The King Is Dead! Hang The Doctor! (Part Four)
The King Is Dead! Hang The Doctor!
By Stanley Booth
(Part Four)
While all this television business was happened, I knew nothing about it. I had my own worries. They led me Dr. Nick. On March 24, 1978, I had fallen from a granite boulder on a north Georgia mountainside, breaking my back, bruising my brain, learning more about pain than I cared to know, finally developing a drug dependence only slightly less grand than that of the late (and no wonder) Howard Hughes.
After a year I tried to stop taking the drugs my doctors prescribed. I tried twice and twice had grand mal seizures, full-scale epileptic brain-fries, blind, rigid, foaming at the mouth, fighting off unseen enemies, screaming, turning into a hydrophobic wolf. A neurologist tested the impulses coming from my head, told me they were abnormal, and advised me to have my brain injected with radioactive dyes, which I declined to do.
About this time, a friend, a patient of Dr. Nick's, advised me that one night soon I was going to be dead before I was asleep, and advised me to see Dr. Nick. On July 5, 1979, I told Dr. Nick all the above.
"This is interesting," he said, "but what do you want from me?"
"I've been given this room full of drugs," I said. "I don't want to go on taking drugs, and I don't want to be epileptic. What are my chances?"
I filled a bottle, bled, coughed, inhaled, exhaled, held still, bent over, dressed, and waited, sitting on a metal table in a cold little room. Dr. Nick came in, shook his head and said, "Looks like you've lived through a nightmare."
I've survived, I thought. It was news to me. Dr. Nick sent me into his office to wait for him. On the wall beside the door there was a large photograph of Elvis Presley, signed and with the inscription, "To my good friend and physician, Dr. Nick." The office was thick with things that obviously were gifts from Dr. Nick's patients. Among them were many small frog figures, so that the office looked like a Greek gift shop being taken over by swamp life.
Dr. Nick came in. We talked about diet and exercise. I hadn't drunk a glass of milk in years and hadn't exercised since running for a helicopter at Altamont. I mentioned that I had worried my family, and Dr. Nick said he would call and reassure them. He gave me no drugs, sent me to no specialists, but he let me know that I was going to be all right. I was a bit dazed, trying to get used to the idea.
On September 13, 1979, the ABC television network presented the 20/20 show titled "The Elvis Cover-Up." One of its most characteristic touches was an interview with a retired pharmacist from Baptist Hospital, where Presley's stepbrother, Ricky Stanley, picked up a prescription of Dilaudid for Presley from Dr. Nick the night before Presley died. The pharmacist said that having sold Presley the fatal dose weighed mightily on his conscience. No one bothered to tell the man that no Dilaudid was found in Presley's body.
After "The Elvis Cover-Up" was shown, I saw Dr. Nick socially two or three times. He had been presented with a list of charges by the Board of Medical Examiners —— not pathologists but doctors who, to help maintain professional standards in the state, examine the practices of other doctors —— but he wasn't interested in talking about the case. "The lawyers don't want the Medical Examiners to get the idea that we want to try this thing in the media," Dr. Nick said. His accusers had no such reluctance.
On January 13, 1980, Dr. Nick's hearing before the Board of Medical Examiners began. Because of Tennessee's "sunshine" requiring that proceeding of this kind be held in public, the hearing took place in the Memphis City Hall. Public interest in the case was believed to be great, and attendance was expected to be heavy, but it had not been thought necessary to hire the Mid-South Coliseum.
Whatever else the hearing may have been, it was a physical ordeal. The weather was seasonable for January, cold and sometimes wet. The sessions lasted from Monday through Saturday, starting each morning at 8:30 and adjourning usually ten hours later.
The audience, smaller than anticipated, averaged about a hundred people. It included Elvis fans of many descriptions, from old ladies in E.P. baseball jackets to a pair of effete young male twins who had come from Ohio to see Dr. Nick swing. Also in the audience were Dr. Nick's immediate family and many of his friends, among them his priest, Father Vieron. There were reporters, print and broadcast, local and international, and the photographers were like ants at a picnic. ABC television's numerous lights, cameras, sound recorders, and crew, including Charles Thompson, James Cole and Geraldo Rivera, were a constant presence, on hands to take postcards of the hanging.
