Interview: Sally Hoedel

author of 'Destined To Die Young'

Interview by Nigel Patterson, December 2020

Sally Hoedel author of 'Destined to Die Young'

Interview by Nigel Patterson, December 2020  

Introduction: Why did Elvis die so young? A new book examines the reasons why and EIN recently had the chance to talk in-depth with author Sally Hoedel about her research into the untold story of Elvis’ health struggles. In her revealing interview, Sally discusses the key factors that affected Elvis’ life and health from pre-birth and how his lifestyle and overuse of prescription medication contributed to his premature death. What Sally has to say challenges several commonly held beliefs about the causes of Elvis’ death! 

The Interview

EIN: Sally, who is Sally Hoedel?

Sally Hoedel:  First, thank you for this opportunity to discuss my book. Second, I am a person that believes strongly in following your passion. I’ve seen, first-hand, that when someone is passionate and committed to their interests, amazing ideas can come from that. When I first had this theory about Elvis’ health struggles, I debated about turning it into a project for many reasons, but I ultimately believed I could bring something new to the table. All to say that I am curious and that’s at the heart of any exploratory writer. I loved the process of fully exploring a singular idea over 300 pages. The quest for truth, coupled with that curiosity and passion, led me here.

(Right: Sally Hoedel with Ron Strauss, pilot of the Lisa Marie)

That’s who I am as a writer. I am also a wife and mother to four daughters. I’ve been homeschooling the kids for 15 years now. My husband and I own Character Development & Leadership, which is a high school curriculum development company.

My degree is in Journalism from Michigan State University. Past professional experience includes assistant editor for a national bridal magazine and marketing for commercial real estate. Most recently, my writing skills were applied to creating materials within our curriculum company.

EIN: How did your interest in writing a book about how Elvis died come about?

SH: Well, I’ve been a fan since I was a little kid so the curiosity was always there. The contradictions in Elvis and his story always left me wanting answers to questions. Each book only seemed to leave me with more questions. Even with him gone, there is still so much contradiction to weed through because even the people that knew him often disagree on who, what, when and where of any given circumstance. I always felt there must be a “why” to examine for the prescription medication use. It just seemed to me that a guy like Elvis would have a reason, an explanation he could offer if we could ask him today why he developed such a problem. The obvious similarities between his death and the death of Gladys felt like a good place to start. Then rediscovering the first-cousin marriage in his maternal side of the tree also felt like a worthy piece of the puzzle. From there the research began and after a certain point, it didn’t feel like a theory to me any longer.

There was too much evidence to ignore. I felt an obligation to explain in book form what I discovered. I also believe strongly that Elvis would want people to know this. He was a private person, without question. However, he never intended to be remembered by many for his prescription medication problem. He took the medication to hide the health problems he was suffering from for decades. It worked. The health problems have long been buried and the drug problem remains a large part of how pop culture remembers him. Elvis deserves better than that.


EIN: How did you go about researching Elvis’ death?

SH: Interestingly enough, this book turned out to be more about his life than his death. It truly explores the health problems from decade to decade. It explains how he found ways to live and function with those ailments. Ultimately, he found a way to continue being Elvis Presley and he didn’t see anything wrong with relying on medication to do that. Of course he didn’t realize it would become a problem as tolerance levels changed and ailments worsened.

In terms of research, it started with reading close to 100 books. That meant rereading many since as a fan, I was already pretty well read. It’s amazing what you find when you’re looking for something you weren’t previously trying to see before. There are many important health tidbits throughout the books that are valuable pieces of information, but if a reader wasn’t seeking them out, they would be easily missed. Next, I spoke with several doctors and presented my theory to make sure it was credible and logical. I researched not only Elvis, but his ancestry, every ailment he suffered and the eras in which each major event in Elvis’ life happens in order to fully understand time and place of a situation.

