Icons From the Age of Anxiety: Billionaire Howard Hughes

Time magazine, July 19, 1948.  Art by Ernest Baker. The caption ironically reads "money + brains = fun (somtimes)." Nothing could be further from the truth.

Time magazine April 19, 1976. Art by Baron Storey. One of Storey's most famous works is perhaps this portrait of Hughes from 1976, drawn overnight while Storey was talking on the phone with the coroner who described the wasted state of Hughes’ body. I'm proud to add that I edited Vanguard Production's Best of Baron Storey's Watch #1 and 2.

You probably saw this one coming, right? Where to start? The very obsessions  and compulsions that made Howard Hughes (1905-1976) an enfant terrible and prodigy tormented him relentlessly later in life. His OCD and eccentricies, enabled by his great wealth, are the stuff of legend. He took the anxiety-producing concept  of "avoidance" to new stratospheric heights.

What I wonder is, could he have been helped by proper, modern medical treatment? According to many, he took a drastic turn for the worst after his near-fatal XF-11 plane crash in Beverly Hills, Callifornia.

From ye Wiki, "Howard Hughes was involved in a near-fatal aircraft accident on July 7, 1946, while piloting the experimental U.S. Army Air Force reconnaissance aircraft, the XF-11, over Los Angeles. An oil leak caused one of the contra-rotating propellers to reverse pitch, causing the aircraft to yaw sharply. Hughes tried to save the craft by landing it at the Los Angeles Country Club golf course, but just seconds before he could reach his attempted destination, the XF-11 started to drop dramatically and crashed in the Beverly Hills neighborhood surrounding the country club.


When the XF-11 finally came to a halt after destroying three houses, the fuel tanks exploded, setting fire to the aircraft and a nearby home at 808 North Whittier Drive, owned by Lt Col. Charles E. Meyer. Hughes managed to pull himself out of the flaming wreckage but lay beside the aircraft until he was rescued by Marine Master Sergeant William L. Durkin, who happened to be in the area visiting friends. Hughes sustained significant injuries in the crash, including a crushed collar bone, multiple cracked ribs, crushed chest with collapsed left lung, shifting his heart to the right side of the chest cavity, and numerous third-degree burns. A oft-told story said that Hughes sent a check to the Marine weekly for the remainder of his life as a sign of gratitude. However, Durkin's daughter denied that he took any money for the rescue."

One of the first effective medications for OCD, clomipramine (trademarked as Anafranil), a tricyclic antidepressant (TCA) was developed in the 1960s by the Swiss drug manufacturer Geigy (now known as Novartis) and has been in clinical use worldwide ever since. Along with SSRIs, clomipramine is a frequently prescribed drug for the treatment of OCD. As is typical with the older tricyclic antidepressants (the tertiary amines), it has more side effects than SSRIs, so some authorities regard it as a second-line treatment to be used if treatment with SSRIs fails. However, disregarding side effects, it may be slightly more effective in combating the symptoms of OCD.

I've never read that Hughes ever tried Anafranil. He sure consumed plenty of other drugs though. Another interesting irony is, according to one of the biographies I read, is that when he opened the Howard Hughes Medical Institute (HHMI), the non-profit medical research organization based in Chevy Chase, Maryland, it was founded cynically as a tax dodge.

Initially, the institute was formed with the stated goal of basic research including trying to understand, in Hughes' words, "the genesis of life itself." Despite its principles, in the early days it was generally viewed as largely a tax haven for Hughes' huge personal fortune. Hughes was the sole trustee of HHMI and transferred all his stock of Hughes Aircraft to the institute, in effect turning the large defense contractor into a tax-exempt charity.

Hughes never intended it to become the world-class medical research facility it is today. HHMI spends about $1 million per HHMI investigator per year, which amounts to annual investment in biomedical research of about $825 million. The institute has an endowment of $16.1 billion, making it the second-wealthiest philanthropic organization in the United States and the second best endowed medical research foundation in the world.

It was not until after Hughes' death in 1976 that the Institute's profile increased from an annual budget of $4 million in 1975 to $15 million by 1978. In this period it focused its mission on genetics, immunology and the rapidly growing field of molecular biology. Since Hughes died without a will as the sole trustee of the HHMI, the Institute was involved in lengthy court proceedings to determine whether it would benefit from Hughes' fortune.

