding and warned Florence that Harding “would never amount to anything”. He refused to speak to Harding.

Florence Harding went to work in their newspaper business. She also got active in his political ambitions. “The only things I know are publishing and politics,” Florence was quoted as saying. She was especially good at politics.

History—now one hundred years after Harding’s death—records Harding to be an excellent speaker, very personable with a great memory for people, a driven man, but not too bright. Florence was smart, and she used her intelligence to make connections and pave roads for Harding to travel as he moved up the Ohio political ladder.

Warren Harding served as an Ohio State Senator from 1900 to 1904. From then to 1906 he was the Lieutenant Governor of Ohio, and in 1910 he ran as Ohio’s Governor but was defeated. Harding went back to the paper industry but in 1915 he entered federal politics and won a seat as a Senator for the State of Ohio. This opened doors in Washington.

The Republican national convention was deadlocked in the 1920 presidential selection race. Ultimately, the delegates chose Warren Harding as a compromise candidate. He went on to represent the Republicans as a moderate in the November 1920 presidential election. Together with running mate Calvin Coolidge, they won a landslide victory over the Democrats.

Warren G. Harding was inaugurated as the 29th United States President on March 4th, 1921. He ran on the slogan “Return to Normalcy” which fit his leadership style. America was only two years past the end of WWI and the public longed for a return to pre-war normal. The country was in a financial recession with what many Americans thought was unnecessary ties still with foreign countries.

Harding focused on a protectionist America by lowering taxes, increasing foreign tariffs, and getting the country out of the League of Nations process that dynamited Woodrow Wilson’s presidency. In one year after taking off, the country rebounded and began prosperity never seen before. It was the Roaring Twenties.

Warren Harding was a hands-off president. He appointed people he thought he could trust into high office and let them loose to do their jobs. His error was not holding them accountable and, given human nature, even his closest friends began to abuse their positions for personal gain.

Harding’s other error—his vice and weakness—was womanizing, drinking, and gambling. Rumors put him having secret tunnels under the White House where he would smuggle his girls in and ply them with illegal alcohol. (Remember, this era was the start of Prohibition.) Harding’s poker games were legendary as well as a well-known fact that he supported mistresses and had at least one illegitimate daughter. Warren and Florence were childless.

Among the brewing political and criminal crises was what’s known as the Teapot Dome Scandal. This involved an oil-producing region in Wyoming that held reserves set apart for the U.S. Navy. Harding had appointed his close Marion Gang friend, Albert B. Fall, as Secretary of the Interior who oversaw the federal lands at Teapot Dome and had the power to award oil production contracts. Fall pocketed hundreds of thousands of payoff money for preferential treatment. This scandal (among others), which Harding knew about, had the potential to have President Harding impeached.

It was under this stressful black cloud that Warren Harding departed Washington on his “Voyage of Understanding” cross-country train and ship tour in June of 1923. Members of Harding’s staff observed his health rapidly deteriorating. A once vibrant man with the world’s best handshake was notably nervous and privately conferring with advisors about how to diffuse the runaway in the Marion Gang.

“I can take care of my enemies all right. But my damn friends… they’re the ones that keep me walking the floor at night,” Harding said to one aide. To another, “If you knew of a great scandal in our administration, would you for the good of the country and the party expose it publicly, or would you bury it?”

President Harding’s tour took him across the west and up to Alaska. He spoke before hundreds of thousands of common folks in places like St. Louis, Kansas City, Denver, Salt Lake City, Helena, and Spokane. He went to a small Alaskan village called Metlakatla, then did a by-stop in Vancouver, Canada before heading straight for San Francisco and checking into the Palace Hotel with an extensive entourage including the future president Herbert Hoover who was his Secretary of Commerce.

Harding’s health had been going downhill since leaving Washington. The stress of his job and unfolding issues gave him a malady then diagnosed as neurasthenia which is an overly nervous condition where the sufferer is unable to relax. Compounding this condition, including non-recognizing many presenting symptoms of bad physical health, was the president’s personal doctor.