Behind the Chamber's wooden railing sat the state's attorneys and interrogators, Dr. Nick and his lawyers, the five Medical Examiners, and the referee, or hearing officer. Police in plain clothes stood against the rear wall, staring at the audience.
The start of the hearing was delayed by the glare of the television lights. As the Medical Examiners shielded their eyes, the hearing officer insisted that the lights be moved: "We're going to be here a week, and we can't have everybody go blind."
The charges against Dr. Nick were: first, gross incompetence, ignorance, or negligence; second, unprofessional, dishonorable or unethical conduct; and last, dispensing, prescribing or distributing controlled substances "not in good faith" to relieve suffering or to effect a cure. On the first day of the hearing, the state's attorneys called ten of the twenty patients of Dr. Nick listed in the charges to testify. Tennessee has no statute protecting the privacy of exchanges between doctors and patients; Dr. Nick's patients had to testify or go to jail. The patients —— among them an investment banker, a record promoter, a landscape gardener, a restaurant cashier, a doctor's wife, and two ex-heroin addicts —— were questioned before the public and the press concerning their most intimate problems, which included alcoholism, insomnia, divorces, abortions, obesity, cancer and bereavement. After each person's name in the charges there was a list of prescriptions from Dr. Nick, each list showing a decline in the amount of medicine prescribed. Contrary to the usual pattern in malpractice by over-prescribing, Dr. Nick made no charges for prescriptions and saw his patients often, giving frequent physical examinations. Every patient who testified praised Dr. Nick.
After the patients had testified, the state called Dr. Nick himself to the witness stand. His lawyers insisted that he should not be forced to testify for his accusers; that he would take the stand and submit to cross-examination, but as part of his defense, not the state's prosecution. The hearing officer took the position that the hearing was not a criminal court, and that no statute prevented the state from calling Dr. Nick. The first day ended with Dr. Nick's lawyers intending to seek a ruling on the question in chancery court.
But on Tuesday the defense relented. A chancery court suit might take years; so Dr. Nick, wanting to settle the larger issue, took the stand. He discussed his prescribing practices, talking about each patient in the charges. Count number fifteen, Elvis Presley, received the most attention.
Responding to questions from the state's attorneys and the Medical Examiners, Dr. Nick described the progress of his relationship with Elvis Presley. He told of his efforts, with the help of Memphis alcohol and drug abuse specialists David Knott and Robert Fink, to save Presley's life and restore him to health after his nearly fatal overmedication by the fake acupuncturist in Los Angeles. After Presley learned that Drs. Knott and Fink, who had been called in by Dr. Kick, were psychiatrists, he refused to see them.
Keeping drugs from other doctors away from Presley was a continuing problem, Dr. Nick said. He attempted to consult with other doctors who saw Presley, "trying to get some continuity in his treatment," but Presley, without telling Dr. Nick, saw doctors in other towns, some of whom sent him medications by mail. Presley employees were instructed by Dr. Nick to turn over to him all medicines from other doctors so they could be discarded or replaced with placebos.
In 1973, following Presley's "acupuncture" treatments, Dr. Nick said, "I thought he was addicted. I do not think he was an addict." Although he made extensive use of placebos in treating Presley, Dr. Nick said, Presley "had a lot of chronic problems ... degenerative changes in his back and neck ... that you couldn't treat with placebos." Still, there were times when Presley could not be persuaded to take any medicine at all. Before a Las Vegas opening that Presley considered most important, he refused to take even antihistamines, saying, "This one's on my own."
On "The Elvis Cover-Up" program, Geraldo Rivera had accused Dr. Nick of prescribing five thousand drug doses to Presley in the last six months of his life. The Board's revised list of charges made it twelve thousand drug doses in Presley's last eighteen months. Perhaps the single most important point in Dr. Nick's testimony was his statement that the drugs were not for Presley alone but for the entire company, as many as a hundred people, who worked with Presley on the road. Presley appeared with a male vocal group, a female vocal group, a rock and roll rhythm section, and a large orchestra with strings. Dr. Nick, after learning from a few tours' experience what he was likely to need, came prepared to care for everyone from the equipment handlers to the flute player, including the record producer with the kidney transplant.
