Dr. Nick, like Elvis’s other physicians, had been seduced by the frothy glitter of show business, and with his tanned and striking appearance he fit right in. His style diverged from the practice of medicine that was increasingly a matter of business and less a matter of personal service. He was born and reared in Anniston, Alabama, where his father was a highly respected restaurant owner and businessman. George Nichopoulos, however, had not at first been a high achiever. He had not progressed smoothly through college and medical school. He had first entered the University of Alabama on a football scholarship, but dropped out before the school year ended, and he served in the army for two years. He was a student at Birmingham Southern University for a year and then moved on to the University of the South at Sewanee, where he earned his Bachelor of Science degree in 1951. He worked in a research lab at Vanderbilt University before his admission to the medical school in 1952. He failed biochemistry and physiology, was put on probation, and tried to make up for his failures during summer school, but failed again. In the fall, he was not readmitted. He moved to Memphis and for three years worked in the University of Tennessee’s medical school. In 1956, he was readmitted to Vanderbilt Medical School, graduating in 1959. After finishing his training, in 1962 he entered practice in Memphis with several doctors who called themselves the Medical Group.
Other doctors looked askance at George Nichopoulos’s personal and sartorial style. Too much informality, they thought. He allowed his patients, friends, and acquaintances to call him “Dr. Nick.” He seemed unduly proud of the stylishly arranged thatch of white hair that crowned his head, and he was not averse to revealing his chest hair. He often wore his shirts open at the throat, showing off a very large, tasteless gold medallion suspended by a necklace and resting against his bare chest. The medallion was a special gift from Elvis Presley and marked him as a member of the star’s inner circle, some of whom were macho young men who proudly called themselves “the Memphis Mafia.” Dr. Nick usually sported a highly visible array of expensive rings, bracelets, and wristwatches, some of which were gifts from Elvis. Without his white smock and dangling stethoscope, one would have difficulty recognizing him as a doctor, even in a medical office or hospital. How could he command sufficient authority among his patients? his medical colleagues wondered. How could he justify his fees?
Dr. Nichopoulos was making his rounds at Doctors Hospital far out on the east side of Memphis when the call came that Elvis was in trouble. Dropping everything, he rushed to Graceland in the green Mercedes-Benz Elvis had given him. He was taken by surprise by the call. He had done everything he could think of to preserve Elvis’s life in the face of his drug addiction, and he thought he was succeeding. He was looking forward to flying off in the Lisa Marie with Elvis to Portland, Maine, for a ten-day tour. For years the doctor had often toured with Elvis, carrying all the necessary drugs with him. Elvis would sometimes introduce him to his adoring audiences, publicly expressing his fond appreciation for his physician as thousands of people looked on and Dr. Nichopoulos stood in the spotlight graciously accepting their applause. Now and again, when Elvis was mad at Dr. Nick, he would punish him by not letting him come along on a tour.
The day before Elvis died, Dr. Nick had loaded up his bag at the Prescription House, a pharmacy just across the street from his office. Later, investigators found that for this ten-day trip, Dr. Nick had picked up 682 pills and tablets, including Dilaudids, Percodans, Amytals, Quaaludes, Dexadrines, and Bephetamines, along with 20 cc’s of liquid Dilaudid.
Elvis paid the doctor $800 a day for his services on tours, which lasted from about ten to twenty days. He also paid the doctors with whom Nichopoulos practiced $1,000 a day to cover for him while he was gone. Between 1970 and 1977, Elvis paid Dr. Nick more than $76,000 for his services on the road and $147,000 to the medical group.
The material benefits that Dr. Nichopoulos enjoyed from his association with Elvis did not stop at gifts and fees. In 1975 he had persuaded Elvis to loan him $200,000 to build a house in a newly developing and affluent neighborhood well east of town. With a tennis court, a swimming pool, and an enclosed racquetball court, the banks found the home too costly even for its well-to-do neighborhood and refused to lend Dr. Nick the money he needed. Elvis did so, and before he passed away $55,000 more. They did draw up a paper shortly before Elvis’s death that would pool the loans and obligate Nichopoulos to repay the amount over a period of twenty-five years at 7 percent interest, but Elvis never got around to signing the document.
