Both drugs carry a precaution against use with alcohol, since alcohol also depresses respiration. In addition, caution is advised when liver function is impaired. A drug that is metabolized by the liver can rise to toxic levels, if the liver is not working well.

The report says Dr. Bell returned nine days later, August 29th, because “the deceased had apparently fallen off the sofa and complained of pains in the legs. He was quite sober at that time but had been drinking, he felt sick and was probably rather shocked. He was given 40 mgms [mg] pethedine [sic] intramuscularly.” The report does not state what time of day that injection was given.

Dr. Bell was summoned one last time, at 9:30 a.m. on August 30th. Dunn “had been found lying in the prone position, apparently dead…There was a little vomit on the floor and on the sheets.” The report notes: “Police were called. No suspicious circumstances.”

Pethidine is meperidine, a synthetic morphine sold in the U.S. as Demerol. Current prescribing information for Demerol from Sanofi-Synthelabo advises, in capital letters: “MEPERIDINE SHOULD BE USED WITH GREAT CAUTION AND IN REDUCED DOSAGE IN PATIENTS WHO ARE CONCURRENTLY RECEIVING… BARBITURATES…AND OTHER CNS [central nervous system] DEPRESSANTS (INCLUDING ALCOHOL). RESPIRATORY DEPRESSION, HYPOTENSION, AND PROFOUND SEDATION OR COMA MAY RESULT.” And: “Meperidine should be used with extreme caution in patients…with chronic obstructive pulmonary disease or cor pulmonale…In such patients, even usual therapeutic doses of narcotics may decrease respiratory drive while simultaneously increasing airway resistance to the point of apnea.” (Apnea means cessation of breathing.) The leaflet also includes a precaution against prescribing Demerol in patients with liver dysfunction.

Several lines above Thurston’s one-paragraph narrative is the query: “If any known illness existed before death, state, if possible, the nature of it, and its duration.” The answer, in blotchy type from a manual typewriter, states only: “Severe skeletal deformity. Fortral for pain. Seconal for sleeping.”

The post-mortem examination on Michael Dunn is dated August 31st, 1973, and was performed by a Professor R. D. Teare at St. George’s Hospital in southwest London. The entire text of the one-page report is as follows:

Found dead at Cadogan Hotel. Had complained of sickness and pains in legs and had been drinking. An achondroplastic dwarf 3’ 10” in height. Various old surgical scars were seen about both knees. The body was very cyanosed. The chest was barrel-shaped. The cerebral vessels were healthy and the meninges congested. The right side of the heart was widely dilated and hypertrophied to twice its normal thickness. The left ventricle was normal in size. There was no valvular disease. The myocardium was healthy. The coronary arteries were free from atheroma. The lungs were rather bulky and emphysematous. They showed some chronic bronchitis and were intensely congested. A little vomited material was seen in the air passages. The stomach was virtually empty. Its lining was healthy. The liver was congested and the gall bladder normal. The kidneys were perfectly healthy. Spleen: Normal. Endocrines: Normal. Cause of death: Cor pulmonale. Due to (or as a consequence of): Achondroplastic dwarf.

No laboratory work is included—neither toxicology nor microbiology. A small space at the top of the form, labeled “histology, bacteriology, chemistry,” is left blank. The nature of Dunn’s complaint of “sickness” is never explained.

John Hain, MD, a board-certified forensic pathologist in Carmel, CA, agrees that the scanty post-mortem findings are consistent with the presence of cor pulmonale; but he characterizes Dr. Teare’s conclusion as “an unsupported guess.”

“People die with all kinds of disease processes present, but that doesn’t mean they died of those diseases,” says Hain. “This is the sort of setting in which we start looking for blood levels of the drugs that were prescribed and administered—and of alcohol, in this case. If you know how many pills were prescribed, you can at least look to see how many were left. This was not a very thorough exam—the report is very incomplete.” He characterizes Dr. Bell’s prescriptions as “quite probably not appropriate.”

The post-mortem contains no findings suggestive of alcoholism—no liver cirrhosis, no inflammation of the stomach lining or pancreas. The liver congestion is a nonspecific finding but could be consistent with right heart failure. Congestion of the meninges (brain membranes) is also nonspecific. Jaundice is not even mentioned. Only cyanosis is noted—the usual blue skin tone of a corpse.

