Williams was born with a mild undiagnosed case of spina bifida occulta, a disorder of the spinal column, which gave him lifelong pain—a factor in his later abuse of alcohol and other drugs.

In 1951, Williams fell during a hunting trip in Tennessee, reactivating his old back pains and causing him to be dependent on alcohol and prescription drugs.

Carr later kept driving until he reached a gas station in Oak Hill, West Virginia, where Williams was discovered unresponsive in the back seat.

[6] Williams was scheduled to perform at the Municipal Auditorium in Charleston, West Virginia, on Wednesday, December 31 (New Year's Eve), 1952.

[7] Because of an ice storm in the Nashville area that day, Williams could not fly, so he hired a college student, Charles Carr, to drive him to the concerts.

Carr called the Charleston auditorium from Knoxville to say that Williams would not arrive on time owing to the ice storm and was ordered to drive him to Canton, Ohio, for the New Year's Day concert there.

Carr also requested a doctor for Williams, as he was feeling the combination of the chloral hydrate and alcohol he had drunk on the way from Montgomery to Knoxville.

At around midnight on New Year's Day, Thursday, January 1, 1953, they crossed the Tennessee state line and arrived in Bristol, Virginia.

[11] Carr later drove on until he stopped for fuel at a gas station in Oak Hill, West Virginia, where he discovered Williams seemingly asleep in the back seat.

Carr immediately realized that he was dead and informed the filling station's owner, Glenn Burdette, who called the chief of the local police, O.H.

[12] Stamey and Janney found some empty beer cans and the unfinished handwritten lyrics to a song yet to be recorded in the Cadillac convertible.

[13] The town's coroner and mortician, Dr. Ivan Malinin, a Russian immigrant who barely spoke English, performed the autopsy on Williams at the Tyree Funeral House.

Malinin also found that, apparently unrelated to his death, Williams had also been severely kicked in the groin during a fight in a Montgomery bar a few days earlier[14] in which he had also injured his left arm, which had been subsequently bandaged.

Carr was exhausted and, according to the police reports, nervous enough to invite suspicion that foul play had been involved in Williams' death.

[31] The president of MGM told Billboard magazine that the company got only about five requests for pictures of Williams during the weeks prior to his death, but over 300 afterwards.

[33] As part of an investigation of illicit drug traffic conducted by the Oklahoma legislature, representative Robert Cunningham seized Marshall's files.

He attributed the decision to Williams' declining career: "Most of his bookings were of the honky-tonk beer joint variety that he simply hated.

If he came to this conclusion (of suicide), he still had enough prestige left as a star to make a first-class production of it ... whereas, six months from now, unless he pulled himself back up into some high-class bookings, he might have been playing for nickels and dimes on skid row.

"[36] On March 19, Marshall declared that he felt Williams was depressed and committed suicide by taking a higher dose of the drugs he had prescribed.

[37] On March 21, Robert Travis of the State Crime Bureau determined that Marshall's handwriting corresponded to that of Dr. Cecil W. Lemmon on six prescriptions written for Williams.

[38] The same day, the District Attorney's office declared that after a new review of the autopsy report of Faye Marshall, toxicological and microscopic tests confirmed that her death on March 3 was not related to the medication prescribed by her husband.

[39] Oklahoma Governor Johnston Murray revoked the parole of Horace Raphol "Toby" Marshall, who returned to prison to complete his forgery sentence.