"I carried three suitcases full of equipment," Dr. Nick said. "I had everything you'd expect to find in a pharmacy —— all kinds of antibiotics for people who were allergic to penicillin, I had expectorants, I had decongestants, I had just what you can imagine you'd use every day in your office. I carried a laryngoscope, I carried some long forceps in case he aspirated, I carried these little bags for breathing, I carried suture material, adhesive tapes, splints, everything that you would expect a first aid stand to have, plus what a physician would have."
The suitcases were kept locked and in Dr. Nick's possession. When he was away, a nurse kept the suitcases and dispensed drugs only according to Dr. Nick's specific orders. Twice during the last six months of Presley's life, Dr. Nick's car was broken into and drugs for tours were stolen and had to be replaced. The Memphis Police Department had been notified both times.
The drugs were bought in Elvis Presley's name because otherwise Vernon Presley, his son's bookkeeper, wouldn't have paid for them. A long-time acquaintance of the Presleys has said, "Vernon would cringe when he had to spend money. You could actually see him cringe." Dr. Nick wrote prescriptions in his own name before a vacation trip to Hawaii with Presley, some of his associates, and their families because "I knew that if I had charged him for the medication that I was taking along, his father would blow a gasket." Presley gave away fleets of cars, fortunes in jewelry, houses, hundreds of thousands of dollars, but his father could never stop pinching pennies. It was all part of the unique dilemma of being Elvis Presley's physician.
Dr. Nick acknowledged the absence of written records of Presley's treatment, saying, "The reason some of these things were not kept in the office or someplace was that people were always perusing his charts. It was difficult to have any confidentiality with his records, whether it be in my office or the hospital or wherever. I certainly wish now there were records. That would certainly be helpful. I think that if he hadn't died, the end result as far as his improvement during this period of time is answer in itself."
Dr. Nick said that he had received with Presley's help a bank loan to pay for his house, and that he was repaying the loan with interest. He had never charged Presley for visits to Graceland. Speaking of the per diem fee Presley paid the Medical Group for Dr. Nick's time on the road, Dr. Nick said, "It's difficult to pay for services that last eighteen hours a day.
"My objective was to help him," Dr. Nick said, "because I thought that he helped so many people —— not physically or monetarily, but —— to keep him rolling and to go to his show and see what reward all these people got —— it's an experience that you'd have to go through."
In spite of Dr. Nick's talk of rewards, the state's assumption seemed to be that Presley was, as Geraldo Rivera had said on 20/20, "just another victim of self-destructive over-indulgence" who had "followed in the melancholy rock and roll tradition of Janis Joplin, Jimi Hendrix, and Jim Morrison." The idea of Presley following in the tradition of Joplin, Hendrix and Morrison defies chronology, sociology, musical history and common sense, but neither "The Elvis Cover-Up" nor the hearing had any connection with common sense.
On the second day of Dr. Nick's testimony there was a bomb threat. Years of effort to keep Elvis alive had earned Dr. Nick threats and accusations, cost him many thousands of dollars in legal fees, and brought shame to his family. "You killed Elvis!" people driving past Dr. Nick's house yell at him, or his wife, or his children.
The Medical Examiners didn't appear to sleep while he testified, as some of them seemed to do at times when other witnesses testified, but Dr. Nick's testimony had the effect of making the witnesses for his defense anti-climactic. The first of the three doctors who were expert witnesses for the state was a pharmacologist who had never treated any patients; the next said that drug addiction should be cured in two or three weeks, and the last testified that he refused to treat patients who smoke. None of them had any firsthand knowledge of Dr. Nick's patients. Each of the experts perused the charges, saying where he thought Dr. Nick had gone wrong.
Then the defense began. It was late Wednesday afternoon. The party had been going on for three days. There was time this afternoon for the defense to present only two witnesses. Both were ex-girl friends, one of Presley, one of Joe Esposito. Both were good-looking, and though they verified important matters —— Dr. Nick's treating Presley with placebos and intercepting drugs from other physicians —— their very glamour made them seem out-of-place; they seemed to be comic relief.
