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The King and Dr. NickWhat Really Happened to Elvis and Me
By George Nichopoulos Rose Clayton Phillips
Thomas NelsonCopyright © 2009 George Nichopoulos
All right reserved.
Chapter OneKindred Spirits
Dr. Nichopoulos. Paging Dr. George Nichopoulos," announced the anonymous voice from the hospital intercom. At the same time, the beeper attached to my belt chirped.
What now? I thought, hesitating with my hand on the cold, steel exit bar, ready to push open the heavy side door. May as well answer, I thought, closing out the humid air on that smoldering hot day in Memphis-Tuesday, August 16, 1977.
"Dr. Nichopoulos. Paging Dr. Nichopoulos."
More chirping from my pager.
There had been a time when hearing my name called over the intercom was exciting for me-the same way I'd heard doctors paged on television: "Calling Dr. Kildare." That was sometime between my Boy Scouts days and medical school. Dr. Marcus Welby, MD, was my idol back then. Those were the days when doctors were the most respected members in a community-the link between life and death. I had liked Dr. Welby's approach, his gentle bedside manner, the way he was always available to his patients.
"Dr. Nichopoulos. Paging Dr. George Nichopoulos."
The personal pager on my belt beeped a third time.
What in the world is going on? I wondered, heading promptly to the nearest telephone andpunching in the number.
"This is Dr. Nick," I said firmly into the receiver, knowing I would soon be heading in the direction of the call-Graceland, the home of my famous patient Elvis Presley.
"Dr. Nick!" The frantic voice was unmistakably that of Joe Esposito, Elvis's disciplined, Chicago-born-and-bred road manager, who seldom lost his cool. "You need to get here quick. Something's happened to Elvis."
"Calm down, Joe," I responded automatically.
Joe continued racing through his message: "I think he's had a heart attack."
"Is he responsive at all?" I asked, attempting to hide my concern. Joe paused for a few seconds, then replied: "Yeah. When we tried to turn him on his back, I heard him breathe."
I sighed with relief. Before I could give instructions, Joe interrupted: "You need to get here quick," he repeated in a trembling voice. "I've called for an ambulance."
"On my way," I snapped, slamming the receiver back into its cradle.
Elvis had been doing very well health-wise, so this episode concerned me. I did not expect anything critical to be going on-especially nothing terminal. Since I had no other details, I tried to review what I knew.
I had swung by Graceland to see Elvis last night and left about ten o'clock when Ginger Alden, his current beauty-queen girlfriend, came in to accompany him to the dentist. As usual, the dentist was prepared to accommodate Elvis's nocturnal schedule. When I talked with Elvis later, about two o'clock this morning, his tooth was still hurting. At that time he sounded very nervous; his conversation was rambling. He was muttering as if he was upset and didn't know how to explain it at the time, or as if someone was standing there listening.
He told me he wanted to play some racquetball. Since he had been under so much stress because of Ginger's refusal to go on tour with him, I thought playing racquetball might be good for him. I also wanted him to get a good night's sleep before leaving for the tour. Maybe that is all that had happened-Elvis had simply overexerted himself. At the same time, I knew Joe was definitely not an alarmist, yet his voice sounded anxious in a way I had never heard it before.
Certainly by the time I get to Graceland everything will be all right, I reasoned, trying to keep my eyes and my mind on the road for the six-mile drive. I was very familiar with the route I would travel-a fifteen-minute drive if I observed the forty-mile-per-hour speed limit-ten if I didn't.
My mind began meticulously running down a list of everything that had happened to Elvis in the past that could apply to the situation I might encounter-such as a seizure. I considered the different medications he was taking and any side effects or interactions he might be experiencing. Since Elvis had planned to play racquetball, I thought about the time I had to do CPR (cardiopulmonary resuscitation) on a player who collapsed on the racquetball court. That situation would have been doubtful for Elvis because he did not work out hard when he played doubles with Ginger. She was new at the sport.
Elvis was on his usual pre-tour liquid diet of mostly diet drinks and sugarless Jell-O and Popsicles. I had warned him that with only these in his system he could dehydrate. Maybe that is what happened. If Elvis had dehydrated, that could have altered his electrolytes and caused his potassium level to drop. In the worst-case scenario, that can create a cardiovascular event.
I sped past the busy commercial airport, with its early afternoon traffic. We planned to leave sometime after midnight from Memphis Aero, the city's private airport, on Elvis's jet, the Lisa Marie, for Portland, Maine-the first stop on his scheduled twelve-day, sold-out tour. Whenever we arrived at the airport to leave for a tour, excited fans and family were always there for a big send-off. The only thing lacking was a high school band playing Elvis's dramatic opening number, "2001: A Space Odyssey." That song was always on my mind when the Lisa Marie rolled down the runway and took to the air.
