He changed the face of rock ‘n’ roll forever – but by the time he died, Elvis Presley was just as unrecognisable.
As a teenage heartthrob adored by millions of female fans in the 1950s, ‘The King’ was a picture of good health, famously serving in the army despite his superstar status.
Yet in his later years, the pop legend had become famous for his life of excess, gorging on meatballs wrapped in bacon and drinking so much Pepsi that entire lorries reportedly delivered directly to his Graceland residence.
On August 16, 1977, Elvis was found dead at home, face down on the floor of his bathroom after appearing to have fallen off the toilet.
Weighing 25 stone, a post mortem found he had compacted stool that was four months old sitting in his bowel, while it later emerged he had been prescribed almost 9,000 pills, vials and injections in the seven months before his death.
News of the death sent shockwaves around the world, and to this day theories linger about the star’s final days – and just why his extraordinary life was cut short at the age of just 42.
Heart twice the size and grim bowel discovery
As a young man Elvis had been extremely fit, playing football and practising martial arts.
Struggling with his rapid rise to international fame, however, the singer began taking amphetamines in his early twenties, along with depressants to cope with insomnia.
Alongside his spiralling drug use, Elvis’ diet also became the stuff of pop legend.
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He developed a fondness for fried peanut butter and banana sandwiches and other unhealthy snacks, which paved the way for a number of conditions including diabetes, high blood pressure and glaucoma.
In his final months, he spent days barricaded and bed-bound in his home, gorging on platters of cheeseburgers.
On the day of his death, it was his fiancee Ginger Alden who found the rock and roll star’s body with his pyjama bottoms around his ankles and his bottom in the air.
Of the distressing scene, Ginger, who was just 21 at the time, wrote in her memoir: “His arms lay on the ground, close to his sides, palms facing upward.
“It was clear that, from the moment he landed on the floor, Elvis hadn’t moved.”
“I gently turned his face toward me. A hint of air expelled from his nose.
“The tip of his tongue was clenched between his teeth and his face was blotchy.
“I gently raised one eyelid. His eye was staring straight ahead and blood red.”
An autopsy was carried out that same day but the report was immediately sealed for 50 years by the family, sparking a slew of speculation as to what killed him.
Nonetheless, post mortem results laid bare just how seriously the once lean and fit star’s health had deteriorated.
Elvis’ heart had swollen to almost twice its normal size and it emerged he was in the advanced stages of cardiovasuclar disease.
Despite never having smoked, his lungs were riddled with emphysema, which would have made it almost impossible for him to breathe.
His bowel contained the most gruesome discovery of all – it was almost twice the length it should have been and was filled with stool at least four months old.
The first post-mortem recorded Elvis’ cause of death as cardiac arrest and the medical examiner, Dr Jerry Francisco, insisted “drugs had played no part in Presley’s death”.
However, as the extent of his substance abuse became clear, fans demanded answers – particularly over the actions of his personal physician.
Carried three suitcases of drugs prescribed by doc
Three years after Elvis’ death, Dr George Nichopoulos – the singer’s Memphis physician – had his medical licence suspended by the state of Tennessee for three months for indiscriminately prescribing controlled substances.
The medical professional, dubbed ‘Dr Nick’, inspired the name of the questionable doctor who became a recurring character in The Simpsons.
It emerged that in the last 20 months of Elvis’ life, he was prescribed more than 12,000 pills and carried three suitcases of drugs around with him – though Dr Nick claims these were meant for use by the star’s entire team.
His supply of drugs included uppers, downers and painkillers so strong they were usually given to patients in the end stages of cancer.
While arguing that he prescribed the pills to stop the musician turning to street drugs, the doctor later admitted Elvis was in denial about his addiction.
“Elvis’ problem was that he didn’t see the wrong in it. He felt that by getting it from a doctor, he wasn’t the common everyday junkie getting something off the street,” he said.
In 1981, Dr Nick was charged with 11 counts of overprescribing drugs, but acquitted. However, he lost his medical licence permanently in 1995.