On Thursday the defense called sixteen witnesses, among them doctors, members of the Presley staff, Health Related Boards investigators, a coordinator from the Medical Group and a patient, a department store executive who told how Dr. Nick helped him overcome the addiction to narcotics he developed while hospitalized for months following a car wreck. The coordinator testified that the Medical Group had fifteen thousand patients, thirty-five hundred of whom were Dr. Nick's. The twenty patients listed in the charges represented one half of one per cent of Dr. Nick's patients. By choosing at random and comparing six of Dr. Nick's full working days at the Medical Group, it was shown that he prescribed controlled substances to only one out of every twenty patients.
The Health Boards investigators admitted meeting and exchanging information with the 20/20 staff before the charges were delivered to Dr. Nick. One of the investigators testified that the recommendation for the state to file charges against Dr. Nick was made without consulting even one licensed physician. Later, James Cole would admit that he gave the investigators the tip on the Presley "drug death" in the first place.
The Presley employees testified that Dr. Nick cared for all the people who worked with Presley, not just Presley himself. They verified that Dr. Nick gave Presley no medication in an uncontrolled manner, that Presley at times left town to get drugs he couldn't get from Dr. Nick, and that Dr. Nick had instructed them to intercept all drugs coming to Presley from other sources.
Dr. Nick had testified that in 1975 he had arranged for a nurse to live at Graceland "so we could better control and dispense medications." The nurse, Tish Henley, testified that she often took away from Presley medications that did not come from Dr. Nick, and that she sometimes, under Dr. Nick's orders, gave Presley placebos. At no time was dispensing drugs left up to her discretion. After tours, she said, copious amounts of leftover drugs were destroyed.
Some doctors to whom Dr. Nick referred Presley testified that Presley had showed no signs or narcotic or hypnotic abuse. Dr. Nick was said to show a remarkable interest in patients he referred to other doctors. Dr. Lawrence Wruble, a gastro-intestinal specialist, said that at one point he and Dr. Nick had told Presley to stop doing two shows a night in Las Vegas or they would stop being his doctors, and from that time Presley did only one show. Wruble spoke highly of Dr. Nick's care and concern for Presley. Dr. Walter Hoffman, a cardiologist at the Medical Group who has known Dr. Nick since he was a graduate student, described him as "more empathetic than any practitioner I have ever known."
During the hearing's first days, the audience had been divided between Dr. Nick's supporters and detractors. By Thursday afternoon, the troops were tired. Some of us had settled down to being simply reporters with battle fatigue. When the hearing stopped for the day, I had a question for Geraldo Rivera, who was sitting amidst his crew beside an empty seat. After "The Elvis Cover-Up" story, Rivera had done a follow-up in which he said that if Presley's autopsy report were released, the information in it——
"'...would send at least one doctor to jail,' yeah, I remember," he said.
"Were you talking about Dr. Nick?"
"Yes, but I didn't understand. I didn't know about all his other patients. I didn't believe Elvis was getting drugs in the mail. I'm beginning to see another side of Dr. Nick. He was definitely no scriptwriter. He made mistakes with Elvis, but I think he's a good man. I just feel bad about his family. I see them looking at me, and I can tell what they're thinking."
"It's obvious they hate your guts," I said pleasantly.
On Friday morning, Dr. Jerry Francisco, the Shelby County Medical Examiner, took the stand and repeated his conclusion that Elvis Presley died of cardiac arrhythmia brought on by high blood pressure and hardening of the arteries. Presley's heart was twice the normal size for a man of his age and weight, his coronary arteries were occluded, and he had a long history of hypertension.
Dr. Francisco said that the amounts of drugs in Presley's body did not, even in combination, indicate the likelihood of a drug overdose. The circumstances of his death also indicated that drugs were not at fault. If Presley had taken an oral overdose of drugs shortly after 8:00 A.M. on the day he died, he might have been in a coma by 2:30 P.M., the time he was found, but he would hardly have been stiff and blue, dead for several hours. The typical victim of an oral drug overdose dies a lingering death in a comfortable position, not pitched forward on a bathroom floor.