The multiple trips to Tupelo and Memphis to explore and interview those who knew Elvis were without a doubt the most incredible part of this three-year process. It was incredible for me to go to Relics Antique Store in Tupelo and be in the building that was once the Tupelo Garment Company where Gladys worked so hard for many, many long hours. To walk on those same wood floors and be in that space, was one of many time and place emersions. The ultimate gift of this project has been getting to know people like Tish Henley Kirk, Ron Strauss, Azalia Smith Moore, Guy Harris and Sheri Lacker. Their time and willingness to speak with me regarding this project was beyond generous.

It can be difficult to think about something in a different way than how it has been presented for decades. In one interview I said that much of what’s in my book has been known, but it is pieced together in a way that has not been done before. Of course some took that to mean there is nothing new in this book, which is not true. I interviewed people like Nancy Clarke, the daughter of Gladys’ cardiologist, and Lee Clark, a cousin of Elvis’ that grew up in Tupelo, and Larry Presley. Larry is a surviving son of Noah Presley.

I believe Noah is the reason for Elvis’ level of generosity because it was Noah that demonstrated that type of generosity time and again throughout Elvis’ childhood. These are people that have rarely, if ever, been interviewed about Elvis and their time with him. Since Elvis’ health has been largely dismissed prior to 1975, it really was so important to talk to these people and others that had a piece of the puzzle. They each added something that had not been known before.

EIN: In Destined to Die Young you provide a fascinating examination of part of the Smith family side of Elvis’ family tree and the genetic defect which would impact Elvis throughout his life. Without giving too much away could tell us about this.

SH: There are a number of things that will forever remain unknown when it comes to the health of Gladys and Elvis. For example, how many miscarriages did Gladys suffer?? That is not a topic that would have ever been discussed during the decades she lived. Exactly what the heart ailment was that many of the Smiths suffered from and ultimately Elvis as well, is still unclear. What we do know is that there was a serious genetic liver/lung disease present. We know Elvis was a carrier for it and it had to come from somewhere. Tracing that backwards up the tree, helps to explain not only the death of Gladys, but the long illness of Gladys’ mother as well. Doll Smith was thought to have had Tuberculosis for over thirty years. Again, something that doesn’t make sense, but continued to be passed down the family tree and then throughout recorded Elvis history as well. This book explains how that Tuberculosis was most certainly a misdiagnosis in the early 1900s. From there, with the first cousin marriage, we can see that Gladys most likely inherited two damaged genes and a more serious version of the disease.

Her hepatitis was a mystery to the doctors in 1958. By exploring this lung/liver ailment that was genetically present, it explains why it was a mystery to those doctors and allows us to truly understand what was wrong with Gladys for the first time. Of course, we can then look for instances of this in Elvis as he was a known carrier. It is truly fascinating the way it connects through the generations with obvious evidence along the way.

EIN: You mention the critically acclaimed work by Elaine Dundy, Elvis & Gladys (Genesis of the King), in your book. How useful was it for your research?

SH: The Elaine Dundy book was very useful, but also very meaningful to my research. In many ways, it was kind of the launch pad for this project. When I was a kid, I would save my money and buy new Elvis books when they came out. This was around the time that Elvis & Me was released. So as a kid, I bought that book and Elvis & Gladys and several others. I lost track of those books after going to college and getting married. Four years ago my sister passed away from cancer and in going through her things, I discovered that she had kept all my old books. She too was an Elvis fan. So I was reunited with my original copies of those books. As a 10 year old, I never read more than a chapter or so into the Elvis & Gladys book. It just didn’t capture my interest. When I got it back a few years ago, I devoured it in two days time. From that book I learned that Elvis’ maternal grandparents were first cousins and from there the realization that Elvis had inherited health issues came to fruition. The similarity in death of Elvis and Gladys made sense.

It was astounding to then find that several of Gladys’ brothers also had similar ailments and early deaths. So the idea came to me after reading Dundy’s book. I still sat with it for awhile before putting it into action, but that was the root. That’s why the book is dedicated to my sister, Molly. If she hadn’t kept my old books, this book might never have happened.

EIN: A key issue in your book is the 11 human body systems that are central to the quality of our lives. Please tell us about these and what they meant in Elvis’ case.

