The Autopsy

The photographs of Marilyn Monroe in death are nothing new with the possible exception of her body lying on its side in her bed in her Brentwood home, her face turned away from the camera. in bed. Movies and recreations of her death always show her with her hair coiffed and wearing red lipstick. The reality shows a thoroughly New_York_Mirror_Front_Page_of_August_6,_1962disheveled Marilyn, her hair an absolute, tangled mess, her face turned away from the camera. It’s hard to believe that this is the corpse of Marilyn Monroe. Of course we couldn’t expect that Marilyn looked like a beauty queen in death, but the picture is still unsettling, not for her appearance in death so much as knowing how little Marilyn was able to care for herself at the end of her life. Dr. Thomas Noguchi, a new coroner with the Los Angeles County Hospital, conducted the autopsy on the actress. In a press conference he detailed every possible means of death, including the possibility of someone else having administered the fatal dosage of nembutal. Noguchi stated, “I conducted a thorough search of her body looking for syringe marks including a close examination of the vagina. The unembalmed body is that of a 36-year-old, well-developed, well-nourished Caucasian female… the scalp is covered with bleach blonde hair… a slight ecchymotic area is noted on the left hip and left side of lower back.Noguchi was satisfied no forced injections had been given to Marilyn.

Along with samples of blood, internal organs were sent off for toxicology tests. Within several hours 04-bodyNoguchi the toxicology report. The tests on the blood showed 8.0 mg per cent of chloral hydrate, a sleeping pill, while the liver tests revealed 13.0 mg per cent of pentobarbital (or Nembutal). Both of these were well above the fatal dose. Noguchi admits he made a mistake at this point. The toxicology tests had only been performed on the blood and the liver. He should have insisted that all the organs were examined. ‘I am sure that this could have cleared up a lot of the subsequent controversy, but I didn’t follow through as I should have. As a junior member of staff. I think that was a great shame,’ he says, speaking very deliberately. ‘Not suspicious. I’m not saying that; it was a perfectly normal procedure. But still a shame.’  In other words, the good doctor insists that Marilyn was not murdered, and had he followed up with further toxicology tests on other organs, there would have been no doubt about the means of death.

Almost 60 years on, Noguchi, now 82 believes now – as he believed then – that Marilyn’s death was suicide. As for the purportedly suspicious aspects to her death, he picked them off one by one.There was nothing strange that no pills were found in Marilyn’s stomach. A habitual pill user would have had no problem digesting both the Nembutal and the chloral hydrate. As a result, he wouldn’t have expected to have found the barbiturates in her stomach since they would have been pumped straight into the intestine. And anyone familiar with Nembutal would know that the yellow dye on the pills doesn’t run when it is swallowed. And what about Dr Curphey’s insistence that Noguchi perform the autopsy? ‘That is something I still don’t understand,’ he admits. ‘I have thought about it a lot over the years. Maybe he just thought that I would do a good job.’ Anthony Summers in his biography Goddess: The Secret Lives of Marilyn Monroe, stated that when Noguchi pulled the sheet back on Marilyn’s body he and the other staff in the morgue were silent for a moment. “It was as if this young, young woman should get up off the table and walk out the door.”

craveychartDuring the press conference the day after the autopsy, Curphey made the following statements: Any person who takes any depressing drug the pattern of death is pretty much the same. They lose their ability to judge and to act. They lose muscular power and they slip into coma.” Medical evidence also suggested Marilyn had taken drugs hours before dying. This doesn’t at all interfere with the finding of the autopsy that Marilyn committed suicide. The combination of the drugs already in her system and the massive amount of nembutal tablets she took at once, reached a fatal level and caused her death. I don’t see how this is a contradiction or how it suggests murder.