Charles E. Sawyer was part of the Ohio Gang. Sawyer wasn’t a trained physician. He was an odd, self-taught homeopath who prescribed plants and birds and rocks and things (not sure about sand and hills and rings) as substitutes for accepted medical practices. But Sawyer was a likable, down-homey Oh-Hi-Yo officially forehead-stamp-approved by Mrs. Harding who saw Sawyer as a 1920s genuine guru teaching them a better way.

Harding also traveled with a real doctor—Joel T. Boone. Dr. Boone knew Harding was critically ill and telegrammed ahead from Alaska to San Francisco, having two of the country’s leading cardiology specialists standing by. These were Dr. Ray Lyman Wilbur, the president of the American Medical Society, and Dr. Charles Cooper, the leading cardiac surgeon in the USA.

Dr. Boone knew what was happening.  President Harding was presenting these symptoms:

  • Severe abdominal and thoracic pains as in a crushing weight on the chest
  • Pain radiating down both arms
  • Shortness of breath
  • Dyspnoea at night
  • Nausea
  • Severe bouts of indigestion
  • Off and on fever—chills & sweats
  • Exhaustion after little energetic effort
  • Foul acetonic breath

Dr. Boone knew President Harding was suffering congestive heart failure and likely experienced a series of myocardial infarctions where his enlarged heart muscles were quickly failing. Boone knew Harding’s heart was likely to stop, and that he would suddenly die.

That happened at 7:20 pm on August 2nd, 1923. President Harding was in his hotel suite with his wife and two nurse care aids. Florence was reading a favorable column in the Saturday Evening Post. Harding remarked, “That is good. Go on.”

Florence continued when, with only a shudder and not a sound, the President of the United States stiffened, laid back on the bed, and instantly died.

President Harding’s staff came into the room. That included Herbert Hoover and Doctors Sawyer, Boone, Wilbur, Cooper, and another cardiac expert, Hubert Work. These medical practitioners debated the primary cause of death.

They knew the American public would immediately want to know what happened to their Commander-in-Chief and be assured nothing illegal, conspirator, or dark was behind the president’s sudden and unexpected death—especially when the official reports released to the following press during the Voyage of Understanding assured that Warren Harding was a man fit to competently hold office and guide the nation.

The doctors knew, under the circumstances, that no conclusive cause of death could be established without a complete and thorough autopsy. To this, Florence Harding was fiercely opposed. As Doctor Wilbur put it in his notes written the next day, “We shall never know exactly the immediate cause of President Harding’s death since every effort that was made to secure an autopsy was met with complete and final refusal by Mrs. Harding.”

Knowing that the public must be notified of the president’s death as soon as possible and that they would demand to know what happened—what the true cause of death was—the team of five physicians signed this statement:

Realizing their rush to judgment without medical evidence (and strongly suspecting a myocardial infarction or a heart attack), they released this second statement twenty minutes later:

Stroke of Cerebral Apoplexy. Myocardial Infarction. Let’s look at what these medical terms mean.

So how did the 1923 American public and folks over the last one hundred years go from accepting that President Warren G. Harding died of natural causes to a conspirator suspicion that he was murdered—possibly by his wife?

I think a few reasons. One is the president’s staff poorly handled the president’s health information. One day the president was strong as an ox. The next day he died.

There was no autopsy. His body was embalmed an hour after death. And this was through an ironclad order from the wife, Florence Harding, who knew full well of her husband’s infidelity and unwinding scandals.

Note: I cannot find anything in historical notes to determine if there was a San Francisco coroner having jurisdiction and the authority to hold the body while an independent autopsy was done. Or if any other authorities like the SF police were notified.

