The misuse of Michael Jackson and Propofol by Murray and AEG

“Propofol is safe, but Conrad Murray was not” 

Sometimes we need to come back to a topic when we learn something new about it or when we happen to make an experience in connection with it. It can be amazing when things we have written and talked about suddenly affect us personally and give us new insights, confirmations or recollections.

These recollections now will come back especially with the upcoming trial against AEG, and we will also remember the trial against Murray and the way Michael died. 

But before I come to this topic I have to start with a story about my sister.

I have a sister who suffers from PKU (phenylketonuria), a genetic metabolic disorder which leads to mental retardation by the amino acid phenylalanine which accumulates in the body because it cannot be metabolized. Today a mental retardation mostly can be avoided because through newborn screening the disease can be detected immediately after birth and the children receive a strict Phe-less or low-protein diet, usually their whole life. However, when my sister was born – in 1962 – the newborn screening did not yet exist in Germany. It was only found out what she suffered from when she was 2 years old, her brain was already damaged. The phe-less diet was started too late. So unfortunately my sister is disabled and cannot speak – only a few words. She is afraid of medical treatments because 12 years ago she was very sick and almost died. But she is a very lovely person, always in a good mood, smiling, trusting, and we can communicate with her very well. She understands many things we tell her and is very attentive to everything that happens around her.

And the most important thing is: She is singing the whole day. She has one huge talent and that is music. She hears a song once – and can sing the melody immediately. And she has a feeling for different genres of music. Well, we are a musical family and she learned to listen to all kinds of music through us. But it’s just amazing, how she sings chorales of Johann Sebastian Bach as well as blues songs of B.B. King and Muddy Waters. She sings Eric Clapton, Bob Dylan and Joan Baez as well as the famous Hallelujah of Händel’s “Messiah”. She loves R&B as well as Irish folk or baroque or church music.

And, of course, she loves Michael’s music, who combined several music genres. She knows every song by heart and expresses great joy when I play his songs. She even knows the sequence of the songs on the albums by heart and starts singing the next song before it begins to play. I am 100% sure that Michael would have been very impressed by her if he had known her. She literally cannot live without music, it must play the whole day and she complains when someone turns it off.

But this is just the introduction to this post. I wanted to make understandable why my sister needs a sedation for a dental treatment. In fall last year we realized that she needed to have her teeth checked. This is always a problem because she doesn’t open her mouth. I am her legal guardian and so I looked for a dentist who would treat her with the help of an anesthesiologist. This is not always easy because the treatment is more complex, needs more time and patience as usual. Of course, she doesn’t understand what’s going on, is afraid and tries to resist a treatment. She is crying and sometimes screaming. It can be nerve-racking.

The documents for my sister’s anesthesia said that it would be deep sedation with Propofol

But then I found a wonderful dentist who really cared. He arranged for an appointment with an anesthesiologist who worked with him, and they were both very kind-hearted and understood the problem. We discussed the procedure and I had to sign the documents for anesthesia.

It said: “Deep sedation with propofol.”

I wasn’t surprised and it was okay for me. I am working at a university children’s hospital and I know that many of our children are sedated with propofol when they need a cardiac catheter or an MRI for diagnostics.

However, at that time I didn’t know that I eventually would be present when the sedation is carried out. The appointed day was the 21st of December of last year, the day when the world was supposed to end. Well, I knew that in reality it was meant as the beginning of a new cycle, and that’s what I exptected it would be for us, too, because we would be very glad when we finally got over with it right before Christmas.

I hoped I could avoid being present, I shied away from seeing her being sedated. But it was clear that someone would have to hold her because she would try to resist.

We brought her to the dental chair, my mother held her one arm, and I held the arm where the cannula was placed to inject the propofol. And so I witnessed the direct effects of propofol with my own eyes.