Hain explains that if the severe jaundice noted by Phoebe Dorin had resolved by the time of death, it could have been due to a drinking binge that ended after Dunn’s visit to Roosevelt Hospital—assuming a time lapse of several weeks. He also points out that many medications can poison the liver and cause jaundice. Infectious hepatitis is another cause. If Dunn died directly of right heart failure, jaundice may have been present at death; but swelling of the ankles and legs (peripheral edema) and ascites almost certainly would have been present—yet these findings were not noted.

Concerning the lung congestion, Hain comments: “ ‘Congestion’ in an autopsy report describes vascular congestion [fullness of the blood vessels]—not bronchial phlegm, which is what a pulmonologist means by ‘congestion.’ It’s impossible to differentiate vascular congestion from a very early, rapidly progressive pneumonia, without performing a microscopic examination of the lungs.”

Vascular congestion could suggest left heart failure, which causes blood to back up into the lung vessels; but the report shows no obvious reason for left heart failure. Pneumonia also causes fullness in the lung vessels, as blood rushes in to fight infection; microscopic exam would show a high concentration of white blood cells.

The post-mortem mentions vomited material in the airways but does not specify how far down the respiratory tree the vomitus traveled. Dr. Hain explains that no conclusion is possible about aspiration as a contributing cause of death, because vomitus present in the mouth at death can trickle backward down the airway when the corpse is moved. “Stomach contents in the air passages to the lungs is meaningless at autopsy. Only a microscopic exam will indicate whether aspiration occurred before death,” says Hain. Dunn was found lying on his stomach, a position less likely to allow aspiration.

Dunn’s first complaint of “sickness” may have represented symptoms of oxygen starvation (hypoxia) from advanced cor pulmonale—which then became progressively worse from the drugs Dr. Bell prescribed at his first visit. Pulmonologist Thomas E. Addison, MD, Clinical Professor of Medicine at University of California, San Francisco, comments: “Alcohol and the prescribed medications could have led to his death—not necessarily as an overdose, but as agents that pushed him over the edge from a compensated chronic respiratory failure to acute CO2 retention and death in a coma.”

The term “compensated” means that the patient usually is able take in enough oxygen by cutting back on activity. Ingestion of alcohol, or drugs that reduce the urge to breathe, will reduce the patient’s intake of oxygen. So this viewpoint is consistent with the precautions listed by the drug manufacturers—that is, that extreme caution and reduced dosage are warranted in patients with respiratory insufficiency and in patients receiving other central nervous system depressants.

Addison’s comment suggests an additional possibility: The sudden activity and excitement of working in London may have been simply too taxing for Dunn, at that stage of his illness. He may have been able to compensate for shortness of breath up to that point, then started to slip into hypoxia when forced to exert himself more than usual on the movie set. It is also likely that his need for painkillers rose along with his activity.

Although the post-mortem notes “some chronic bronchitis,” Dr. Hain comments that British physicians often use this term interchangeably with emphysema, and that chronic bronchitis cannot be discerned at post-mortem exam without a microscope. Dunn was a smoker; his wheeze is audible in films shot when he was only 30 years old—but age 30 would be very early for development of symptomatic emphysema due only to smoking. Dr. Hain remarks: “There are genetic conditions which result in the early development of severe forms of emphysema—for example, alpha-1-antitrypsin deficiency. Perhaps Mr. Dunn suffered from this as well.” In any case, Dunn’s cor pulmonale could have been due to thoracic constriction along with some type of chronic obstructive pulmonary disease (COPD). Patients with any type of COPD are vulnerable to pneumonia.

What about Dunn’s complaint of leg pains, after his tumble from the sofa? Dr. Hain replies: “There are too many possibilities: sciatica, alcoholic neuropathy, thrombophlebitis, claudication, arthritis, fracture, muscle spasm, and so forth.”

Hain concludes that the most likely candidates for Dunn’s immediate cause of death include respiratory depression due to the prescribed drugs, with or without alcohol; frank right heart failure from cor pulmonale—due to thoracic constriction, some type of COPD, or both; and pneumonia.