Lionel Grandison, a former Deputy Coroner’s Aide, took part in an inquest into Marilyn’s death. In his new book, Memoirs of a Deputy Coroner: The Case of Marilyn Monroe, Grandison claims Marilyn was murdered. Seeking his five minutes of fame, Grandison claims a diary was recovered in Marilyn’s bedroom and Grand2that it was stolen from the Los Angeles County Hospital. Ronald Caroll, an Assistant District Attorney, took part in an inquest into Marilyn’s death to determine if a full-scale homicide investigation was justified in Marilyn’s death..Caroll’s intention was to prove or disprove whether evidence in Marilyn’s death had been destroyed or hidden and whether her diary had disappeared from the coroner’s office. Supposedly the diary contained several key names of government officials. Grandison claimed 32 nembutal tablets were lodged in Marilyn’s throat but there were none in her stomach. Grandison claimed that when the file was sent to his desk for signing, key police reports and medical documents were absent. He approached the Deputy Coroner Dr. Curphey and inquired about the paperwork. Grandison claims Curphy insisted he sign the death certificate and that “we will take care of that later.” When Grandison refused he claims Curphy threatened him by stating, “sign the death certificate or else I’m going to do something.” We have only Grandison’s word that Curphey threatened the Deputy Coroner’s Aide. Curphey died several years ago and is not here to defend himself. This seems a bit melodramatic. Grandison was later convicted of fraud making him an untrustworthy source.

I lean towards Noguchi’s assessment of Marilyn’s death.He was the doctor who conducted the intensive autopsy of Marilyn Monroe. It was his use of the phrase “probable suicide” that caused confusion. I believe what Noguchi meant was Marilyn herself ingested the lethal amount of pills, then Jackie-Kennedy-talked-about-JFK-assassinationcontacted Peter Lawford believing he would send someone to her aid. This Lawford did do unfortunately the person who was about to attend Marilyn’s house changed his mind. The press conference that was held later in the day showed Dr Curphey discussing the details of Marilyn`s death. Curphey discussed Marilyn`s history of drug overdose. He briefly discussed Marilyn`s psychiatric history.He also used the phrase `it is our opinion that the case is a probable suicide.“

I have included a link below to a blog that used Donald Spotos’ highly acclaimed biography on Marilyn.

Preliminary Report and Final Statement
The preliminary report from the Office of the County Coroner, dated and signed by Noguchi at ten-thirty on Sunday morning, is contained in File Number 81128 in the Los Angeles County Coroner’s Mortuary, Hall of Justice. Los Angeles. The first supplement, a report of chemical analysis of the blood and liver, was dated and signed by R.J. Abernethy, Head Toxicologist, at eight o’ clock on the morning of August 13 (file Number 811128-I) Subsequently, on August 10, Curphey’s preliminary judgement was that death occurred because of a, “possible overdose of barbiturates.” On August 17, this was amended to be a, “probable suicide,” and on August 17, Curphey made his final statement still more forcefully, as “acute barbiturate poisoning – ingestion of overdose.” 

This decision was based on the chemical findings of toxological analyses:

  1. There were no external signs of violence.
  2. There was in the blood a count of eight milligrams of chloral hydrate and four and a half milligrams of Nembutal – but in the liver there was thirteen milligrams, a much higher concentration of Nembutal.

Suicide Prevention Team
There were an empty bottle that had contained twenty-five 100-milligram Nembutal capsules, a prescription dated August 3, 1962, on authorization of Dr. Hyman Engelberg,; and ten capsules remaining from an original bottle of 500-milligram chloral hydrate capsules, a prescription dated July miner25 and refilled on July 31 on authorization of Dr. Ralph Greenson. This was important information for the Suicide Prevention Team, convened at the coroner’s request to come up with a psychological profile of the deceased and thus the likelihood of suicide. “It was obvious to us, after speaking with Dr. Greenson about Marilyn’s psychiatric history,” said Dr. Robert Litman, “that the only conclusion we could reach was suicide, or at least a gamble with death.” But Litman and his colleagues did not believe that Marilyn took her own life deliberately. ”Since our studies from 1960, we have found no authenticated case where barbiturates were involved that a person was so drugged he didn’t know what he was doing.”

She was neither psychotic nor, as Dr. Norman Farberow, another member of the team, added significantly, “an addict among addicts, and she had no physical dependency on drugs. Her intake could be considered light to medium. And she was certainly not mentally unbalanced so far as I could determine.” Litman said, “We wanted to get this over with, to come to a decision, close the case, issue a death certificate and move on. But of course, that turned out to be a misplaced hope. Nobody ever moved on.”