Despite my brief mental diversion, the echo of "Something's happened to Elvis" in Joe's nervous voice would not leave my thoughts for long.
At last I was there-in record time. The wrought iron gates of Graceland were already open and I swirled in. Through the tall trees gracing the circular driveway, I could see the familiar orange-striped ambulance from the Memphis Fire Department. It was ominously waiting in front of the Southern colonial mansion Elvis referred to simply as "the house." My heart pounded as I prayed the situation would not be more serious than I had imagined.
As I pulled my car in behind the ambulance, I could tell Elvis was already inside it on the gurney. Rushing over, I hoisted myself up on the high back step to gain a position close to Elvis's head and the available emergency equipment. The loud chugging drone from the truck's diesel engine made it difficult to communicate with the paramedic. Charlie Hodge, a member of Elvis's band, and Joe climbed inside, and the heavy metal doors closed behind us.
Not knowing what had happened before I arrived at Graceland, I assumed my role in the resuscitation mode already in progress-treating Elvis as though he might have had a syncopal attack (loss of consciousness), seizure, accidental overdose, or cardiac arrest. Joe assured me again that he had heard air come from Elvis's lungs when he moved him. I had no way of knowing how long ago that had been.
I instructed our driver to take Elvis to Baptist Memorial Hospital. It was a split-second decision that I would not allow myself to second-guess. Methodist South Hospital was only a mile away, but Elvis had never been a patient there. I believed Baptist was where Elvis could get the best help the quickest. I could admit him expediently since his records were there; plus I was a staff doctor at Baptist, so I was familiar with the competent specialists who had previously treated Elvis at that location. Baptist also had a renowned Harvey team, a specialized crew who perform emergency cardiac resuscitation. I told our driver to radio ahead to Baptist so they could alert their Harvey team and make ready a room for Elvis Presley; he would be arriving by ambulance in respiratory distress. I then called for the head of cardiology to hurry to the ER.
Our driver eased the emergency vehicle out the front gates, where concerned fans had already started to gather-alerted by their unique grapevine communication system that mysteriously rolled into place whenever Elvis was in town. The emergency medical technician riding with us in the rear of the ambulance began running an IV. He allowed me to take the lead as we worked frantically the entire distance to the hospital, located just seven minutes to the northwest.
Elvis's pitiful-almost unrecognizable-face was swollen and blue, symptoms of cyanosis, a lack of oxygen in his blood.
Several things could be happening, I thought. His condition could be due to toxins such as cyanide or carbon monoxide, or he could have had an allergic reaction causing his lips or epiglottis to swell. He could have choked or suffocated. One thing was certain: he needed a source of oxygen as quickly as possible.
We tried in vain to intubate (put a tube down his throat to allow air in), but we could not position his neck properly to insert the tube. I was not able to see the vocal cords well enough to pass the tube through them into the trachea. As if the procedure itself were not delicate enough, I had the added pressure of knowing that the vocal cords at my fingertips were the instrument of one of the world's greatest singers. Unable to intubate him, we continued the bag breathing that the paramedics had started in order to force air into his lungs. He had severely bitten his tongue, which is common with a seizure or from the impact of a fall. Tiny red carpet fibers were in his mouth-remnants of his futile efforts to gain air; his face had most likely been submerged in the thick pile.
He had no heartbeat. Along the way the EMT and I alternated giving closed chest massage. We administered different medications in an attempt to stimulate his heart, but we were unable to get any sort of blood pressure or heartbeat on the heart monitor. Frantically we worked on different options that would increase Elvis's chances of being revived. Nothing we did brought a response. The longer we worked, the warmer and tighter it became inside the small emergency vehicle, where our hopes were decreasing along with Elvis's chances.
Finally we arrived at Baptist Memorial. The gloomy gray building housed one of the city's most respected hospitals, and I felt secure knowing I would be able to get the help we needed there. The EMTs jerked open the ambulance's metal doors and hauled out the stretcher. They burst through the battered doors of the emergency room entrance and wheeled the gurney quickly down the hallway into trauma room number 1, actually a small operating room already prepared to receive Elvis. I moved aside to let the skilled Harvey team take over.
The lead physician of the Harvey team stepped forward and shot life-giving stimulants into Elvis's body while all sorts of evaluations were going on simultaneously. No response. They placed paddles on Elvis's discolored chest and gave the order to discharge the electronic shocks-still nothing. I stared at the monitor in the distance. Six or eight beats in succession registered on the electrocardiogram machine.
