Elena was eventually diagnosed with tuberculosis, a typically fatal disease at the time, that eventually claimed the lives of almost all of her immediate family. Tanzler, with his self-professed medical knowledge, attempted to treat and cure Elena with a variety of medicines, as well as X-ray and electrical equipment, that were brought to the Hoyos' home. Tanzler showered Elena with gifts of jewelry and clothing, and allegedly professed his love to her, but no evidence has surfaced to show that any of his affection was reciprocated by Elena.