In fact, all three elements may have been involved. Dunn did have cor pulmonale with lung vascular congestion from some cause, and he told Bell he had been drinking. Bell judged him sober, but Dunn still could have had alcohol in his blood. The coroner’s report does not say whether Bell warned Dunn not to take his nighttime dose of the other two drugs; but the injection of meperidine is documented.

What would Dr. Bell have noticed about Dunn, when he first saw him? “He was probably very short of breath,” says Dr. Hain, “but if shortness of breath was his usual condition, he might not have complained about it.” Regardless of Dunn’s specific complaints or demands, shouldn’t Bell have taken his vital signs, pulled out a stethoscope and listened to his chest, felt for swollen lymph nodes, felt for enlarged liver or abdominal tenderness, looked for swollen ankles, taken a thorough history? Doesn’t it sound as if he barely glanced at his patient, gave him some drugs, and left? Dr. Hain replies, “Yes, well—it happens a lot.”

Bell seems to have missed his chance to shine in history next to that other Dr. Bell—Joseph Bell, consulting surgeon at the Royal Infirmary of Edinburgh under Queen Victoria, and the main inspiration for Sir Arthur Conan Doyle’s character Sherlock Holmes. “Diagnosis, he taught, was not made just by visual observation, but also by the employment of all the senses: do not just look at a patient, he advised, but feel him, probe him, listen to him, smell him.”44

Doctor-patient complicity

Clearly, Dunn was suffering from several chronic conditions at the time of his death. His deterioration over time is visible in his films, and his arthritic pain must have been grueling and unremitting, especially at the end of a work day. But acting was his life. He was filming on location for a limited time and needed to be able to sleep at night and function during the day. This is probably the main requirement he presented to Bell, at their first meeting.

Dunn may have been reluctant either to learn or to reveal the extent of his illness, in case Warner Brothers might cancel his contract (much as Ms. Dorin had warned him). He may have realized his health was somewhat precarious but chosen simply to pursue enough pain relief to keep working. If he had wanted to kill himself, he was already well supplied with drugs and alcohol. Unfortunately, it seems that Bell, too, was reluctant to learn the extent of Dunn’s illness.

Yet, Dr. Addison has a more lenient view, based partly on his knowledge of those times. He writes: “I think it is likely he was in a relatively precarious state. His arthritic pain and his desire to continue to work probably seduced both him and his physician into some degree of comfort [about the painkillers], which might not have happened with someone less driven and motivated.

“The post mortem clearly showed that he was suffering from cor pulmonale—usually a pre-terminal complication of severe kyphoscoliosis. I’m not sure the degree of respiratory embarrassment [impairment] caused by kyphoscoliosis was as recognized in 1973 as it is today. Now, we have easy access to arterial blood gases and sophisticated physiologic measurements. We have devices such as non-invasive ventilation [forced oxygen by mask] for these patients who are decompensating [losing the ability to compensate for poor oxygen intake]. In 1973, some experts were recommending that such patients sleep in an iron lung to improve their ventilation during sleep.

“If cyanosis [bluish tone of the lips, nail beds and skin] was recognized, then oxygen might have been prescribed; but without modern technology for pulse oximetry [measurement of oxygen saturation in blood with a photoelectric device] it could easily have been missed. Furthermore, if it were recognized, and oxygen were prescribed, his depth of respiratory depression could have been made worse—due to the loss of ‘hypoxic’ drive to breathe—and the resultant downhill course would have still ensued.” That is, oxygen could have reduced his urge to breathe vigorously, and he would have ended up in the same situation.

Addison continues: “Similarly, I’m not sure that the effects of Talwin and Seconal on respiratory drive in those patients with compensated right heart failure was appreciated until the advent of nocturnal respiratory monitoring (sleep studies), which became more common about 15 years later.”

Still, an alert and conscientious doctor would have recognized trouble from a thorough physical exam without sophisticated equipment. Diagnostic signs certainly included shortness of breath and wheeze, and may also have included distended neck veins, ankle swelling, bluish tint to fingernail beds, abnormal heart sounds, abdominal swelling and palpably enlarged liver.