Again a doctor injected stimulants directly into the heart and directly into the IV. Minutes went by-nothing. The electronic shock paddles charged again; another four weak beeps registered on the monitor. The time intervals were brief, with each beat occurring two to three seconds apart, then nothing but silence. The ringing in my ears grew louder and louder in those silent intervals as I strained to hear signs of hope. I slowly began to realize I would never again hear Elvis calling me by my name.
The attending personnel resumed talking-communicating about different things they could try that had worked before and might again. My eyes were foggy with tears. I could discern only blurred images ministering to the still body on the table that had once moved with such power and skill. My own body grew weaker and weaker, drained from anticipating the breath of life that never came.
Medically and scientifically I had suspected that Elvis was gone, but I just could not accept it. I wanted so much for it not to be true. I could not bear the thought of losing Elvis and of letting down everyone who had placed so much faith and trust in me.
The question for me had never been simply whether Elvis was dead or even whether we could revive him. The question was also, had so much time elapsed that if we revived him, he would be brain damaged? There is such a small window of opportunity to supply vital oxygen to the brain. Sadly, I reached the understanding that the air Joe said he heard Elvis exhale when he turned him over was just positional air movement.
The thought kept going through my mind that we were spinning our wheels in the emergency room, but I just could not give up. The doctors kept glancing my way, waiting for me to say the words that would put an end to their futile efforts to help Elvis reclaim his life. Finally, in a voice barely audible even to me, I said the dreaded words: "Stop CPR. He's gone."
The Harvey team slowly backed away from the table, removing their masks and revealing faces of absolute exhaustion. Slowly, with sad resignation, they began undoing all the IVs, breathing tubes, and EKG monitors-life support that had proved useless.
Gradually my shock began to dissipate, awakening me to the painful reality of the situation at hand. I could not imagine what lay ahead for his father, Vernon, still waiting back at Graceland. He needed confirmation; so did Elvis's guys waiting in the next room. Somehow I had to regroup and find enough strength to face those who loved Elvis and were praying for him to pull through. My own feelings needed to be set aside; I still had a job to do.
After arriving at the hospital, Elvis's guys had been ushered into trauma room number 2. There was no sound from inside the small, cramped area until I opened the door, trespassing on the silence. The tears running down my cheeks put an end to their waiting.
"It's all over. He's gone," I said quietly.
Wails of disbelief filled the air.
There with Joe Esposito and Charlie Hodge in the sad space were Al Strada, a trustworthy aide who handled Elvis's wardrobe and other personal matters; Elvis's cousin Billy Smith, who was like a brother to him; David Stanley, a stepbrother, who worked as an aide and helped with security; and David's mother, Dee, who was married to, but currently separated from, Elvis's father. David and his brother Rick, known collectively as "the Stanley boys," had continued to work for Elvis throughout the disrupted marriage. Dick Grob, Elvis's chief of security, had arrived to take charge of the impatient press corps. Belligerent reporters were attempting to maneuver themselves into the scene for a career-boosting scoop on the status of Elvis's condition.
I wanted to stay with the guys so we could comfort one another, but there was an urgent need at Graceland, where hope was surely fading. There were other matters as well that I needed to discuss with Vernon that I knew would be hurtful.
It is very difficult for a doctor when he is a patient's friend. The patient and his family have more confidence in him; their faith in his ability is on an entirely different level. Everybody expected me to do something magical. They were anticipating that I would pull Elvis through because I had done that before during several serious events. The difference was this time I had not been present when the close call came. Sadly I discovered that despite all the precautions we had put into place, the people hired to look out for Elvis had not been there either.
Dick Grob and Al Strada stayed at the hospital for security reasons, and Joe Esposito stayed behind to make the official announcement of Elvis's death at a press conference. I planned to call from Graceland to confirm that the Presley family had been informed, so the world could be told. Joe had been Elvis's point person ever since they were in Germany during their army days. He automatically knew what needed to be done before the story of Elvis's death leaked to the press. His first call was to Elvis's longtime manager, Tom Parker, whom the guys called "the Colonel." Joe had been Elvis's liaison with Parker and knew the urgency of canceling the impending concert dates.
Next Joe would call Elvis's ex-wife, Priscilla. Knowing how crude and insensitive some tabloid reporters could be, Joe wanted to make certain Priscilla heard of Elvis's death directly from him. He understood how concerned Priscilla would be for her nine-year-old daughter, Lisa Marie, who was spending summer vacation with her daddy at Graceland. The couple had remained good friends, thanks to the civility the mutual love for a child can bring to even the saddest of broken marriages.
Excerpted from The King and Dr. Nick by George Nichopoulos Rose Clayton Phillips Copyright © 2009 by George Nichopoulos. Excerpted by permission.
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