Only days after the funeral, Vernon summoned Nichopoulos to Graceland and with insulting haste compelled him to sign a document in which he mortgaged his home to Elvis’s estate for the total amount he owed. He also increased the interest rate to 8 percent and warned Nichopoulos that if he was late on even one month’s payment, foreclosure would summarily follow. Vernon had never trusted Dr. Nick. Court records indicate that as of June 27, 1979, Nichopoulos had not missed a single payment and still owed the estate $245,807.33.
As the ambulance raced down the driveway and up the boulevard on the afternoon of the death, Dr. Nichopoulos could not accept the reality that lay before him. Working desperately on the body, the doctor kept shouting to the dead man.
Later that day, Jones described the scene in the ambulance. “All the way to the hospital,” he said, “the doctor had this look of sheer disbelief that this could happen to Elvis.” He recalled that Dr. Nichopoulos kept shouting, “Breathe, Elvis … come on, breathe for me.”
Baptist Memorial Hospital
The ambulance left Graceland at 2:48, sixteen minutes after it arrived. At 2:56, it pulled up at the emergency room at Baptist Memorial Hospital. The hospital maintained a superbly well trained crew of eighteen doctors, nurses, and medical specialists to deal with life-or-death situations. Dubbed the Harvey Team, it could gather at a given point in the building within minutes after the alert was sounded. Already assembled and waiting when this patient arrived, the team rushed him into Emergency Room B and went to work. They had not been officially told that it was Elvis. “Why are we working on this guy?” asked one young medic, seeing that he was already dead. “Because he’s Elvis Presley,” answered one of her older teammates.
Ulysses Jones watched while the Harvey Team worked with professional steadiness. After some twenty minutes, they gave up. Dr. Nick turned to Joe Esposito, Elvis’s road manager. “There is nothing we can do,” he said. “We tried.” Jones saw Nichopoulos’s eyes begin to water as he shepherded people out of the room. “Then he left too,” Jones said, “shutting the door behind him.” Jones and Crosby drove Dr. Nick back to Graceland in the ambulance.
The corpse was wheeled to the hospital morgue, where a resourceful, if graceless, newspaper photographer was lying on a gurney under a white sheet, pretending he was a cadaver, waiting for an opportunity to snap a photograph of Elvis’s body. Such a photo would be worth thousands of dollars to the tabloids. The would-be photographer was quickly discovered and roughly expelled, and a guard was set until the autopsy began.
Sergeant John Peel of the Memphis Police Department arrived at Baptist Hospital about 3:45 p.m. and began to take notes for the official police report. He wrote that by 4:10 the body was already in the morgue. He had learned that the victim “appeared to have been sitting on commode & lunged forward.” He “had gone to the bathroom to read.” He noted that “Dr. Nick” had left the “hospital en route to get autopsy papers at Graceland.” His last entry indicated that Dr. Nichopoulos “wouldn’t give cause of death.”
At Graceland, Nichopoulos secured Vernon Presley’s signature to a document authorizing an autopsy of his son’s body by the staff of Baptist Hospital, to be paid for by the Presley estate. Thus, Vernon might share—or not share—the resulting report with anyone he chose. If the object was to keep the cause of Elvis’s death a secret, it was an excellent move both for the Presley family and for Dr. Nichopoulos. If Elvis died by his own hand from popping too many pills, only trusted people needed t
o know the truth, and the carefully constructed public image of Elvis would be secure. Also, if Dr. Nichopoulos had prescribed too many pills for Elvis, that fact might be kept from authorities who might otherwise take away his medical license or even bring him up on criminal charges.
The Cover-up
Baptist Hospital administrators realized that in dealing with the death of Elvis Presley they were involved in a public relations matter that might damage the hospital’s sterling reputation. Over the years they had carefully concealed the nature and seriousness of his often embarrassing illnesses, including those resulting from drug abuse. Dr. Nichopoulos had always checked Elvis into Baptist Hospital because he knew they were discreet. That was surely one reason why he ordered Charles Crosby to drive the ambulance some seven miles to Baptist Hospital rather than to the nearest emergency room, at Methodist South Hospital, only blocks away from Graceland.