SH:  There are eleven main systems in the human body and Elvis endured disorder/disease in nine of them. His heart (circulatory system), his lungs (respiratory system), and his bowels (digestive/excretory systems) required medication. Insomnia affected his nervous system. The adrenal gland failure and resulting low testosterone are both issues of the endocrine system. His immune system was compromised. His urinary system was not functioning properly. The arthritis that caused Elvis severe pain throughout his body impacted his muscular system and skeletal system. There is clearly more at play here than a dependence on prescription medication when more than eighty percent of Elvis’ bodily systems did not function properly. When we add to that the evidence that I have uncovered proving that of those nine, five—the circulatory (heart disease), respiratory (Alpha 1), digestive/excretory (megacolon), nervous (insomnia) and immune (hypogammaglobulinemia)—were present since birth and certainly prior to the prescription drug use that accompanied fame.

Again, in the last year of his life, is Elvis dying from prescription drug abuse or from the list of ailments that plagued him? Or from the constant touring that makes both of those problems merge into one?

EIN: In your pre-interview discussion with EIN, you said Elvis’ early death could not have been prevented. Please tell us why this was the case .

SH: First, I believe there were just too many limitations at the time. Even today, immune system disorders are a challenge to diagnose and determine effective treatment for, but at least we know they exist. In the 1970s, that realm of study was truly in its infancy. With his heart, liver and bowel issues, again without an MRI or CT Scan it was much more difficult to figure out what was going on. The first human MRI was performed in 1977, but that technology was not widely available until the 1980s. Just like with Gladys in 1958, the doctor knew she had a liver ailment, but couldn’t pinpoint what it was. Her doctor talked about not fully understanding her ailment. The same was true in 1977. They knew Elvis had the dysfunction of his liver or his bowels, but they could not pinpoint why. The dependency on prescription medication often clouded the problem as well. His bowel problem was there since birth, but many medications he took would have slowed his bowel and digestive system. Coincidences like that would have only led to more confusion. Dr. Nick does deserve credit for consistently trying to solve the mystery of Elvis’ health issues, along with trying to walk a difficult line between physician and friend.

I personally believe there was too much wrong with Elvis in too many of his bodily systems and all without the advancements that we have today in medicine. If we then factor in that his mother and three of her brothers died in their 40s and 50s, there has to be a thread there that is common to all of them that was unknown in each of their cases, not just Elvis’.  

EIN: Sally, a double-barrelled question - how did Elvis’ large ingestion of prescription medication interact with his genetic disorder and how significant was polypharmacy in his death?

SH: Elvis has multiple disorders that are either genetic or congenital in nature, which means they were either passed on to him from his parents or they were present since birth. The medication is a double-edged sword so to speak. It does enable him to be Elvis Presley longer than he could have without it. He tells a doctor in 1973 that he cannot physically perform two shows a day without the medication. Elvis told us how horrible he was feeling in that moment. He wasn’t looking to not feel anything, like an addict would. He was looking for a way to function and escape the pain and limitations brought on by his ailments. Having said that, it did become a problem. As his ailments multiplied and worsened, along with the touring increasing, the medication also increased. He had a liver problem. It was the same liver problem that led to Gladys’ early death. The disorder, which is fully discussed and explained in the book, can present in totally different ways in different people. With the potential for liver dysfunction because of the inherited disorder, asking his liver to process all those medications was a further strain on the liver. Without question, that would have been the case.

Same is true for his bowel problem. Elvis suffered from severe constipation basically since birth, which we now know from newly uncovered evidence. The prescription medication did not cause his megacolon. That ailment alone would have made it very difficult to be Elvis Presley. Some of the medication certainly would have further slowed down his digestive system, which would have further contributed to the already existing problem.

Like everything with Elvis, there is contradiction. One lab said the polypharmacy caused his death and another said all levels were there for medical reasons and in therapeutic range. Since he took all those medications previously and they weren’t strong enough to even induce sleep that night, I don’t believe polypharmacy was the biggest factor. The heart, liver and bowel problems were most likely inherited, and they play a bigger role. Without them, it is likely Elvis would not have turned to medications in the first place, but it is even more likely that he would have had an opportunity to stop the medications, just like all the other guys did. They took the same medications and lived long lives. Keep in mind too that the Elvis of 1957 has the same ailments of 1977…they’re just not visible yet.