The other factor was the collective doctors’ stick handling of the “probable cause of death.” They were aware of the public backlash for knowing how serious the president’s medical condition and the perception of them not being seen to do something about it and prevent his death, but they first wrote it off as an unpredictable and unpreventable stroke, not a preventable heart attack. From Dr. Wilbur’s notes:

“In the aftermath, we were belabored and attacked by the newspapers antagonistic to Harding, and by the cranks, quacks, antivisectionalists, nature healers, the Dr. Albert Abrams electronic-diagnostic group, and many others. We were accused of starving the president, overfeeding him to death, of assisting in slowly poisoning him, and plying him to death with pills and purgatives. We were accused of being abysmally ignorant, stupid and incompetent, and even of malpractice. We were said to have forced our way to Harding’s bedside “through political pull and for political reasons.”

But the craziest theory of them all came from a book written by Gaston B. Means in 1930 titled The Strange Death of President Harding. Means claimed that Florence Harding murdered her presidential husband with poison. Without a shred of evidence, Means suggested two motives. One was because of her husband’s cheating. The other was to save him the embarrassment of the scandals. Gaston Means, by the way, went to jail over a con job in scamming the Charles Lindberg baby homicide case.

One hundred years have passed since United States President Warren G. Harding passed. There’s no doubt Harding had a fatal heart attack. That’s life, but the fallout from living the presidential life sucks. Here are lines from Herbert Hoover while dedicating a memorial to President Harding:

We saw him gradually weaken not only from physical exhaustion but from mental anxiety. Warren Harding had a dim realization that he had been betrayed by a few of the men whom he trusted, by men whom he believed were his devoted friends. That was the tragedy of the life of Warren Harding.

DID JEFFREY EPSTEIN REALLY KILL HIMSELF

On August 10, 2019, Jeffrey Edward Epstein—a 66-year-old American mega-millionaire and registered sex offender powerfully connected to presidents and royalty—died in his prison cell at the Special Handling Unit of New York’s Metropolitan Correctional Center. The coroner ruled the death a suicide but, shortly, the publicly-exposed mass of improprieties surrounding Epstein’s custody control and supervision within the detention facility raised a massive foul play speculation. Many properly wondered, “Did Jeffrey Epstein really kill himself?”

It wasn’t just the crazy conspiracy theorists who wondered if Epstein truly committed suicide. There were just too many suspicious circumstances to ignore. Switches in cellmate placements. Epstein left unchecked for nearly eight hours before his death while under a suicide watch. Security cameras on his cell being disabled. Guards “asleep” at their station. Falsified records. No cell search for contraband. A blatant disregard for prison policies and procedures set in place to prevent such a death. Plus, the horde of high-profile people Epstein had dirt on.

Then, there’s the autopsy review by America’s high-profile forensic pathologist, Dr. Michael Baden, who said Epstein’s broken neck bones could not have been caused by a self-inflicted, ligature hanging. In Baden’s opinion (who performed more than 20,000 autopsies in his 45-year career), it was far more likely Epstein was a homicide victim than a suicide statistic.

On June 27, 2023, the United States Department of Justice (DOJ), through its Office of the Inspector General (OIG), released a 128-page report on the Jeffrey Epstein in-custody death investigation. Before dissecting the report and reaching a conclusion, let’s review who Jeffrey Epstein was and the facts leading to his sudden and unnatural death.

Putting it bluntly, Jeffrey Epstein was an enormous con man and an extreme pervert. He was born in Brooklyn in 1953 and completed high school with skipped-grades but never sought a college degree. That didn’t stop him from getting a physics and math teacher’s position at the prestigious Dalton School in Manhattan. Epstein was quickly fired for inappropriate behavior towards underage female students.

Epstein reinvented himself as a banker. Given credit where credit is due, Epstein functioned at a near-genius level with figures. He worked his way toward the top of Bear Stearns but was “dismissed” for regulatory violations.