Such a doctor could have forced a frank discussion of Dunn’s condition and urged him to undergo testing and telephone his family. He might have made his patient more comfortable on oxygen and diuretics, to reduce any edema. He could have avoided agents causing respiratory depression and tried managing Dunn’s arthritic pain with the relatively new anti-inflammatory, ibuprofen. He could have advised him at least to rest off camera with his feet up, at every chance, and to sleep semi-reclined, in order to minimize heart strain.

Bacterial pneumonia, if present, could have been treated with oxygen and antibiotics. Emphysema might have responded to oxygen and a bronchodilator (theophylline was available at the time). If Dunn was still smoking, he should have been urged to stop, and to stop drinking. With these measures—and perhaps some time in a hospital—his condition might have stabilized enough to let him finish filming and return home. However, discontinuation of narcotics might have made his arthritic pain unbearable.

Only the coroner’s second-hand description of Dr. Bell’s performance survives. But Bell’s apparent negligence, the coroner’s omission of his full identity, and the omission of any lab work on Dunn’s body suggest uniformly casual handling of this case. Despite being an educated white male, Dunn may have suffered low status as a dwarfed disabled foreigner. Or perhaps Bell was known as a supplier to movie stars—a so-called Harley Street doctor—and the coroner viewed his patients as somewhat culpable.

By U.S. standards of 2002, Dr. Hain would consider toxicology studies essential, in order to determine precisely the immediate cause of death. But interpretation of Dr. Teare’s professional conduct must take into account the constraints under which he practiced.

Analytical toxicologist John Ramsey, now Director of TICTAC Communications, Ltd.—a drug identification database operating within St. George’s Hospital Medical School—was Head of the Toxicology Unit at the medical school, in 1973. The laboratory, at Hyde Park Corner, was part of the Department of Forensic Medicine then headed by Professor Donald Teare (R. D. Teare). Responding to an e-mail query sent to and forwarded by the Forensic Toxicology Service at St. George’s, Ramsey writes:

I have been unable to find any laboratory records relating to that period. The laboratory was easily capable of detecting and measuring all the drugs mentioned in the case to which you refer. However, my guess is that it would have been unlikely that any [samples] would have been submitted in this case. The function of the Coroner was, and still is, to exclude crime rather than to establish an accurate cause of death. The practice at the time was for the laboratory to report the results of any investigation to the pathologist (Dr. Teare in this case), who would then present the results as part of his PM [post mortem] report and later in court, if an inquest was held. Toxicology was (and still is) expensive and only carried out if the cost was authorised by the Coroner. Gavin Thurston was not noted for his generosity in this respect. One would hope that if such a case occurred today, it would be investigated more rigorously, but the budgetary restraints still apply.

In separate messages, Ramsey muses: “There were some private doctors in London notorious for their lax prescription of controlled drugs in the late ‘60s and early ‘70s—perhaps Dr. Bell was one of those,” and: “I have vague recollections that a Dr. Bell was a notorious prescriber.” But his e-mail query to John Gerrard at the Home Office Drugs Directorate—which regulates the control of drugs in the U.K.—turns up no record from the 1970’s on a Dr. Bell. This could mean merely that Bell never came under disciplinary action for violation of prescription statutes.

Dunn himself, with his wry humor, might have enjoyed an old English nursery rhyme’s eerie echo as his epitaph:

Doctor Bell fell down the well
And broke his collar bone.
Doctors should attend the sick
And leave the well alone.

Body theft?

Phoebe Dorin is certain she was told that Dunn’s body was stolen. Yet, the coroner’s report shows that the body was picked up right away, that police were notified, and that the autopsy was completed the following day. Ten days later, Dunn’s body was buried in the United States. Bureaucratic procedures obviously filled some of those days, if not all of them—notification of employer, executor, next-of-kin, the American Consulate; embalming; arrangements for transport and reception on the other end; cancellation and return of passport and personal possessions.

Softness and Rosenthal both report they never heard anything about a body theft. “I never heard anything like that,” says Softness, “and I can’t imagine I could have forgotten such a thing.”

“This is the first time I’m hearing it—I don’t have any information,” Rosenthal remarks. “We had to get the embassy involved and go through all sorts of red tape to ship the body, which we did through Freeslate International Shipping. But I never heard that the body was missing at any time.”