Within seconds of pushing the syringe my sister was motionless and knocked out. No way someone can do it him/herself. She was knocked out before the syringe was completely pushed to the end. I could see the effect at first in her eyes. Her eyes suddenly ossified and stayed open. The lids only became a little heavy. And then her mouth opened automatically. We then went outside and the dentist began his treatment, but when I left my sister I saw her like Michael’s assistants described it – with fixed open eyes and open mouth.

However, it was a wonderful feeling to know that the anesthesiologist stayed at my sister’s side for the procedure and watched her breathing, ready to intervene in any case of complication. I wasn’t there when they finished and she awoke, because I had to go to work. But my mother told me that she was awake very quickly, they just sat with her for a while in the waiting room before they took her home – altogether she was at the dentist’s for barely 2 hours.

When my mother also described me how caring the anesthesiologist was, that he even dressed her with her jacket, zipped it, and walked with her to the door to make sure she is alright, I thought: If only Michael had had such a doctor.

I can only say: Propofol can be a blessing. It’s so helpful for cases like my sister or for the kids in our children’s hospital, who would be scared to death without being sedated in case of very grave diagnostic methods and treatments. I was nervous before we went to the dentist and it was a bit odd to watch this situation, but now I am glad I could see all this. It seems so normal now to me that a substance like propofol is used for the benefit of patients.

Afterwards at work I talked with two of our doctors about the use of propofol, and they both confirmed to me how useful and popular it is. One of them even called it a “blockbuster” because everybody prefers it now to former anaesthetics. The experience also made me somewhat emotional and I had trouble to sleep the following night. The picture of my sister on the dental chair switched with Michael’s picture all the time. It’s so incredible that Murray left him alone in this state and didn’t care. And it’s strange that the substance that killed Michael is such a blessing for everybody else.

But it was good for me to get the confirmation with my own eyes that in reality it wasn’t the substance that killed Michael, but a person who did it the wrong way, an entertainment company that apparently put a lot of pressure on him – and on a larger scale the mankind that was so cruel to him.

To remind us of what really happened to Michael when he died, I want to repeat the judgment of Dr. Raphael Gershon, Chief of Anesthesiology at Grady Memorial Hospital, on Conrad Murray in an interview with CNN. He said that it isn’t the matter of propofol per se as it is a very safe medicine to use in a proper setting – it is the matter of the “wrong person doing the wrong thing in the wrong way and in the wrong setting”.

It is the matter of the wrong person doing the wrong thing in the wrong way and in the wrong setting.

We can find the statement in this blog’s post of 28^th September 2011: https://vindicatemj.wordpress.com/2011/09/28/murrays-trial-begins/  

We have to remember this and not be afraid of any use of this anesthetic in our own life by real professionals.

I also want to remind us of the interview with former Deputy DA Hamid Towfigh (Link to Jane Velez-Mitchell talking to Hamid Towfigh:  http://www.examiner.com/jackson-family-in-national/former-la-deputy-da-hamid-towfigh-on-conrad-murray-michael-jackson-propofol-video )

Towfigh: In their opening statement of the defense they are telling us if their theory was based on self-injection or self-ingestion by swallowing the propofol. That’s very interesting. But under both reasons they’ll fail.

First of all propofol or deprivan is only vial available [ ] If you swallow propofol it will not cause the reaction of death. That’s in the medical literature, you can ask Dr. Sanjay Gupta about this.

Velez-Mitchell: What about Michael Jackson somehow making an injection or opening the drug?

Towhigh: This is not possible, because according to the Coroner’s report Michael Jackson had a general anesthesia level of propofol in his blood. If you ask anesthesiologists they’ll tell you it is about 200 mg or higher of propofol. The syringes that were in the room of Michael Jackson were 10cc syringes which is the equivalent of 100 mg. That means that he would have had to inject himself twice 200 mg of propofol to get the levels that the coroners said he had.

That is not possible, because after the first dose that Michael Jackson supposedly gave himself, he would have passed out.

And besides propofol is a very painful drug. That’s why they mix it with lidocaine. Michael Jackson had lidocaine in his system. They mix propofol with it because when it goes into your body it’s very painful. So had Michael Jackson self-administered this (which he didn’t) he would have screamed [ ] and Conrad Murray would have heard him in the other room.