He went on his own, founding International Assets Group which specialized in money recovery for extremely wealthy clients. He once called himself a high-level bounty hunter. Because he excelled at this job, he quickly acquainted himself with some of the richest people in the world as well as those socially and politically elite.

In 1987, Jeffrey Epstein joined Towers Financial Corporation as a “consultant”. By 1993, Towers imploded in one of the biggest Ponzi schemes America had ever seen with over $900 million in today’s value simply gone. Epstein escaped unscratched and went on to an even bigger venture.

He founded J. Epstein & Associates in 1988. Its cover was to manage assets of clients with a minimum of $1 billion net worth—an exclusive club at the least. In 1996, he changed the name to the Financial Trust Company with a new headquarters in the U.S. Virgin Islands tax-shelter haven. Another venture was Liquid Funding Ltd. which was a novel and clever debt-repo service partnered with Bear Stearns that collapsed in the 2008 financial meltdown.

Through these years, Jeffrey Epstein amassed an unknown pot of wealth. Personal properties included a Manhattan mansion, one in Palm Beach, Florida, a New Mexico ranch, and an exotic island getaway called Little Saint James in the Virgin Islands. It was here that some of the sinister sexual seductions with underage girls took place.

Jeffrey Epstein surrounded himself with the elite of the elites. Tarred by the Epstein brush were people like Prince Andrew of the British Royal Family, U.S. Presidents Bill Clinton and Donald Trump, Israeli Prime Minister Ehud Barak, British Prime Minister Tony Blair, Saudi Crown Prince Mohammed bin Salman, Cuban Dictator Fidel Castro, financial titans like Bill Gates, Richard Branson, and Rupert Murdoch, and celebrities such as Harvey Weinstein, Woody Allen, Michael Jackson, Alex Baldwin, a host of Kennedys, and the beat goes on.

The Epstein sex scandals surfaced in 2005. The Palm Beach conducted a 13-month undercover investigation on Epstein that brought in the FBI because of its international scale. Eventually, sixty young females gave evidence of being sex-trafficked through Jeffrey Epstein, his properties, and his female co-conspirator, British socialite Ghislaine Maxwell (who is now serving 20 years for sexual offenses against minors).

One of the sworn allegations was that Epstein had 12-year-old triplet girls flown in from France who he sexually assaulted and had them returned the next day. Other girls came from Brazil, the Soviet Union, and across Europe. These minors were facilitated by Maxwell through her contacts in Jean-Luc Brunel’s MC2 Modeling Agency.

Epstein was arrested in Palm Beach in July 2006 on child abuse charges. These serious allegations were plea-bargained down to one count of procuring a minor and one count of soliciting a prostitute. It was called the “sweetheart deal of the century by the U.S. Attorney General who eventually had the prosecutor fired for agreeing to an Epstein guilty plea resulting in 18 months of open custody.

Meanwhile, Epstein went back to work as a money-maker and a kiddie-diddler. Then the civil suits started, and the criminal investigation continued. He was again arrested by the FBI for sexual offenses against minor girls, this time in New York after returning from Europe. That was on July 6, 2019. He was denied bail and sent to the Special Handling Unit (SHU) at the Metropolitan Correction Center (MCC) operated by the Federal Bureau of Prisons (FBP). Epstein remained there for 35 days until he died on August 10.

To understand what led to Jeffery Epstein’s death, it’s vital to know the chain of events that occurred to allow this to happen. This timeline is clearly laid out in Chapter 3 of the DOJ-OIG report titled Timeline of Key Events. Here is a summary.

September 21-24, 2018 — The FBP at MCC contracts to have their video surveillance system updated from analog to digital recorders.

March 17, 2019 — Resources for video upgrades are temporarily reassigned to other work leaving the recording portion half-finished. Livestream cameras are operational for real-time surveillance but cameras in the Special Handling Unit (SHU), including those near Epstein’s future cell won’t record.