Dr. Francisco was followed by Dr. Bryan Finkle, an English toxicologist, now Directory of the University of Utah Center for Human Toxicology. Dr. Finkle, who has worked in forensic toxicology at New Scotland Yard, testified that the concentration of drugs found in Presley's body was not sufficient to affect Presley's respiration or the amount of oxygen in his blood. Dr. Finkle said that although he had been quoted on "The Elvis Cover-Up" program as saying that drugs may have made "a significant contribution" to Presley's death, he had not been informed, when a member of the 20/20 staff telephoned him, that he was being interviewed or that his statements "would be construed in such a fashion."
Dr. David Stafford, a toxicologist at the University of Tennessee Center for the Health Sciences, said that he had tested Presley's autopsy samples for thirty or forty drugs and had found nothing consistent with the diagnosis of a toxic drug dose.
The last defense witness —— what idiots some lawyers are —— not a doctor, testified that Dr. Nick, by caring enough to seek an opinion from a second surgeon, had saved the leg of his old maid aunt.
After lunch on the last day of testimony, portions of "The Elvis Cover-Up" program were shown to the Examiners, and the lawyers for both sides made their closing statements. The defense said that the collaboration between ABC television and the state's investigators concerning Dr. Nick "allowed the media to punish him unmercifully —— without any justice —— from September 13, 1979, through January 18, 1980." It was pointed out that Dr. Nick profited from no one's drug dependence, that even patients who took advantage of his trust to obtain drugs had, over the length of time in the charges, been withdrawn from drugs. Dr. Nick had at times, for a variety of reasons, kept incomplete records, but that situation had been corrected before the charges against him had been filed. Dr. Nick, the defense said, "is a fine, compassionate, sensitive physician."
The prosecution said that regardless of Dr. Nick's good faith and intentions, we live by standards, and Dr. Nick had violated the standards of his profession. He prescribed too many drugs, in inappropriate amounts, for too long a time. The Examiners were called on to revoke Dr. Nick's license "until such time as the Board can be sure that his practice is consistent with good medical practice."
On Saturday, January 19, 1980, the Board voted on the charges against Dr. Nick. Of the first two charges —— gross incompetence, ignorance or negligence; unprofessional, dishonorable, or unethical conduct —— the Board unanimously found Dr. Nick innocent. But he had violated certain relatively minor regulations. He had discarded, without keeping records, drugs whose fate must be recorded. He had also allowed certain patients to receive too many drugs, even though in the long run he had withdrawn them from drugs. The Medical Examiners found Dr. Nick guilty on ten of the charges of improper prescribing in the complaint.
One patient to whom Dr. Nick was found guilty of improper prescribing was Elvis Presley. However, one of the Examiners said that the guilty verdict was only for faulty record-keeping and commented that he had found "no evidence that Dr. Nichopoulos was negligent in his care of this patient." Another of the Examiners said, "I think we have to consider the extraordinary circumstances under which he was operating. He was under the gun. I think he exercised considerable restraint in trying to control the medication. There are very extenuating circumstances, and I certainly agree that there was no involvement by Dr. Nichopoulos in any way in the death of Elvis Presley."
The Board suspended for three months Dr. Nick's license to practice medicine, and he was put on probation for three years. The sentence, after "The Elvis Cover-Up" allegations, seemed to some people absurdly light. To others, it seemed unnecessary chastisement of an excellent physician.
At least, Dr. Nick thought, he had run the gauntlet, it was over. He had told what he had done, the Medical Examiners had made their ruling, and it was a relief to have the matter settled at last.
So Dr. Nick thought until he realized that the matter wasn't settled at all. No one had gone to great lengths in reporting the testimonies of Dr. Nick or the witnesses for his defense, but in March, 1980, Memphis, the local slick-paper magazine, published an article called "The Elvis Expose: How ABC Unearthed the Story, the Real Story." It said that Dr. Nick at the hearing had described Presley as a "ranting drug addict." Without irony it quoted Charles Thompson as saying, "They haven't said anything that disagrees with our first report ('The Elvis Cover-Up') last September." It took no notice at all of the testimonies that the drugs Dr. Nick ordered in Presley's name were not all for him. This is not surprising, since the writer of the article, Tom Martin, a Federal Express employee who writes in his spare time, attended the hearing only on Friday and Saturday mornings and was not present to hear any of the other testimony. It was as if Dr. Nick and the other defense witnesses had never spoken.