Velez-Mitchell: I think that what you are saying is brilliant. [ ] He had so much propofol in his system according to the autopsy report that it was enough for major surgery. He would have had to use two bottles [in a shot, drip or whatever]. And at the time of administering the first one he would have been knocked out so that he couldn’t have been awake to administer the second one. Is that what you are saying?

Towfigh: Exactly.

Velez-Mitchell: Wow!

 Why MJ cannot have administered propofol by himself is described very well also in this post by Helena, who did a great job in covering the Murray trial in 2011:  https://vindicatemj.wordpress.com/2011/10/18/conrad-murray-trial-week-4/

Dr. Steven Shafer – key witness and brilliant propofol expert at the Murray trial – said that one of the reasons he reviewed the Murray case without being charged was that as a practicing anesthesiologist he now hears patients say to him again and again, “Are you going to give me the drug which killed Michael Jackson?”

It was Dr. Shafer’s personal interest to dispel the fear many patients have acquired after Murray’s deeds. In my case he was successful. I never doubted his explanations. And this also helped my sister, so I want to express my thanks to Dr. Shafer for making this decision easy for me.

Dr. Barry L. Friedberg, another well-known anesthesiologist, said: “The general public has been needlessly traumatized over the safety of propofol. I have said from the outset that propofol is safe, but Conrad Murray was not.” http://www.free-press-release.com/news-murray-guilty-propofol-not-1320709413.html

On January 18, 2013, Dr. Barry L. Friedberg posted on his website:

“We do not blame the automobile for the reckless drunk driver’s deaths. By his own public admission, Conrad Murray was reckless by giving Jackson propofol & leaving the room.

Hundreds of millions of patients worldwide have safely received propofol because someone was watching them breathe & monitoring their oxygenation.

(…)

Conrad Murray was practicing as a cardiologist with hospital privileges to catheterize & stent diseased coronary arteries under propofol sedation & pulse oximetry. Despite this knowledge, he chose to buy the cheapest pulse oximeter monitor for Jackson – one that made no sounds & had no alarms.

Clearly, Murray does not believe the normal safety measures apply to his practice, behavior that defines him as a sociopath that never again deserves a license to practice medicine.”

http://drfriedberg.com/blog/propofol-michael-jacksons-death.html  

When Dr. Shafer called Murray’s deviations from the standard of care unconscionable, I think this assessment also applies to the people of AEG Live, who treated Michael apparently with the same ethical violations of his rights as a human being. The tone of AEG’s attorney Marvin Putnam says it all:

“The most important thing to note is that Michael Jackson asked AEG Live to be his concert promoter, not his sobriety coach. AEG never assumed a duty to protect Michael Jackson from his longstanding private demons or from his longtime doctor,” lead defense attorney Marvin Putnam, a Los Angeles partner at O’Melveny & Myers, wrote in an e-mail to The National Law Journal. ”

http://www.law.com/jsp/nlj/PubArticleNLJ.jsp?id=1202588802957&Michael_Jacksons_concert_promoter_We_werent_his_sobriety_coach&slreturn=20130207060518  

This and the exploitation of Michael by AEG is also very apparent from this leaked email Paul Gongaware wrote 11 days before Michael’s death, obviously because Murray didn’t send him to rehearsals:

“We want to remind (Murray) that it is AEG, not MJ, who is paying his salary. We want to remind him what is expected of him.”

By the way, did Michael Jackson really ask AEG Live to be his concert promoter? Wasn’t it the other way round? Didn’t AEG ask Michael several times to do a concert series with them when Michael was not ready to do it? Randy Phillips himself told it. They persuaded Michael to do the shows together with those who told him he is broke.

AEG Live probably put so much pressure on Michael and also on Murray to get Michael ready for the rehearsals and the shows that propofol was used as means to an end to reach their goal. Propofol was misused the same way Michael was misused. And both are a blessing for mankind and should be treated with respect.