EIN: Elvis’ weight fluctuated greatly, particularly during the 1970s. What is your perspective on this given your research?

SH: Again, his heart, liver and bowel problems were factors in that. His body was not removing waste like it should, which created a toxic situation and bloating. His liver was not functioning properly and neither was his heart. That led to fluid retention problems. The other issue was his adrenal glands. When the adrenal glands are not functioning properly (and Elvis’ were not from 1973 on) fatigue, hormonal imbalance and weight gain can result. His face was also often swollen, which made him appear heavy. The bloating and swelling was also often the result of steroids that Dr. Nick used to treat Elvis’ constant infections. He would have to trade off treating one problem, while creating another.  

EIN: Further to Elvis’ fluctuating weight, many commentators also point to Elvis’ eating habits as being a ‘major factor’ is his early death. What is your view?

SH: Well, if it were just his eating habits then half the country wouldn’t make it over age 50. It is just too simplistic of an explanation for how complicated Elvis’ health struggles were. This is also where so much myth often comes in. For whatever reason, tabloid journalism still loves to run with stories of Elvis gorging himself. They’re rarely true and exaggerated at best. We recently discovered that one often repeated story of Elvis indulging was just that, gross exaggeration. You know the story of Elvis gassing up the Lisa Marie to fly all the way to Colorado just for a “Fool’s Gold” sandwich that consisted of a loaf of bread, a jar of peanut butter, a jar of jelly and a pound of bacon. The story has been told so many times and always with an image of Elvis alone wanting the sandwich, going through the trouble to get it and then eating it all alone.

We know now from Ron Strauss (pilot of the Lisa Marie) and his flight book that there were many people on that flight and the destination was California to return Lisa Marie to Priscilla. Since it was Lisa’s birthday, they decided to stop in Colorado for the famous sandwiches. They cut them up on board the plane, sang happy birthday and everyone indulged. I would wager to bet that most Elvis stories relating to food are misguided in that way. We know he ordered a lot of food and we also know he rarely ate it all. Consider too that his food is homecooked at Graceland most of the time. Is it cooked in butter and fat, yes, but it wasn’t the fake, processed foods that cause trouble today. Also consider that for the first twenty years of his life his diet was mostly corn breads and vegetables because they could not afford meat. Elvis was only wealthy with access to overindulge in food for half of his short life. And even at that, he did not do it all the time. Again, I think common sense tells us that something else is at play wreaking the real havoc in his body.

EIN: The television program, Dead Famous DNA, found that analysis of Elvis’ genome (genetic blueprint) indicated he suffered from the genetic heart muscle disease, hypertrophic cardiomyopathy. Is this finding consistent with your research?

SH: I did not refer to the findings of that program because I personally had no way of confirming that it was Elvis’ DNA used for the testing. I would say that genetic disorder of the heart is likely. It makes sense and fits my research. I could not conclude exactly what his heart ailment was, but it was certainly the same as Gladys and her brothers. I do take time to explain the liver problem though because liver disease can lead to high blood pressure and heart issues. Blood goes through the liver and back to the heart. When this happens normally, it is like sucking water through a straw. When this exchange is abnormal because of fatty liver or other liver ailments then it’s more like sucking pudding through a straw and that leads to the high blood pressure and overworking of the heart. In both Elvis and Gladys, it’s difficult to say whether the heart or the liver problem came first or if they existed simultaneously from two genetic complications. I believe the last is most likely, but we’ll never know for sure.

EIN: Another examination of Elvis’ death, Elvis Presley: Head Trauma, Autoimmunity, Pain, and EarlyDeath by Dr. Forest Tennant, found that his death was caused by cumulative head trauma followed by progressive autoimmune inflammatory disorder. What view did you form on this during your research?

SH: I spoke with Dr. Tennant on multiple occasions. His published information is most valuable. However, I believe there is enough evidence prior to the head trauma incident to show that these disorders were genetic and congenital, as opposed to correlating to an incident later in life.