The autopsy was conducted by a specially selected and highly skilled team of nine pathologists headed by the hospital’s chief of pathology, Dr. E. Eric Muirhead. Dr. Jerry Francisco, the medical examiner for Shelby County, closely observed the proceedings. It would be his responsibility to declare to the world the official cause of Elvis Presley’s death.
Early on, a meticulous dissection of the body revealed what Elvis did not die from. It was not heart failure, stroke, cancer, or lung disease—the usual killers. It also confirmed what his doctors already knew: Elvis was chronically ill with diabetes, glaucoma, and constipation. As they proceeded, the doctors saw evidence that his body had been wracked over a span of years by a large and constant stream of drugs. They had also studied his hospital records, which included two admissions for drug detoxification and methadone treatments. Over time, Elvis had, in effect, been poisoned. The bloated body, the puffy eyelids, and the constipation reflected the slow death. They prepared multiple specimens from the corpse’s fluids and organs to be identified anonymously and sent to several well-respected laboratories across America for analysis. Chances seemed high that Elvis had, in fact, overdosed.
Dan Warlick, Dr. Francisco’s aide, had driven to Graceland after Elvis’s death was confirmed to investigate the scene. Several hours later, he summarized what he had found. Sadly, ignominiously, the crisis had come Tuesday morning while Elvis was sitting on the black leather padded seat on his black ceramic commode reading a book. There had been a trauma of some sort. Probably, Elvis stood up, dropped the book aside, took a halting short step or two, then sank to his knees and pitched forward. Perhaps he crawled a foot or two more before he collapsed, came to rest in the fetal position face down on the deep pile rug, and regurgitated slightly. Warlick told Dr. Francisco that the site had been cleaned up before he arrived, but even so, he had found two syringes and an empty medicine bag in Elvis’s quarters. He thought that drugs were involved in the death.
Dr. Francisco seemed uninterested in Warlick’s findings. He smoked a cigarette while Warlick talked. In front of them, the hospital pathologists continued to dissect Elvis’s body, piece by piece, on a porcelain table. Francisco cut Warlick off before he had finished his report, but invited him to stay and witness the autopsy. The Shelby County medical examiner, perhaps, had already decided what the official cause of death would be.
Francisco and the hospital authorities knew that the world was waiting for their announcement about what killed Elvis Presley. News people were swarming around inside and outside of the hospital. Maurice Elliott, the hospital’s vice president, knew that he had to give the journalists something to report. After Elvis’s body had been wheeled away to the morgue, he told them that Elvis had been pronounced dead at 3:30 p.m., apparently of heart failure. He also scheduled a press conference with the pathologists for 8:00 p.m. As that hour approached, the pathologists were still working on the body and realized that they could not say with scientific certainty what had killed this man. They knew that he did not die of the usual causes, and they knew that addiction to drugs was the probable cause, but they could say nothing with confidence until they got the results back from the laboratories, if then. That would be a matter of weeks. The press and the world were not likely to wait patiently for their verdict.
At eight o’clock the hospital conference room was crowded with journalists when a team of doctors entered and took places behind tables in the front of the room. Dr. Francisco made himself the spokesman for the physicians. He sat down in front of a bank of microphones, flanked by Dr. Nichopoulos, Dr. Muirhead, and five other physicians. All of the hospital doctors still wore their white smocks, while Dr. Nick sported an open-necked black silk shirt, diamond rings, and gold jewelry.
Dr. Muirhead thought that Francisco would say that they would need to study the lab results before they could complete the autopsy and offer their judgment. Instead, Francisco opened with the flat statement that “the results of the autopsy are that the cause of death is cardiac arrhythmia due to undetermined heartbeat.” Muirhead could not believe his ears. Francisco had not only presumed to speak for the hospital’s team of pathologists, he had announced a conclusion that they had not reached. He said that Elvis had simply died of heart failure.