As early as the 1930s, Hughes displayed signs of mental illness, primarily obsessive-compulsive disorder. Close friends reported that he was obsessed with the size of peas, one of his favorite foods, and used a special fork to sort them by size.

Richard Fleischer, who directed His Kind of Woman with Hughes as executive producer, wrote at length in his autobiography about the difficulty of dealing with the tycoon. In his book, Just Tell Me When to Cry, Fleischer explained that Hughes was fixated on trivial details and was alternately indecisive and obstinate. He also revealed that Hughes' unpredictable mood swings made him wonder if the film would ever be completed

In December 1957, Hughes told his aides that he wanted to screen some movies at a film studio near his home. Hughes stayed in the studio's darkened screening room for more than four months, never leaving. He subsisted exclusively on chocolate bars, chicken, and milk, and relieved himself in the empty bottles and containers. He was surrounded by dozens of Kleenex boxes, which he continuously stacked and re-arranged. He wrote detailed memos to his aides on yellow legal pads giving them explicit instructions not to look at him, to respond when spoken to, but otherwise not speak to him. Throughout this period, Hughes sat fixated in his chair, often naked, continuously watching movies, reel after reel, day after day.

When he finally emerged in the spring of 1958, his hygiene was terrible, as he had not bathed or cut his hair and nails for weeks (although this may have been due to allodynia -- pain upon being touched.)

Hughes insisted on using tissues to pick up objects, so that he could insulate himself from germs. He would also notice dust, stains or other imperfections on people's clothes and demand that they take care of it.

As a result of numerous plane crashes, Hughes spent much of his later life in pain, eventually becoming severely addicted to codeine, which he injected intramuscularly. Hughes only had his hair cut and nails trimmed once a year. He may have been in severe chronic pain from his extensive injuries, so much so that even the act of tooth brushing was painful, so he avoided doing it.

A retrospective case study suggests that Hughes' drug situation is more reminiscent of "pseudoaddiction" than true addiction; he suffered chronic pain and used narcotic medicine to control it. He did not inject it intravenously for immediate effect, rather, he injected it into muscle, where it would have more of an effect on pain, however it should be noted that codeine, when injected intravenously, leads to life threatening symptoms and is not by any means a safe route of administration, under any circumstance.

He did not use tobacco or other drugs, and rarely consumed alcohol. He used diazepam to control the symptoms of withdrawal when he had not taken enough codeine. At the time, the field of pain management was small and there were few options for long-term pain control. As codeine is a relatively weak narcotic, his pain was probably not controlled effectively.

Toward the end of his life, his inner circle was largely composed of Mormons, as they were the only people he considered trustworthy, even though Hughes himself was not a member of their church.

Hughes was reported to have died on April 5, 1976, at 1:27 pm on board an aircraft owned by Robert Graf and piloted by Jeff Abrams, en route from his penthouse at the Acapulco Fairmont Princess Hotel in Mexico to The Methodist Hospital in Houston, Texas. Alternatively, other accounts indicate that he died in the flight from Freeport Grand Bahamas to Houston. His reclusive activities (and possibly his drug use) made him practically unrecognizable; his hair, beard, fingernails, and toenails were long (possibly due to allodynia making him averse to touch), his tall 6-foot, 4-inch frame now weighed barely 90 pounds, and the FBI had to resort to fingerprints to identify the body. Howard Hughes' alias, John T. Conover, was used upon the arrival of his body at a morgue in Houston on the day of his death. There, his body was received by Dr. Jack Titus.

A subsequent autopsy noted kidney failure as the cause of death. Hughes was in extremely poor physical condition at the time of his death. He suffered from malnutrition. While his kidneys were damaged, his other internal organs, including his brain, were deemed perfectly healthy. X-rays revealed five broken-off hypodermic needles in the flesh of his arms. To inject codeine into his muscles, Hughes used glass syringes with metal needles that easily became detached. Phenacetin, used for chronic pain until 1983, may have been the cause of his kidney failure. Hughes is buried in the Glenwood Cemetery in Houston, Texas, next to his parents.