News summary of week 8 at the AEG trial. THE SLEEP EXPERT SOLVES THE PROPOFOL MYSTERY

Here is the news summary for the remaining part of week 8 of the trial. The first days of the week were covered by the previous two posts.

The fight between the lawyers for the opposing parties has reached a stage when the AEG lawyers are trying to compromise Brian Panish and his team on a personal level now. On June 17th they claimed that when no one was looking Brian Panish showed Putnam “the finger”. I highly doubt that this was the case because Mr. Panish has a thousand other arguments in favor of his case and does not need a gesture of insult which is often used as a compensation for lack of more valid arguments.

Ridiculous as it looks but the matter was nevertheless seriously discussed in court and taken to the judge during a sidebar. The ABC correspondent reported it as follows:

Michael Jackson wrongful death trial: Hostilities between attorneys erupt

Monday, June 17, 201

Miriam Hernandez 
(excerpt)

LOS ANGELES (KABC) — The Michael Jackson wrongful death trial is in its eighth week, and it appears the attorneys are having a tough time controlling their tempers. Hostilities between the battling attorneys erupted during a sidebar conference with the judge in her chambers Monday.

The attorney representing AEG, Marvin Putnam, said that he was repeatedly flipped off by the attorney for the Jacksons, Brian Panish. Panish denied making any gestures.

According to court records, Panish says, “I don’t think I’ve even gestured anything to Mr. Putnam today.”

“You’ve given me the finger twice,” Putnam said.

“Judge, if I want to give him the finger, I know how to give him the finger,” Panish responded.

“And you did it quite well twice,” Putnam fired back.

The judge said simply that if the gestures were going on, they need to stop.

In the courtroom, a music industry expert paid to testify for Katherine Jackson took the witness stand. The testimony centered on AEG creating an alleged conflict of interest in the hiring of Michael Jackson’s physician, Conrad Murray.

Former record executive David Berman testified that in his opinion, AEG’s lack of production experience paved the way for a series of negligent decisions. Murray’s fee, he testified, was out of whack and should have been a red flag. He said the doctor first asked for $5 million, finally agreeing to $150,000 a month.

Berman says such a deal was also inappropriate, highly unusual and set up an inherent conflict of interest. He stated the physician had an obligation to both the person he’s treating and to the entity who would be paying him.

The lawsuit pits Katherine Jackson against AEG, claiming that it hired Murray and should have conducted background checks on the doctor and supervised Jackson’s care.

Jurors reviewed emails of AEG attorneys discussing a contract with Murray, but not with Michael Jackson’s managers or attorneys. Berman says the emails show that AEG wanted to control the services of Murray.

http://abclocal.go.com/kabc/story?section=news/entertainment&id=9142632

Those interested may have a look at the way the hostilities progressed:

13 (THE FOLLOWING PROCEEDING WAS HEARD AT SIDEBAR:)

14

15 THE COURT: IT’S BEEN BROUGHT TO MY ATTENTION

16 THAT THERE HAS BEEN SOME GESTURING BETWEEN COUNSEL,

17 WHICH IS INAPPROPRIATE.

18 SPECIFICALLY, MR. PANISH, IT’S BEEN BROUGHT TO

19 MY ATTENTION THAT YOU MAY BE GESTURING SOMETHING TO

20 MR. PUTNAM.

21 IS THAT WHAT’S GOING ON?

22 MR. PANISH: I DON’T THINK I’VE EVEN GESTURED

23 ANYTHING TO MR. PUTNAM TODAY.

24 MR. PUTNAM: YOU’VE GIVEN ME THE FINGER TWICE

25 MR. PANISH: WHAT? I SAID LIKE THIS TO STOP

26 (INDICATING).