A query to Scotland Yard brings a reply from a David Capus, responding for the Assistant Departmental Record Officer:

I regret that I have been unable to find any Metropolitan Police records relating to the death of Michael Dunn or the alleged theft of his body. It is possible that because he died from natural causes, police involvement was minimal and that any records created at the time were destroyed during the normal routine process of review. That said, the theft of his body would have been a sufficiently unusual event to ensure the preservation of any relevant records. The fact that there is no record leads me to doubt the veracity of this story.

The October 12, 1973 “Report of the Death of an American Citizen” from the Department of State confirms that the post-mortem was completed “without inquest.”

Neither the Cadogan Hotel nor Pinewood Studios has any record of the affair. Pinewood’s librarian, Travina Smith, reports that she queried the current Studio Manager, who does not recall Dunn’s death but was working for the studio at the time; he knows only that Pinewood did not retain a physician for visiting actors. Numerous inquiries to the Production Research Library at Warner Brothers in Burbank, CA, elicit no answer.

Ms. Dorin was receiving her news about the death indirectly, from John Softness, in New York, and from Dunn’s parents in Florida, Fred and Jewell Miller. Maybe the Millers misunderstood something, in their grief and distress over being so far from the scene.

Yet, according to a tertiary45 source, Dunn’s cousin-once-removed recalls being told that Great-Uncle Fred (Miller) flew to London on receiving news of his son’s death and was upset to learn no inquest would take place. If this bit of family lore is accurate, Fred Miller’s direct involvement should have made him a reliable source. Unfortunately, Mr. Capus finds no police record of Miller’s visit, nor any record under Dunn’s birth name. A written inquiry to the Immigration and Nationality Directorate brings no response.

In theory, Coroner Thurston could have acted to protect Dr. Bell, if he grasped the implications of the post-mortem; perhaps it was the toxicology report and not the body that got “lost.” More likely, however, Thurston saw no reason to spend money on lab work; and the missing-body story could have arisen from something as simple as a tracking report that was misfiled and soon retrieved—perhaps causing Miller to jump to anguished conclusions in the interim. His son seems to have been the victim of an incompetent doctor and a tightwad bureaucrat, but nothing more dramatic than that.

Michael Dunn was buried September 10, 1973, in Lauderdale Memorial Park Cemetery, Fort Lauderdale, Florida, near his parents’ retirement home in Lauderhill.

Love of acting, love of life

Mark Povinelli reacts to Dorin’s comments about Dunn’s state of mind in the weeks before his death: “Well, you know—if an actor has a good job, he can overlook just about anything that’s wrong with his life. It says a lot that Dunn was working at the time of his death.

“Actors see the world differently,” Povinelli explains. “You see through things, you’re cynical—you become a sort of amateur psychologist. Acting involves frequent risks—financially, because work is irregular, and because you get scrutinized and rejected in auditions, over and over.” Most importantly, he says, acting demands that “you have to go places in your own psyche that most people walk away from.”

Povinelli says he can’t wish he were not a dwarf, because that would mean wishing he were someone else. “I think I’m a far more interesting person, because of it. My family is far more interesting. I meet far more interesting people. And it is hard—sometimes very hard. I see the dark side, and it’s a pain in the ass.”

Dunn’s mad-scientist character Dr. Loveless may have “hated life itself,” as Secret Service Agent James West alleged (played by Robert Conrad). But Dunn himself had a very different outlook: “My reason for living is not that I’m brave, but that I like to be alive.”25

Special thanks to Mark Povinelli, Phoebe Dorin, Zelda Rubinstein, John Softness, Barney Softness MD, Bruce Blumberg MD, Ericka Peasley, Paul Hazelrig MD, Valle Surin MD, John Hain MD, Thomas Addison MD, John Ramsey, David Capus, Brother James Wolf, Brother Leo Wollenweber, Monica Pratt, Travina Smith, Ricardo Gil, Bob Robinson, Dorothy Brumlow, Cindy Gronbach, Teddy Rosenthal, Richard Rosenthal Esq., Candyce Powell MPT, Martin Taras, Jamie Bernstein, Steve Capellen, Kristin Sabo, Jennifer Myers.

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45 Personal Communication, Jennifer Myers

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