The deaths of a popular Buncombe County physician and her husband under curious circumstances have been ruled suicides by a medical examiner in Galveston, Texas, where their bodies were found at a hotel in August.

William Allen Cargile, Jr., 58, ingested a lethal dose of barbiturates, opiates and other drugs, Dr. Stephen Pustilnik, chief medical examiner at the Galveston County Medical Examiner’s Office, said Tuesday.

Pustilnik ruled last month that Cargile’s wife, Dr. Leslie Cargile, 53, also died from ingesting similar drugs.

The Cargiles were seen leaving their home in Lake Summit in Henderson County on Aug. 18. Their son, Kenton Cargile, 24, a student at the University of South Carolina, filed a missing person report with the Henderson County Sheriff’s Office on Aug. 22.

The Cargiles’ bodies were found by cleaners at a Holiday Inn Express in Galveston on Aug. 24, a Friday. They had checked in the previous Sunday after traveling from Mobile, Ala, where they spent the night of Aug. 18 at a Hilton hotel.

Pustilnik said William Cargile died first and – inexplicably – Leslie Cargile died up to two days later.

“I’ve seen husbands and wives die together at the same time in different rooms, but they’re usually elderly folks. Nothing like this,” he said.

Pustilnik said the autopsy showed neither of the Cargiles had a life-threatening illness – dismissing one possible motive for the unexplained deaths.

Lt. Michael Gray, a spokesman for the Galveston Police Department, said the Cargiles’ hotel door was locked from the inside, dismissing foul play.

Police, sheriff: No note found

He would not say whether a suicide note was found in the room, but Robert Haggard of Hendersonville, a court-appointed attorney for the Cargiles’ estate, said he is not aware of a suicide note left anywhere by the Cargiles.

“To the best of my knowledge they did not confide in anyone,” Haggard said. “I have no idea why they chose this course of action, or why they drove to Galveston, Texas.”

Capt. Frank Stout with the Henderson County Sheriff’s Office, which investigated the missing-person report on the Cargiles, said the couple did leave notes behind at their home, but they were instructions for the family and not related to their actions in Galveston.

The couple’s cellphones were found in the home, he said.

Initial concern emerged on Aug. 20, a Monday, when Dr. Cargile did not report for work. She owned Family Care Home, with offices in Black Mountain and Old Fort, and served thousands of patients over 27 years.

A number of patients discussed her death in a Facebook thread in late August. They cited her excellence and compassion as a family physician, but a few noted some unusual behavior and appearance during their last visits earlier in August.

Kellie Conner said Cargile wanted her to see another doctor for medications.

“I didn’t understand why she would send me to someone else who didn’t know me,” she wrote on her Facebook page on Aug. 25.

Wrote Barbara Anglin, also on Aug. 25: “Looking back at my last visit, she did look so worn out and incredibly thin. My previous visits with her, she looked beautiful and happy and healthy.”

Haggard said he did not know if legal or financial issues were possible reasons for the Cargiles’ deaths.

“I don’t think it would be appropriate for me to speculate on the reason they chose this course of action. It would just be speculation,” he said.

Haggard said Cargile’s practice re-opened Sept. 6 with Dr. Drew Schnyder directing the office. Cargile had hired Schnyder earlier in the year to work with her, but he had been away on duty in the Air Force.

The Cargiles’ sons, Kenton and Eliot, a businessman in Hong Kong, worked with Haggard to complete the transition.

‘Why’ may never be known

For now, the mystery surrounding the Cargiles’ deaths remain just that – a mystery.

Gray, of the Galveston police, said the case remains open, but “it’s at the bottom of the pile.”

Stout, of the Henderson Sheriff’s Office, said his department’s role was completed when the bodies were found.

He is not optimistic that there will be an answer for all the people who ask: Why?

“I’m not sure if there will ever be,” he said.