Francisco continued his indictment of Elvis’s heart. “There are several cardiovascular diseases that are known to be present,” he said. “One is a mild degree of hypertension that had been under treatment for some time, and that there was hardening of the arteries, the coronary arteries of the heart, known as coronary atherosclerosis.” During the autopsy, the doctors had decided that these conditions were indeed present but not involved in Elvis’s death. Francisco talked pointedly about the existence of these two conditions as if they were important, but he was also careful to indicate that they were not serious. He wasn’t lying, but he really hadn’t said anything of substance either.
If Francisco wanted the world to leap to the conclusion that Elvis died of a heart attack without his actually saying so, it was a brilliant presentation. The message was that Elvis’s physicians had been monitoring his heart closely for a substantial period of time and there had been no indication that heart failure would kill him. The press and soon the world understood that a prestigious team of pathologists had said that Elvis died of heart failure, suddenly and without warning. It was a crisis that could not have been avoided. No one was at fault in Elvis’s demise.
Francisco properly cautioned that the final and official determination of the cause of death would take days or weeks. Indeed, he warned, the cause “may never be discovered.” Nevertheless, he proceeded to announce that he was absolutely certain of one thing: it was not drugs. Elvis was taking medication for high blood pressure and his colon problem, he said, but “there is no evidence of any chronic abuse of drugs, whatsoever.” Again, Dr. Francisco was marvelously ingenious in his use of language. If he referred only to street drugs, he was correct. If he meant to include prescription drugs, he was lying.
Dr. Muirhead was sorely embarrassed for himself, his staff of pathologists, and his hospital. He later said that he wished he had spoken up, but did not because he did not know what the laboratory reports would show. Even later, he was silenced by the fact that the autopsy report belonged to Elvis’s estate, not to the state, and hence was not public knowledge.
During the press conference, Dr. Francisco did not invite Dr. Muirhead or any of the other pathologists to speak after he finished, but rather turned the microphone directly over to Dr. Nichopoulos. Dr. Nick seemed “positively jubilant” over the medical examiner’s pronouncement that drugs were in no way involved and, in effect, no one was responsible for Elvis’s death. He told the journalists that he had been Elvis’s private physician for a decade and he knew positively that he had not been taking hard drugs. “If he was taking cocaine,” he declared, “I would have known about it.” He had given Elvis a complete physical only five days before, he said. “He was getting over an eye infection and a sore throat, but overall he was a healthy man.” Elvis’s death was simply a bolt out of the blue, a tragedy that no one
could have prevented.
What Killed Elvis
Several weeks later, Baptist Hospital pathologists received the laboratory reports. They revealed a number of prescription drugs present at toxic or near-toxic levels in the specimens tested, in particular codeine, which was present at many times the therapeutic level. The pathologists concluded that Elvis died from a reaction to drugs. Virtually unanimously, medical experts involved in Memphis and elsewhere agreed that it was the combination of many drugs, “polypharmacy” as they called it, that killed Elvis.
On October 18, Dr. Muirhead presented the meticulously prepared report to Vernon Presley at Graceland. Vernon did not make the information public, and Dr. Muirhead did not feel that he could ethically do so. However, journalists and other interested parties soon managed to learn the contents of the report, at first in part and eventually in full.
Foremost among the journalists was Beth J. Tamke, a hard-driving young reporter for the Commercial Appeal. On October 22, 1977, she published a complete description of the findings of one of the labs that analyzed the specimens taken from Elvis’s body, proving that Francisco was wrong. She had researched the literature thoroughly and learned, as she wrote, that Placidyl, which the labs had found and Francisco had declared was not present, was “lethal when combined with codeine,” as it had been. The “polypharmacy” diagnosis was correct. Beth Tamke was so aggressive and so effective in getting out the true drug story behind Elvis’s death that her editor took her off the case and assigned her trivial pieces. “I wrote stories about Legionnaire’s disease, about cricks in the neck, about water on the knee,” she told the Memphis writer James P. Cole. Ironically, she also was assigned to write obituaries.
Elvis Presley Page 3
