Elisa Lam's naked body was found in a water tank 19 days after she disappeared. Foul play, paranormal activity, psychosis, suicide, or an accident?

Elisa Lam was a 21-year-old student from Vancouver, British Columbia. She left for an extended vacation in California in January of 2013. Lam was traveling by herself and used Amtrak trains and public transportation to get from place to place. Her stated final destination was Santa Cruz, but she never made it. She called her parents every day of the trip, but on January 31, the calls stopped. Her parents knew immediately that something must be terribly wrong as this was unlike her. They reported her missing and flew to L.A., as she was scheduled to check of out the Cecil Hotel in downtown L.A. on that day.

Nineteen days later, her naked body was found by a maintenance worker floating face up in a water tank on top of the Cecil Hotel after guests began complaining about the lack of water pressure and the water's brown color, foul odor, and strange taste.

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The police were convinced they had a murder on their hands. How would it have been possible for Lam to make it to the roof of the building, then to the top of the water tanks, only to drown in 3 feet of water? Hotel workers told the police that it would have been impossible to reach the roof without someone helping her or noticing because the doors had numeric keypads, were kept locked, and were alarmed.

There was little evidence to go on. Most of her personal possessions including her clothing, hotel key, and watch were also at the bottom of the tank. Notably, her cell phone was missing and never recovered.

The Cecil Hotel had a long and sordid history. After opening in 1924, a series of violent incidents, deaths, and suicides led locals to give the hotel a new moniker: "The Suicide."

The Cecil was attractive to travelers because of its affordably priced rooms in the heart of downtown L.A., but many were unaware that they would be staying in a crime-ridden area. The hotel attracted johns, drug dealers, prostitutes, and the homeless in addition to budget travelers. Two serial killers called the Cecil home for a time. Richard Ramierez (a.k.a. "The Night Stalker") paid $14 a night to live there in the '80s. During his stay in the '90s, Jack Unterweger strangled at least three prostitutes at the Cecil with their own bras after giving them only $30 for their services. The "Hotel" season of American Horror Story is said to have been inspired by The Cecil. The victim of L.A.'s most famous cold case, the Black Dahlia, was seen drinking at the Cecil's bar before her murder.

The Cecil was also a favorite of paranormal investigators, as it was reported that the hotel was haunted by the spirits of those who met untimely deaths there.

There was little evidence to go on. An employee of the fittingly named Last Bookstore was one of the last people to see her alive and recalled that she seemed cheerful and there didn't seem to be anything out of the ordinary. She had initially been staying in a room with others before moving to her own room after her roommates became uncomfortable with what they described as "odd behavior" she was exhibiting. After her body was discovered, posts continued to appear on her Tumblr account. Had her account been hacked, had she arranged for the content to be posted prior to her disappearance, or was her assailant taunting the police?

A video from a security camera in the hotel surfaced that shows Lam in the elevator of the Cecil. Be warned that the video is extremely unsettling. She appears to be very afraid. At times she seems to be talking to someone though no one else is visible in the video and makes strange gestures with her hands. She presses herself up against the corner of the elevator as if she's hiding from an attacker. She frantically pushes all the buttons on the elevator panel, but the elevator seems to be malfunctioning and the doors do not close. Minutes go by, and she eventually flees the open elevator. Mysteriously, the doors of the elevator finally close after she leaves.

An autopsy was performed on the moderately decomposed body, but found nothing unusual--no trauma, no needle punctures or track marks, no sign of strangulation. A rape kit was performed. Samples were sent to toxicology and pathology. No conclusion could be drawn from the pathological evidence as the tissues were too decomposed.

The toxicology report showed that she had not been under the influence of alcohol, marijuana, or any illegal drug at the time of death. Lam had bipolar disorder and was taking Wellbutrin, an antidepressant, and Lamictal, a mood stabilizer to control her symptoms. The toxicology report showed levels of those drugs consistent with her taking them as prescribed, so an overdose hadn't occurred. To those around her, it didn't seem that she was depressed or suicidal.

She was also prescribed Seroquel, an antipsychotic, which was present among her possessions. The toxicology report showed no Seroquel in her system. However, this is not an indication that she had gone off her medications in the days or weeks before her death. The prescription directions on the bottle were "QHS PRN," which means "take at bedtime as needed." It is unclear why she was prescribed Seroquel. It is most commonly prescribed for bipolar disorder and major depression. Despite the fact that it is classified as an antipsychotic, it is often prescribed to people with no symptoms of psychosis, such as those with depression as an adjunct to an antidepressant. It is also prescribed off-label for conditions ranging from anxiety to Tourette syndrome. It can be extremely sedating, so it's possible that she was using it to treat occasional insomnia.

The coroner ruled the death an accidental drowning and listed bipolar disorder as a contributing factor. Lam's full autopsy report is available here: https://medium.com/@jddean/elisa-lam-s-autopsy-report-98c3ec03c309

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Most assume that she had a manic episode, somehow got to the roof, and subsequently drowned. However, others aren't convinced. Where is her cell phone? Why would she go to the roof? It would have been no small feat to get to the top of the tanks and then down inside one of them. Was she running from an assailant in the elevator video, or was she hearing and seeing things that weren't there as a result of a manic episode? Did she witness some sort of paranormal event that frightened her? How does a 5'6" adult drown in knee-deep water when intoxication and injury aren't factors? Why was she naked? The clothing found in the tank was the same as she is seen wearing in the elevator video, but covered in white particulate matter that was never identified. Although a rape kit was performed, it was never analyzed, possibly because of the lack of a suspect. Was she on an illicit drug that hadn't been screened for in the toxicology testing? A Chinese tourist who was interested in the Lam case stayed at the Cecil and found that he could access the roof without a key or pass code and without setting off any alarms. Did the hotel employees deliberately mislead the police in this regard?

While the police investigation has been officially closed, many are hesitant to close the chapter on Elisa Lam's death with so many unanswered questions remaining. In part because of Lam's death, The Cecil was renovated with bunk beds and cheery colors and reopened as the "Stay on Main Hotel and Hostel" in an attempt to appeal to young travelers and disconnect the hotel from its seedy and violent past. However, the hotel has since closed its doors permanently. The owners plan on turning the property, now a historic landmark, into a boutique hotel and "micro" apartment complex in an attempt to breathe new life into a site corrupted by death for close to 100 years.

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