John Miner
Thomas Noguchi, John Miner,deputy district attorney of Los Angeles County and chief of it’s Medical Legal Section; and at least three other highly respected forensic pathologists reached a  different conclusion from that of Curphey and the Suicide Prevention Team“I did not think she committed suicide.” said John Miner thirty years laterAnd after interviewing Dr. Greenson I was more convinced that Miss Monroe did not commit suicide. He did not believe it himself.” Miner’s medical reasons for disbelieving the suicide verdict were supported by his interview with Greenson, from whom he learned that Marilyn was not only making plans for the future but that, “she felt that she had put everything bad behind her and could now go forward with her life.”  (These feelings are also felt by George Barris in his book; Marilyn, her life in her own words.”)

hou.fielder_dumas_DeadMarilynOn the night of Marilyn’s death, the ratio of Nembutal found in the blood compared to that in the liver proved Marilyn lived for many hours after ingesting that drug. There was also “not a large reservoir left in the stomach or gastrointestinal tract to be drawing from” ; in fact, as Noguchi’s report stated, there was no trace of drugs in the stomach or in the duodenum, where absorption occurs. This means that while Marilyn was alive and mobile Nembutal was metabolizing in her body and had reached the stage where much of it reached the liver and was beginning the process of excretion. “The barbiturates were absorbed over a period not of minutes but hours,” according to John Miner, “precisely as is indicated by the high concentration in the liver.”

Suicide by deliberate Nembutal overdose would have been an action entirely inconsistent with everything in Marilyn Monroe’s life at the time – especially after the call from Joe Dimaggio, Jr., as reported by him and by Murray and Greenson. And had she for some unknown reason suddenly decided to commit suicide, she would have taken a large dose at one time (not many capsules throughout the day, which she well knew how to ingest intermittently and at what dosages). The barbiturate would have reached a toxic level rapidly, and she would have died. But in that case: “Forty or fifty pills simply are not going to dissolve so quickly in the stomach,” as Dr. Arnold Abrams reported. “The odds that she took pills and died from them are astronomically unlikely.

The possibility of barbiturate injection must also be rejected. A large dose enough to be lethal, injected intramuscularly or intravenously, would have resulted in an instantaneous death. “This Drug infoleads to a reasonable conclusion that Miss Monroe had not suffered a ‘hot shot’ or needle injection of a lethal dose.” Such a massive injection would also have left a swelling and bruise, the gradual disappearance of which would have ceased with death. But, “every inch of her body was inspected with magnifying glasses,” according to Miner (thus, too, Noguchi), “and there was simply no needle mark.” The only possible route of administration of a fatal dose of drugs is confirmed by the discovery, during autopsy, off a bizarre condition, which Miner said was unique in his review of autopsies: a major area of Marilyn’s colon bore “marked congestion and purplish discoloration,” a condition consistent with rectal administration of barbiturates or chloral hydrate. This abnormal, anomalous discoloration of the colon had to be accounted for,” said Miner in 1992. “Noguchi and I were convinced that an enema was absolutely the route of administrating the fatal drug dose.” If that is the case then Noguchi certainly doesn’t believe so now.

Dr. Arnold Abrams
Dr. Abrams agreed with Miner’s analysis: “I have never seen anything like this in an autopsy. There was something crazy going on in this woman’s colon. And as for suicide, I simply can’t imagine a patient self-administering a fatal dose of barbiturates or even a sedative dose by taking the trouble to prepare and administer the solution” You don’t know what the necessary fatal dose will be, and you have no guarantee that it’s going to be absorbed before it’s expelled. Look: if you’re going to kill yourself with barbiturates, you do it with pills and glasses of water.”

