Justice Antonin Scalia was found dead in a bed at a resort in Texas on Saturday morning. As The Washington Post reported on Sunday, there was some confusion over the exact circumstances of his death, although his doctor indicated that he "suffered from a host of chronic conditions."
That gauziness quickly developed into a full-fledged conspiracy theory over the cause of Scalia's death, jumping quickly from the expected vector of universal conspiracy theorist Alex Jones to conservative talk radio to the Republican front-runner for the party's presidential nomination. Asked about Scalia by Michael Savage on Monday, Donald Trump replied that "they say they found a pillow on his face, which is a pretty unusual place to find a pillow."
The pillow is integral to this plot, whatever the plot happens to be. It appears to stem from a quote from the resort's owner reported by the San Antonio Express-News. "We discovered the judge in bed, a pillow over his head," owner John Poindexter told the paper. "His bed clothes were unwrinkled."
A pillow over his head -- but no autopsy, as The Post reported? A judge who declared Scalia dead without seeing the body?
First of all, the pillow thing appears to have been a misunderstanding. The sheriff of Presidio County, Danny Dominguez, clarified in an interview with the Daily Mail. (Calls to Dominguez from The Post were not returned by deadline.) "[Scalia] was just lying on the bed with a pillow above his head," Dominguez said, with our added emphasis. "Everything seemed normal and he was just there lying down. There was no sign of a struggle, no wrinkles in the cover or on the pillow either."
But, second: Doctors we spoke with suggested that finding a 79-year-old man dead in bed was hardly abnormal -- even if there were a pillow over his head.
"Right when I heard the report," said Asim Roy, medical director at the Ohio Sleep Medicine Institute, "the first thing -- my expertise is in sleep apnea -- someone dies in their sleep in the early-morning hours, sleep apnea is usually number one on the list as a potential explanation for the heart attack or for a stroke or whatever ended up killing him. It would go hand-in-hand with what we tend to see across the population." Speculation is that Scalia died of a heart attack; heart attacks were the most common cause of death in his age group in 2013. But Presidio County Judge Cinderela Guevara, who pronounced Scalia dead without seeing the body, told The Post: "It wasn't a heart attack. He died of natural causes."
Men of Scalia's age, Roy said, will often die suddenly, generally during the daytime. Those with sleep apnea -- the sort of chronic condition of which Scalia's doctor might be aware -- typically die in the early-morning hours, as it appears Scalia did. The prevalence of sleep apnea "goes up astronomically" once someone passes age 60, Roy said, and is more common among men and those who are overweight. Scalia's age, gender and time of death "all lead to the probability that sleep apnea may have been a contributing factor."
Update, Feb. 23: Scalia's doctor indicates that the justice did indeed experience sleep apnea.
Dr. Euhan John Lee, a clinical assistant professor at the University of Pittsburgh Medical Center, agreed that the timing of Scalia's death was "fairly common." He also noted that finding someone asleep with a pillow over his head would also not be particularly abnormal. "People sleep in all sort of positions," Lee said. "Adults sleep with their face in the pillow, on their stomach, on their side. It wouldn't necessarily cause a breathing problem. The body's natural reaction is to move in a position that's more comfortable for sleep. So it wouldn't be suspicious to hear a pillow or a blanket -- some people sleep with a blanket on their head -- unless there's some other detail that they found."
Not that it would be terribly common, Roy said, suggesting that it's a "minority" that people might sleep with something over their faces. "There really are no good numbers on how often that's happening with individuals," he said. Anecdotally, it comes up -- though "it's not the norm."
In other words, the death of a heavyset 79-year-old man in the early-morning hours is not uncommon -- and even if he'd had a pillow over his head, it would hardly be unheard of. It seems, though, that he didn't, making the circumstances of his death even less suspicious.
Scalia's death was exceptional largely because he himself was exceptional -- a powerful man in an important position who died unexpectedly. This is probably a better explanation for the emergence of conspiracy theories than any of the details about how he died on Saturday night.