EIN: In your book you make a really interesting observation about there being the same underlying issues around Elvis in 1957 as in 1977. What do you mean by this ?

SH: As I said before, many of these health struggles were always there. They did not suddenly manifest themselves in 1977. It is merely that they were harder to hide and more visible by then. It’s hard to imagine that Elvis had constipation issues in 1957 with his provocative dance moves, but he did. Just as it’s hard to imagine that he’s having those same issues in 1970 with the way he performs in Elvis The Way It is, but we know it was a problem then because Elvis wrote about it in his TCB oath. He literally asked for freedom from constipation. It was a chronic, lifelong problem. The same is true about his infection rate due to the immune system disorder he had. Tonsilitis was a consistent problem throughout his life and now we know why. Elvis is such a visual for all of us. He is recognizable worldwide still! His visual decline is obvious. The Elvis of 1968 only had nine years left to live, but you cannot predict that from his comeback special. What you see in his last television appearance from 1977 is a decline of much more than a year or two.

EIN: What does Elvis’ genetic disorder mean for Lisa Marie Presley and her children?

SH: That’s difficult to say. With two carrier parents of the particular disorder discussed in the book, there is a 25% chance of a child being normal, a 25% chance of a child inheriting two damaged genes and a 50% chance of the child being a carrier. When the gene pool was made shallow so to speak with Elvis’ maternal grandparents being first cousins, the odds of the union producing children with issues increased. However, with each non-related marriage, the gene pool gets deeper again. So there is a chance that a good gene will replace a damaged gene. Boys are more at risk often times because they inherit a X chromosome from their mother and a Y chromosome from their father. They only have one copy of all the genes on the X chromosome. Girls, on the other hand, inherit one X chromosome from each parent so they get two copies of all the genes on the X chromosome, which provides the opportunity for a good gene to replace a damaged gene. Assuming Priscilla was not a carrier, Lisa Marie could still be a potential carrier having inherited it from her dad and would then have the same risk in passing it on to her children. Genetic disease is not 100% because of the continued new DNA that enters the picture through marriage.

EIN: Some people may be put off reading Destined to Die Young, thinking it may be very technical in content. Is this a reasonable view?

SH: I know this book has a ton of information in it, but my main goal was to humanize Elvis. I did not want medical jargon to distract from that. At its heart, this book is about Elvis’ struggle to survive, along with a presentation of evidence that supports why he was struggling his entire life. I did not want to write a science book. As any investigative journalist has to do, I had much to learn in order to understand what I was researching and discovering. So I took it upon myself to fully understand what was potentially at play here from a scientific/medical angle. I then had to be able to explain it in everyday terms that both myself and the reader could embrace in connection to Elvis and his life.

EIN: Sally, is there anything else you would like to say to EIN readers?

SH: I would just like to add what I’ve consistently said from the beginning of this project. I delved into this project because I believe I found several layers of truth that have not been explored before. Elvis was one to always seek truth and understanding. For me that’s what this book was about. It’s a full, 300 page exploration of a single thought. It started as a theory I had, which quickly became more than a theory. At that point, I had no choice but to follow where it led me. Along the way, I have met the most genuine and kind people throughout the Elvis community. As a person possibly considered “young” to be an Elvis fan, I felt that my interest in Elvis and his story was rather singular. It has been such a joy to discover and connect with so many other people that feel the same way! I hope they will appreciate my effort in this endeavour.  It was a labor of love…

EIN: Sally, thank you very much for talking to EIN today. It has been a pleasure talking to you and learning so much about your enlightening research into Elvis’ death.

Click to comment on this Interview

EIN’s review of Destined to Die Young will be published shortly.

The book can be purchased directly from the author:

Click here > Buy 'Destined to Die Young'

Interview by Nigel Patterson.
-Copyright EIN December 2020
EIN Website content © Copyright the Elvis Information Network.

EIN Website content © Copyright the Elvis Information Network.
Elvis Presley, Elvis and Graceland are trademarks of Elvis Presley Enterprises.
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