The article described with complete acceptance Thompson's personal inclination to believe that Presley died of drugs, James Cole's telling the Health Related Boards' chief investigator about Presley's "drug death," and presented the ABC team in much the same light that they, in one of their various motions to have Presley's autopsy report released, had shone on themselves: "...we think that we behaved toward Dr. Nick with the highest courtesy and consideration. We are confident of the truth, honesty, and fairness of what we have broadcast and believe there are no grounds for charges of unfairness, false portrayal, prejudice, exploitation, or sensationalism."
Except for the Greek newspapers, calendars, and bric-a-brac, Dr. Nick's mother's house in Anniston is exactly like my grandparents' house in South Georgia, down to the African violets in the breakfast room. Being there is my idea of Greek Orthodox Heaven: nobody forces you to do anything, and there is so much delicious food you don't have a chance to get hungry.
We arrived on a Friday; Saturday afternoon we took a break from Mrs. Nichopoulos' wonderful cooking and ate sandwiches from the Golden Rule Barbecue. After lunch we went to the Highland Cemetery to visit the grave of Dr. Nick's father, who died in June, 1979, before the scandal broke. Dr. Nick had told me that one strong bond between him and Presley had been the respect they both had for their parents. I was sure Dr. Nick was glad that his father hadn't died suffering with him the humiliations of the last year.
Later, in the late afternoon at the house Dr. Nick had left to find his future, he reminisced further about the days when he spent so much time taking care of Elvis: "I'd spend two or three hours a night taking care of his eyes. Elvis had glaucoma. He used to dye his eyelashes, and I think that may have had something to do with it. And he'd get these bacterial infections on his skin —— you know, Elvis didn't bathe."
"No," I said, "I didn't."
"He'd take sponge baths, but he wouldn't get wet. He took these pills from Sweden that are supposed to purify your body."
I remembered Billy Smith, Presley's cousin, testifying at the hearing that on the morning of the day Presley died, after they had played racquetball, Presley had cleaned up, and Smith had dried his hair. It was nothing unusual to Presley or to Billy Smith, but I wondered whether many people would ever understand the strange life of Elvis Presley, the sharecropper's millionaire son, the Pauper who became the Prince. He may have been uneducated, he may have been uncultured, his favorite food may have been peanut butter and mashed banana sandwiches, but he was still the King, and the King didn't open jars, or dry his own hair, or take baths like the common folk. Not even Mick Jagger keeps a cousin on hand to dry his hair, but Mick Jagger's mother never worshipped him or cared for him as lovingly as Gladys Presley had cared for Elvis.
Elvis had been the King, and now he was just a dead junkie, and many people thought the one at fault was Dr. Nick. The next day, when we left for Memphis, it was misting in Anniston, with just a few raindrops. As we drove, the rain stopped, the afternoon grew warm, the sky was clear and blue. We opened the sun roof and listened to tapes of Elvis singing. Then the weather changed again, and by the time we reached Memphis it was cold, and the sky was overcast, gray and bleak.
On May 16, 1980, the Shelby County Grand Jury indicted Dr. Nick in fourteen counts of illegally prescribing. Each count is punishable by a prison sentence of two to ten years and a fine of as much as $20,000. Dr. Nick is free on bond and awaiting trial.
A local official, a friend of both Presley and Dr. Nick, told me, "They'll ruin him. It's not that they could do it; they're doing it. The prosecutors don't care what good he's done. They'll put him in jail if they can, and if they can't, they'll bankrupt him. They'll get him on a technicality or keep indicting him on slightly different charges until they break him."
"It's like a medieval ducking trial by ordeal," said a doctor who also knew both Presley and Dr. Nick. "If Dr. Nick drowns, he's innocent."
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