Murder She Wrote
If the above accounts are accurate (which I doubt) the administration by enema was the route by which the fatal dose was administered. Marilyn had a history of taking enemas “for hygienic and for dietetic purposes,” as Miner said.“This was also much the fad among actresses in that era.” But this does not solve the problem of what was administered in this enema and by whom. An explanation is required as to what happened to Marilyn between the end of her conversation with Joe Dimaggio, Jr.and her almost incoherent replies to Peter Lawford at or seven-forty-five. Marilyn seems to have been aware, as she answered Lawford’s call, that she was slipping over the edge from the kind of drug-induced sleep or sedation she knew so well, toward death. Quite contrary to those who say that Marilyn was crying “wolf” is the plain, tragic fact that she knew she was dying and could neither rouse herself nor summon help: “Say goodbye…”

Marilyn-Monroe-Psychiatrist-Ralph-GreensonRalph Greenson had ceased prescribing Nembutal for Marilyn Monroe. He was, as he said, “cutting down her dependence on Nembutal [which he no longer prescribed] by switching her to chloral hydrate [which he did] as a sleep inducer.” In fact, he said he had asked Hyman Engelberg not to prescribe Nembutal without his permission: they were to monitor the drugs each was providing. But the previous day Engelberg wrote Marilyn a prescription for Nembutal without Greenson’s knowledge. “On Friday night,” Greenson wrote to Marianne Kris two weeks after Marilyn’s death, “she told the internists I had said it was all right for her to take Nembutal and he gave it to her without checking with me, because he had been upset for his own personal reasons. He had just left his wife.” During Saturday, however, Greenson observed that Marilyn was, “somewhat drugged,”

During the day she was awake, angry and difficult to manage.Marilyn was fighting with her publicity agent, Pat Newcomb and Greenson advised Newcomb to leave, which she did. Greenson’s solution to this was revealed in the toxicological analysis: chloral hydrate was present in the blood and not the liver. And because the level of chloral hydrate was twice that of the Nembutal ( it is clear that the chloral hydrate was administered, after the Nembutal had been taken.) Greenson perhaps overlooked one crucial factor, the adverse interaction of the two drugs. Chloral Hydrate interferes with the body’s production of enzymes that metabolize Nembutal. It was the chloral hydrate that pushed Marilyn over the edge. Some of the Nembutal was being processed by the liver, but much had not been metabolized. As Milton Rudin recalled Greeson saying on the night of Marilyn’s death: “God damn it! Hy gave her a prescription I didn’t know about!” John Miner recalled a similar, incomplete statement: “If only I’d known about that other prescription…”

Two weeks later, he described his departure that night to Marianne Kris in the most pacific tone: “I told Marilyn,” Greenson wrote to Kris, “that she should call me on Sunday morning when she awakened and I left.”  Greenson felt irritated, resentful and rejected; unable to accept that this romantic self-image of saviour had been terminated and aware that he could no longer continue in the mode of control he had so carefully constructed, he chose the easier route. “He’d had enough, he was exhausted, he’d spent the day with her,” as Milton Rudin said of him. And so, before departing, Greenson arranged for Marilyn to take a sedative enema, since she was physiologically resisting the effects of oral medication. Chloral hydrate would enable her to sleep. Short of the usual Engelberg injection, which Greenson tried but failed to obtain, the most powerful route of administration, as he knew, was an enema – something on which Marilyn often relied for other purposes. But she did not know that a chloral hydrate enema could be dangerous, even fatal, as a sequel to Nembutal.

“She probably regarded this as an ordinary enema being given to her,” said Miner. “It would have been inserted slowly, not unpleasantly, not causing any immediate urgency for evacuation. After several minutes” – during which time she took Lawford’s call – “she then would have lapsed into unconsciousness. The absorption continued, ant though still alive, she was dying.”