July 2, 2029 — A New York federal grand jury indicts Epstein on child sex trafficking charges. A warrant is issued.

July 6, 2019 — Epstein is arrested at a New Jersey airport as he returns from France. He is incarcerated as a pretrial detainee at MCC. The news stories are viral and he is assigned to the SHU for protection from other inmates.

July 8, 2019 — Epstein is arraigned and pleads not guilty. The MCC Chief Psychologist routinely interviews him and finds no evidence of suicidal thoughts.

July 10, 2019 — Guards report Epstein appears “distraught, sad, and a little confused”. A specific suicide risk assessment is done, and the MCC administration assigns Epstein a suitable cellmate as a safety precaution.

July 11, 2019 — Epstein is re-evaluated as a suicide risk. The psychologist minimizes the potential and orders weekly follow-ups.

July 18, 2019 — A federal judge denies Epstein bail even though he offered a $100 million surety. The judge found Epstein “a danger to the community and a flight risk.”

July 23, 2019 — At 1:21 am, guards hear a commotion coming from Epstein’s cell. Epstein was on the floor, semiconscious, with an orange bedsheet strip around his neck. There are notable skin injuries on Epstein’s neck. The cellmate says he woke up hearing Epstein in distress. Epstein said the cellmate tried to kill him. Epstein is moved to the Psychiatry Unit and placed on a suicide watch, alone in a cell.

July 24, 2019 — Epstein is removed from the suicide watch after another psychiatric assessment but is still left alone in a cell at the Psych Unit.

July 25-29, 2019 — Daily interviews are done. Epstein emphatically denies having suicidal tendencies and states he does not remember how he received injuries to his neck.

July 30, 2019 — Epstein is transferred back to the SHU and placed in a cell visible from the guard station. MCC administration orders that Epstein be assigned a new cellmate. A suitable candidate is found and housed with Epstein.

August 2, 2019 — MCC administration concludes its investigation into the suspected Epstein suicide attempt on July 23 and determined they cannot conclusively categorize it as a suicide attempt.

August 8, 2019 — Epstein has a private meeting with his lawyers and updates his will. The prison staff is not aware of this change.

August 9, 2019 — Epstein’s cellmate is moved out at the request of the U.S. Marshals and taken to an out-of-state facility. Epstein is once again alone.

August 9, 2019 — Over two thousand pages of evidence in proceedings against Ghislaine Maxwell are unsealed. They contain very damaging evidence against Epstein, and they receive international media attention. Epstein meets with his lawyers. He then makes an unauthorized phone call to an unknown person.

August 9, 2019 — The last known bed check on Epstein happens at 10:40 pm.

August 10, 2019 — Guards begin breakfast service at 6:30 am. They find Epstein semi-suspended with his buttocks 2 inches from the floor with his legs straight out. A torn prison sheet is noosed around his neck and tied to the upper bunk ladder. Epson is unresponsive. Resuscitation fails, and he’s taken to the morgue.

August 11, 2019 — The New York City Coroner’s Office autopsies Epstein and rules the death a suicide caused by hanging.

June 27, 2023 — The DOG-OIC report titled Investigation and Review of the Federal Prison’s Custody, Care, and Supervision of Jeffrey Epstein at the Metropolitan Correctional Center in New York, New York is released. They concluded there were “numerous and serious failures by MCC New York staff including multiple violations of MCC and BOP policies and procedures” that included falsifying records to cover up the lack of supervision on the night of August 9/10. The report upheld a suicide ruling and made eight recommendations to minimize a re-occurrence of the Jeffrey Epstein event.

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That’s the timeline of what led to Epstein’s death. Let’s deal with the highlights before wrapping up with the biggest issue of all—that the autopsy findings allegedly support a homicide ruling over a suicide.

Cell Search — The BOP has a policy of ongoing cell searches to locate contraband or items that an inmate could use to harm themselves or others. The report found no record that Epstein’s cells had ever been searched and that he had an excess of bed linens that he could use to make a hanging ligature.

