Cyril Wecht: Forensic Pathologist

Elvis Presley

On August 16, 1977, Ginger Alden found Elvis Presley, the King of Rock 'n' Roll, dead in his bathroom at Graceland Mansion.  He was only 42.  There was much speculation about how a man so young—though obviously overweight--could just suddenly die.  People speculated about drugs, and hoped to hear that it was from some natural cause.

Memphis medical examiner, Dr. Jerry Francisco, gave a quick statement to reporters about his findings. He said that Presley's heart had stopped, possibly from cardiovascular disease. When asked if there were drugs involved, Francisco stated quite definitively that "drugs played no role in Elvis Presley's death." 

This was a relief to those who wanted to preserve their idealistic image of Presley.  Yet in the months after Presley's death, Francisco refused to release the autopsy and toxicology reports to the public, claiming they were not part of an official investigation.  He also said that the autopsy had been done at Baptist Hospital in Memphis by their pathologists, and that he was not the official medical examiner.

Then in October, Baptist Hospital pathologists contradicted Francisco when they said they believed drugs were responsible for Presley's death.

Francisco held a press conference in response and once more denied that drugs were involved.  It appeared that someone was wrong.  Was Francisco covering something up?

In 1979, Charlie Thompson from the ABC television news show, 20/20, asked Cyril Wecht to review and interpret the medical reports he had acquired for Presley. 

"My task was simple," Wecht writes in Cause of Death. "Review the toxicology report and compare it to the final autopsy report.  I was then to determine if there were any disparities, contradictions or irregularities in the medico-legal investigation." 

Wecht studied the documents and realized that Baptist Hospital had made separate identical samples of specimens, sending one set to Dr. Francisco and the other to Bio-Sciences Laboratory in California, a highly respected private toxicology lab.  Townsend gave him a copy of the Bio-Sciences lab report and he was astonished by what he saw.   He concluded that Presley had indeed died as a result of a combined drug effect.  The use of different types of central nervous system depressants, or "downers," had depressed his heart and lungs.   To his mind the death was accidental, and he went on to stress the dangers of two or more doctors prescribing medications for one patient but failing to check with each other.  

"I think this would be a bona fide medical malpractice case that would certainly require further study and possible legal action," he pronounced in an interview.

He also said that if one doctor prescribed all the medication, it would have been "poor, unacceptable, and potentially dangerous medical care." 

But there was another matter as well—the matter of professionalism.  Dr. Francisco had given several press conferences.   Wecht believed he had been unprofessional and had acted in an inconsistent manner.   He had offered a cause of death while the autopsy was still being performed and before any official statement had been issued.  He had also spoken before getting results from the toxicology lab.   Even worse, Francisco had claimed that cardiac arrhythmia was the cause of death, when that is a condition that can be determined only on a living person, and not from an autopsy. 

Wecht went public to denounce this behavior.

In response, a judge in Tennessee ordered the entire Elvis autopsy report to be released to the public.  It supported Wecht's analysis and further contradicted Dr. Francisco's initial statement.  The report showed no congestive heart failure, no blood clots or hardened arteries to indicate a heart attack, and no sign of a stroke.  "He had a slightly enlarged heart," Wecht recalls," but that's not heart disease."

Dr. Nichopoulos, Presley's personal physician, also had made a statement after Presley's death that dismissed the possibility of a drug overdose. But since his reputation—and his practice--was on the line, his statement could not be trusted. 

After Wecht's appearance on 20/20, Dr. Nichopoulos was charged with over-prescribing drugs to Presley.  It was shown that within the seven months preceding the singer's death, the doctor had prescribed more than 5,300 tablets of various stimulants and downers to him.  However, when Nichopoulos' attorney demonstrated he had been attempting to wean Presley from his addiction and prevent him from buying street drugs, the physician was acquitted. 

When questioned about this case, Wecht says, "I'm not a hyper-moralist, but when I'm asked about a case in the news media, I'm not going to try to finesse it.  I don't dictate anyone's ethical standards, but neither will I be an apologist for them. Jerry Francisco pulled a fast one.  Forget that it's Elvis Presley.  He was 42 and died unexpectedly.  If that's not a medical examiner's case, then I'll eat the protocol of any office—of course it's a medical examiner's case.  They [the people around Presley] weren't going to do anything to besmirch the reputation of the number one industry in Tennessee and one of the number one industries of America—the Elvis memorabilia.  I don't have time for professional BS in my field."

Despite his reputation for readily expressing his opinion, there are times when he believes the evidence is insufficient to make a definitive call, and such was the case in the controversial Green Beret murders.