Eunice Murray
Who gave the chloral hydrate enema? The only person who could have done it was Eunice eunMurray, and this was indeed her last act as Marilyn Monroe’s employee and Ralph Greenson’s watchdog. “I always felt the key was Mrs. Murray,” said John Miner thirty years after the fact, speaking fully for the first time. But Eunice was acting under orders from Greenson, the man she had looked to for fifteen years as her protector and employment provider. As her son-in-law Philip LaClair insisted years later, “Eunice did only what Ralph Greenson told her to do. She always followed his orders closely, because she had no formal training as a nurse. There’s a lot I could say about Greenson, but I won’t.” Giving an enema is not within the range of a psychiatrist’s duties, especially not a male psychiatrists with a female patient: no matter how obsessive his attachment, One accusation is levied against Greenson: asking an untrained woman with no nursing credentials to give a drug in such a way that its method of administration is potentially lethal – no matter how careful the instruction might have been – is professional imprudent and in fact downright reckless. That is, of course, if Murray did indeed give Marilyn an enema.

This scene of the drama closes with another important detail previously remarked upon but never taken into account: Eunice’s inexplicable washing of garments and linens, as Clemmons attested and as Miner later learned. “Why, under these circumstances,” as Miner asked rhetorically, “would a housekeeper be doing the laundry at such an hour – unless the bed clothing had become soiled as a result of the administration of these drugs?” Abrams concurred: “Eventually, of course, when she slipped into her terminal coma, the enema had to be expelled. Thus the washing of the sheets,” which, as Miner added, “was an especially hard thing to understand unless Mrs. Murray was destroying evidence.”  “Arthur said it was horrendous, Natalie Jacobs recalled him saying after that night. “He never gave me any details, and I never asked him. He said only that it was too dreadful to discuss.”

EngelbergHymanThere was an attempt to revive Marilyn, to reverse the effects of the drugs. (Henry Weinstein recalled that at least once before, Greenson summoned Engleberg to pump out Marilyn’s stomach when she had apparently taken too many Nembutal in her Doheny Drive apartment.) According to both Eunice and a note in the district attorney 1982 report, an ambulance was summoned around midnight and then dismissed on arrival because she was dead, since California law prohibits the transport of a corpse in an ambulance. Greenson and Murray must have felt panic as the enormity of the disaster became clear to them. How does one announce the death of Marilyn Monroe?

“Mrs. Murray was concealing information. She simply wasn’t telling the whole truth and never did thereafter.” Miner was correct, for apart from the insufficiency of her stories about the light and/or telephone cord beneath Marilyn’s bedroom door, Eunice did not lie so much as deny. Rightly she denied the presence of Robert Kennedy: “I don’t recall him being there at all” in July
or August,
she said, because, indeed, he was not. (Kennedy’s presence at the remote Bates ranch in Gilroy that weekend is beyond dispute: It was documented by the Bates family and household employees in detail and the Gilroy Dispatch: “The attorney general and his family were with us every minute from Friday afternoon to Monday,” said John Bates, “and there is simply no physical way that he could have gone to South California and returned.” Accounts to the contrary by the media and so-called eyewitnesses Bates always considered, “outrageous, ridiculous and disgraceful.” Bates is correct, as the airstrip nearest to his ranch is at San Jose, an hour’s journey by car. Because of the deep canyons, steep mountains and high power lines, helicopter flights have been always dangerous in and out of Mount Madonna, the site of the Bates ranch. The only practical means of transportation from Gilroy to Los Angeles in 1962 was by car, a journey more than four hours each way.

deathAsked about her published memoir as a basis for solving the mystery, Eunice’s last statement on record about the death of Marilyn Monroe sounds very like the beginning of a confession: of her book The Last Months, she said in 1987, “I wouldn’t swear to my version at all.” (She also apparently, when being interviewed forgot her microphone was still turned on after finishing filming and said at the age of eighty-five, twenty-five years later, “Oh, why – at my age – do I have to keep covering up for this thing?” As for Engelberg, his distribution of dangerous drugs put him in no position to expose anyone which he likely considered an unfortunate accident.

Not swearing to one’s version of events doesn’t mean the witness is lying. After so many decades she may be referring to making mistakes in her recollection of events, a perfectly reasonable deduction. As for her comment why do I have to keep covering up for this thing? it hasn’t been proven she actually said it. Why hasn’t it been released on Youtube? And it could very well be referring to something else, although what I can’t say.

Extract used from pages 582-591 and page 562.

 

 

 

 

 

 

 

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