Fears over Elvis’ drug use led to claims he may have died from an overdose, but when the investigation was reopened in 1994, coroner Joseph Davis disagreed.
He explained: “The position of Elvis Presley’s body was such that he was about to sit down on the commode when the seizure occurred. He pitched forward onto the carpet, his rear in the air, and was dead by the time he hit the floor.
“If it had been a drug overdose, [Elvis] would have slipped into an increasing state of slumber. He would have pulled up his pajama bottoms and crawled to the door to seek help. It takes hours to die from drugs.”
Bizarre accidents may have sparked health battles
One fascinating line of inquiry that emerged following Dr Nick’s misconduct trial was the theory that Elvis’ mental state had shifted following a series of freak accidents.
In 1967, while filming the movie Clambake in Los Angeles, the actor tripped over an electrical cord, cracking his head on the edge of a bathtub, which left him unconscious.
Michael Ochs Archives)
Dr Forest Torrent, a Californian physician specialising in how opiates can be used for pain treatment, discovered three further incidents involving blows to the head and suggested Elvis may have been suffering from Traumatic Brain Injury.
The condition can lead to brain tissue leaking into the blood circulation, causing autoimmune disorders that spark the breakdown of other organs, according to Huff Post.
This can result in side effects such as chronic pain, irrational behaviour, obesity and the enlargement of organs like the heart or bowels.
In the years following his accident, Elvis complained of vertigo, back pain, and insomnia, eye infections and headaches.
In 1973 he was rushed to hospital in a semi-coma and found to be suffering from jaundice, severe respiratory distress, marked swelling of his face, distended abdomen, constipation, a gastric, bleeding ulcer and hepatitis.
He was hospitalised again in 1975 with high blood pressure, high cholesterol and a condition called megacolon, whereby the large intestine becomes distended and can allow toxins to flood the body.
He also had at least four near-death overdoses that left him unconscious and in need of resuscitation, and his heart was double the normal size.
‘I’m sick and tired of my life’
In recent years, dark theories have even suggested the star may have committed suicide.
In the HBO documentary, Elvis Presley: The Searcher, ex-wife Priscilla hinted at Elvis’ unhappiness, as letters to a close friend emerged in which he claimed: “I’m sick and tired of my life.”
The LIFE Images Collection via Getty Images)
“He knew what he was doing and people go, ‘Why didn’t anyone do anything?’ Well, that’s not true,” Priscilla told the show.
“People there in the inner group did – but you did not tell Elvis what to do.
“You’d have been out of there faster than a scratched cat. They would try and – no way.”
The singer was tormented in his final days by the looming release of a tell-all book by two former bodyguards, which laid bare the extent of his drug use, The Sun reported.
“Their book came out 10 days before he passed but he’d had the manuscript for six months,” his stepbrother David Stanley said.
“Reading those truths tore him apart. It got to him so badly that he felt he couldn’t put himself into a situation where he was seen in public.”
Elvis’ nurse Letetia Henley also previously revealed that he was “depressed about ageing and not having a woman he loved”, following his split from Priscilla in 1973.
However, the star’s fiancee, Ginger Alden, appeared to pour cold water on such claims, revealing he had expressed his hopes for the future on the day he died.
In January 1977, Elvis proposed to his new love, whom he had been seeing for a year, with a huge diamond ring and he invited her to stay with him in Graceland in the days before his death.
“He was in a good mood,” Ginger said of the fateful day she found his body. “We had just set a wedding date literally hours earlier and he told me a couple of weeks before he passed that he had been off too long,” she said.
“He was ready to go back on stage, something he loved with all of his being.
“This day had begun with excitement and hope for Elvis and me, but ended in heartache and disbelief.”
While mystery still surrounds the circumstances of his heartbreaking death, fans will look to 2027, when full details of the autopsy and toxicology reports sealed by the Presley estate will be made public.
Until then, rumours will continue to swirl about just how Elvis left the building.
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