Cell Checks — The last recorded cell check on Epstein was at 10:40 pm on August 9. He was found at 6:30 on the 10th. Checks are to be made hourly so that’s eight checks in a row that were missed. This is what the two night-shift guards falsify. However, they were caught by their own cameras.

Faulty Cameras — The conspiracy crowd made a lot of media and internet noise over the “disabled” cameras. The DOJ/OIG report takes a deep dive into this issue in Chapter 6. They found nothing intentional had been done to sabotage the cameras. Every camera aimed at Epstein’s cell was in proper working order except they were only on livestream mode. The recorders had never been updated. Typical bureaucratic inefficiency.

The only recorded video, though, was crucial. That was the camera with both Epstein’s cell door and the guard station in the viewfinder. It was clear evidence that no one had gone near Epstein’s cell door from 10:40 pm until 6:30 am. It was also clear that both guards in the recording never moved from their station during the same time. Apparently, they were asleep. Later, they were convicted of falsifying the bed check documents.

The Cellmates — The report does not name either of Epstein’s cellmates, but it does detail every move, the reasons for the move, and the concern the MCC administration staff had about a suitable watch person being with him at all time.

The Previous Suicide Attempt — The report overrules the MCC finding that there wasn’t sufficient evidence of a clear earlier suicide attempt. The OIG investigation notes this was a huge red flag and Epstein’s supervision should have been done accordingly.

The Ghislaine Maxwell Documents — This was the proverbial straw that broke Epstein’s back. He knew his case was hopeless and that he’d be spending the rest of his life in jail. It was now just waiting a suitable moment for him to hang himself. He found it on the night of August 9/10 when he was alone and unsupervised.

The Will and the Call — Both events seem suspicious, but the report lets the BOP and MCC off light here. There is no way prison officials could know what was going on in a meeting between Epstein and his attorneys. And there is no way to know what was said in a 27-minute private call that happened around 9:00 pm on August 9th despite that Epstein was supposed to be under outgoing call monitoring. He was using an unauthorized smuggled smartphone that should have been discovered if he’d ever had a cell search.

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So, let’s deal with the autopsy and the controversial broken neck bones. Dr. Kristen Roman, M.D. was the prosector (a person who dissects bodies.) She was a very experienced forensic pathologist employed by the New York City’s Medical Examiner Office. Her report’s final diagnosis is very clear, and the coroner has never deviated from it. Rather than paraphrase it, see the image below

 

The “broken neck bones” referred to by the news media through Dr. Michael Baden (who was hired by Jeffrey Epstein’s brother to second-guess the suicide ruling) are not bones at all—certainly not true neck bones like the thoracic and cervical vertebrae that make up the upper spine. Dr. Roman refers to “fractures of bilateral thyroid cartilage cornuae and left hyoid cornua”. These two anatomical features are soft cartilage in the throat—one supports the tongue, and the other supports the thyroid gland. They are almost always damaged or “fractured” in ligature hangings.

Let’s go to the source of this “broken neck bone” trouble. Dr. Baden gave an interview to Fox News on October 30, 2019. Here’s a Fox News quote from that show. 

Jeffrey Epstein’s autopsy is more consistent with homicidal strangulation than suicide, Dr. Michael Baden reveals. 

He noted that the 66-year-old Epstein had two fractures on the left and right sides of his larynx, specifically the thyroid cartilage or Adam’s apple, as well as one fracture on the left hyoid bone above the Adam’s apple, Baden told Fox News. 

“Those three fractures are extremely unusual in suicidal hangings and could occur much more commonly in homicidal strangulation,” Baden, who is also a Fox News contributor, said. 

While there’s not enough information to be conclusive yet, the three fractures were “rare,” said Baden, who’s probed cases involving O.J. Simpson, President John F. Kennedy, Martin Luther King, record producer Phil Spector, New England Patriots star Aaron Hernandez, and many others. 

