Elvis Presley’s last days were quite sad and different from his glory days of performing chart-topping hits for adoring fans.

The iconic star had gained a lot of weight, was covered in sores, and was cared for by a live-in nurse. The singer was also taking lots of drugs and had been prescribed almost 9,000 pills, vials and injections in the seven months before he passed away.

Elvis had stopped doing shows because people said he was hard to understand due to the many prescription pills he was taking every day, and because he was finding it hard to get out of bed. His cousin Billy Smith remembered how Elvis would sit in his room and chat for hours, sometimes talking about his favorite Monty Python sketches and telling stories from his past, but more often he was worried by “paranoid obsessions”.

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Elvis Presley’s nurse, Letitia Henley, penned in her memoir: “He was miserable. He was depressed about ageing and not having a woman he loved.” He missed Priscilla. His friends kept introducing him to pretty 17- and 18-year-old girls but he had nothing in common with them.”

In his final days, the beloved star headed to the dentist at night for prescription pills, played racquetball with Billy at 4am, and enjoyed impromptu piano sessions.

Elvis, at only 42 years old, was then found face down on his bathroom floor. His girlfriend Ginger Alden found him in a peculiar pose with his pyjama bottoms around his ankles. Ginger, only 21 at the time, mentioned in her memoir about the terrifying sight: “His arms lay on the ground, close to his sides, palms facing upward.”

She added: “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.” On that day, autopsy took place, however, the report was sealed immediately by the family for 50 years, leading to numerous speculations about the reason of his untimely death.

Elvis’ heart was found to be nearly twice its normal size, indicating severe cardiovascular disease. Despite never being a smoker, he had serious lung problems that would have made breathing almost impossible.

His bowels held a horrifying discovery; they were nearly double their usual length and filled with stool estimated to be four months old. Dan Warlick, an investigator from the Tennessee State Medical Examiner’s Office, gave credibility to the theory that Elvis died while trying to use the restroom. He stated: “Presley’s chronic constipation – the result of years of prescription drug abuse and high-fat, high-cholesterol gorging – brought on what’s known as Valsalva’s manoeuvre.” Furthermore, “Put simply, the strain of attempting to defecate compressed the singer’s abdominal aorta, shutting down his heart.”

Some people argued that Elvis overdosed on drugs, but coroner Joseph Davis disputed this when the investigation was reopened in 1994. 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 pyjama bottoms and crawled to the door to seek help. It takes hours to die from drugs.”

Only three years after Elvis’ death, Dr George Nichopoulos, who was his doctor in Memphis, got his medical licence taken away for three months. The state of Tennessee said he was giving out controlled substances without caring who got them.

They found out that in the 20 months before Elvis died, he was given more than 12,000 pills and he always had three suitcases full of drugs with him. But Dr Nick says he was meant to give these drugs to everyone on the star’s team.

Among the drugs were some that wake you up, some that make you sleep and super strong painkillers that are usually only given to people with late-stage cancer.

The doctor did say he gave Elvis all these pills because he didn’t want the singer to start buying drugs off the street. Later, he admitted that Elvis wouldn’t admit he was addicted to drugs.

“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.

By 1981, Dr Nick was in trouble with the law for giving too many drugs to patients. They said he did it 11 times, but he wasn’t found guilty. Still, they took his medical licence permanently in 1995.

There’s another reason people think Elvis may have died. This story started ten years before he actually passed away.

California’s renowned doctor, Forest Tennant, looked over Elvis’ autopsy in defense of The King’s physician. He thinks a 1967 head injury led to an autoimmune inflammatory disorder for Elvis. In his 2013 medical paper, he revealed that Elvis tripped over a TV cord and knocked out on the bathtub; the wound was so bad it caused brain tissue to leak into his blood.

The body saw this as an attack and started producing antibodies to wipe it out, causing hypogammaglobulinemia – an immune system disorder. Back then, we didn’t know much about autoimmune diseases but today, from random behavior and constant pain to obesity and diseased organs like hearts and bowels, these are linked to symptoms Elvis had.

Garry Rodgers, a retired detective and forensic coroner, relayed to the Huffington Post in 2016 that based on those findings, he’d attribute Elvis’ death to a heart complication caused by disease and drug use due to an autoimmune condition induced by a brain injury.

Rodgers expressed: “I’d have to classify Elvis’s death as an accident. There’s no one to blame – certainly not Elvis. He was a severely injured and ill man. There’s no specific negligence on anyone’s part and definitely no cover-up or conspiracy of a criminal act.

“If Dr. Forrest Torrent is right, there simply wasn’t a proper understanding back then in determining what really killed the King of Rock and Roll.”

A version of this story was published on January 1, 2024.