“I’ve not seen in 50 years where that occurred in a suicidal hanging case,” the 85-year-old medical legend told Fox News.

There are three things wrong with the Baden/Fox release.

  1. Given credit to Dr. Baden for correctly identifying the hyoid and thyroid cartilages, it was Fox News that sensationalized them as a broken neck. ie – this couldn’t have happened in a suicide hanging so it had to be a murder.
  2. Dr. Baden is out-of-line stating the hyoid and thyroid cartilages fractures are extremely unusual in suicidal hangings and are more consistent with manual strangulations.
  3. Dr. Baden infers that he was physically present at the autopsy as an independent observer hired by the Epstein family.

Let’s examine these issues.

Dr. Roman’s autopsy report is very clear. She was the one who examined the body, and her findings are conclusive. She refers to the fractured hyoid and thyroid cartilages and never refers to them as neck bones or a broken neck as in vertebrae fractures. She clearly concludes Epstein hung himself with a torn bedsheet and no one else was directly or indirectly involved in intentionally causing his death.

In Chapter 7 of the OIG report titled Conclusions and Recommendations, the investigators deal with the Baden interview and his statement that fractured hyoid and/or thyroid cartilages rarely occur in suicide ligature suspensions. They interviewed Dr. Roman who contradicted Dr. Baden confirming that these fractures often occur in cases like the Epstein death. She pointed out that the ligature was a wide bedsheet fragment and not a small-diameter cord like the electrical connection on the C-PAC machine found in Epstein’s cell.

Dr. Roman explained the mechanism of the ligature and how the forces worked in this case. Because the fabric and the tied knot were wide, they created an upward furrow that was evident on Epstein’s neck. She stated the force was at the right location and would have exerted sufficient pressure in his suspended position to cause the cartilage fractures—she would have been surprised if the fractures hadn’t occurred.

The pathologist also commented in the OIG report that there was nothing on Epstein’s body to indicate defensive wounds usually seen in violent homicide deaths. There was no bruising except for the ligature location and what’s known as petechiae in the eyes which are small red dots or blood vessel ruptures caused by the circulation interference. Furthermore, there was no debris in his fingernails associated with a fight, and no contusions on his knuckles.

Nowhere in Dr. Roman’s autopsy report and interview with the OIG investigation does she confirm Dr. Baden being at the autopsy. This (in my experience as a homicide investigator and coroner) is highly unlikely. Autopsies, especially forensic autopsies like performed on Jeffery Epstein, are carefully controlled. Only those absolutely necessary may attend.

There would be no value in Baden being there. If he were contracted by the family for a review, he would be supplied with the entire material including photographs, documents, and whatever exhibits had been processed. Baden gave his Fox interview two months after the autopsy. By then, the entire autopsy results would be in and supplied to the family, ergo to Baden.

There’s one more reason that Baden probably wasn’t in that autopsy suite. He’s a publicity-seeking narcissist, and it’s well-known he’s never seen a camera or a mic he didn’t like. Anytime there’s a high-profile death, information processors like Fox News look for sensational sources. Dr. Michael Baden is on their speed dial.

And there’s a credibility issue over the suicide vs homicide conclusion in the Jeffery Epstein postmortem examination. Dr. Kristen Roman received her M.D. in 1999 and was board-certified as a forensic pathologist in 2004. When she autopsied Epstein, she had 15 years of operational experience with the New York Medical Examiner Office as an active prosector. Roman had nothing to gain by not being candid on the Epstein file.

You might want to read this Intelligencer article titled Why You Might Not Want to Believe Michael Baden, Celebrity Pathologist, on Epstein’s Death.

By Jeffrey Epstein committing suicide, he cheated dozens of innocent victims out of justice. It’s a travesty that this travesty developed into the widespread social mockery meme, “… and Epstein didn’t kill himself.”