27 MR. PUTNAM: I KNOW WHAT —

28 MR. PANISH: JUDGE, IF I WANT TO GIVE HIM THE

1 FINGER, I KNOW HOW TO GIVE HIM THE FINGER.

2 MR. PUTNAM: AND YOU DID IT QUITE WELL TWICE.

3 MR. PANISH: I WAS TRYING — I WOULD TELL YOU;

4 OKAY? I ADMIT WHAT I DO. IF I WANTED TO GIVE YOU THE

5 FINGER — ARE YOU COMPLAINING AND SAYING I GAVE YOU THE

6 FINGER?

7 MR. PUTNAM: I DIDN’T.

8 MR. PANISH: I DID — I WENT LIKE THIS WHEN HE

9 WAS TALKING (INDICATING), AND ALL THREE OF THEM WERE

10 INTERRUPTING.

11 AND MS. STRONG, SINCE SHE’S BEEN HERE, YOU CAN

12 SEE HOW THE INTENSITY AND HOSTILITY. AND IN DEPOSITION,

13 SHE HAS BEEN UNBELIEVABLE. I’LL SHOW YOU THE

14 TRANSCRIPTS. THE MOST UNCIVIL LAWYER, DISRUPTIVE,

15 ATTACKING LAWYER. NOW WE COME IN HERE, THE THREE OF

16 THEM ARE TALKING.

17 I TRIED TO LET THEM TALK. I DIDN’T GET IN AN

18 ARGUMENT WITH THEM. THEY STARTED ADDRESSING ME. I

19 HAVEN’T ADDRESSED THEM.

20 I DIDN’T FLIP MR. PUTNAM THE FINGER OR FLIP HIM

21 OFF. IF HE WOULD LIKE ME TO, I KNOW HOW TO DO IT,

22 BELIEVE ME. I HAVEN’T EVEN TALKED TO MR. PUTNAM OR MADE

23 ANY — DID I HAVE ANY DEALINGS TODAY OTHER THAN WHEN WE

24 CAME IN HERE?

25 MR. PUTNAM: NO.

26 YOUR HONOR, EVERY TIME THAT YOU HAVE RAISED AN

27 ISSUE WITH MR. PANISH ABOUT SOMETHING THAT YOU THOUGHT

28 WAS IN TERMS OF CIVILITY AND DEALINGS BETWEEN COUNSEL

1 WHAT IMMEDIATELY OCCURS, HE COMPLETELY THEN TURNS AND

2 BLAMES SOMEBODY ELSE FOR SOMETHING ELSE; OKAY? AND I

3 THINK THAT’S NOT ONLY INAPPROPRIATE, BUT IT ATTEMPTS TO

4 BELIE WHAT’S ACTUALLY GOING ON.

5 AND I THINK THE ISSUE RAISED IS AN ISSUE. I

6 DID NOT RAISE THIS ISSUE WITH THE COURT, BUT I WILL

7 REPRESENT THAT THAT ABSOLUTELY OCCURRED AND DID OCCUR

8 TWICE.

9 THE REASON I DIDN’T RAISE IT WITH THE COURT IS

10 BECAUSE THIS HAS BEEN REPEATED FOR TWO MONTHS NOW. WE

11 ARE CONSTANTLY ACCUSED ON THE RECORD OF MANY THINGS,

12 INCLUDING LACK OF CIVILITY. WE HAVE DONE NOTHING TO

13 LACK CIVILITY. BUT CONTINUOUSLY WE ARE SWORN AT, WE ARE

14 GIVEN THE FINGER, AS TODAY, WE’RE ACCUSED OF THINGS THAT

15 ARE ABSOLUTELY BASELESS.

16 AND I THINK WHAT YOU’RE ASKING TODAY IS THAT

17 THERE BE REQUIRED CIVILITY, YOU’RE NOT EVEN ASKING OF

18 THE EXPECTED, THE ACTUAL REQUIRED CIVILITY. I THINK

19 THAT IS SOMETHING THAT EVERYONE WOULD BENEFIT FROM.

20 MR. PANISH: WELL, FIRST OF ALL, I DON’T KNOW

21 WHEN I’VE SWORN AT MR. PUTNAM. OF COURSE, APPARENTLY HE

22 HAS SAID THAT.

23 BUT I HAVE BEEN TRYING MY BEST, IN LIGHT OF THE

24 CONDUCT OF COUNSEL, TO BE CIVIL. I’VE NEVER HAD AN

25 ISSUE IN 100 JURY TRIALS WITH CIVILITY UNTIL THIS CASE.

26 I’VE NEVER HAD SUCH ATTACKS ON MY LAW FIRM AND MYSELF

27 BEFORE ANY LAWYERS BEFORE THEIR CASE. AND I COULD BREAK

28 OUT CHAPTER AND VERSE OF THE LETTERS AND THE THREATS BY

1 THIS LAW FIRM.

2 I DIDN’T GIVE MR. PUTNAM THE FINGER. IF HE

3 WANTS ME TO GIVE HIM THE FINGER, I’M HAPPY TO DO THAT.

4 I’VE SAT THERE ALL DAY LISTENING TO THESE OBJECTIONS AND

5 THESE SPEECHES BY MS. STRONG; OKAY? AND I ASKED TO COME

6 BACK HERE TO STOP THAT. I DIDN’T DO IT IN FRONT OF THE

7 JURY.

8 BUT I WILL NOT TALK TO MR. PUTNAM, AND I DIDN’T

9 ADDRESS MS. STRONG WHEN SHE ATTACKED ME IN HERE, AND I

10 BROUGHT IT TO THE COURT’S ATTENTION.

11 NOW, HAVE I BEEN UPSET WITH THEM? YES,

12 ABSOLUTELY. WAS I UPSET WITH THEIR WITNESSES?

13 ABSOLUTELY. NO QUESTION. I DON’T DENY THAT.

14 THE COURT: WELL, I HAVEN’T SEEN IT, BUT IF

15 THAT’S GOING ON, IT’S GOT TO STOP. IT REALLY DOES.

16 I MEAN, I JUST — YOU KNOW, THIS TRIAL IS

17 DIFFICULT ENOUGH FOR BOTH OF YOU, AND IT JUST — IT

18 REALLY, AS I’VE SAID TO OTHER PEOPLE, IT DOESN’T HELP TO

19 ENFLAME PROBLEMS WITH GESTURES OR ATTITUDE OR RAISING

20 VOICES OR ANY OF THAT. IT REALLY DOESN’T. IT MAKES ALL

21 OF OUR JOBS A LOT HARDER. SO PLEASE DON’T DO THAT.

22 I HAVEN’T SEEN ANYTHING UNCIVIL ON THEIR PART,

23 MR. PANISH. I KNOW YOU KEEP ARGUING THAT SOMEHOW

24 THEY’RE DOING SOMETHING TO YOU, BUT I HAVEN’T SEEN

25 ANYTHING LIKE THAT. SO I DON’T KNOW WHY YOU FEEL

26 THEY’RE DOING THAT.

27 MR. PANISH: SHE JUST ATTACKED ME RIGHT HERE IN

28 CHAMBERS.

1 THE COURT: SHE DIDN’T ATTACK YOU.

2 MR. PANISH: DID YOU HEAR WHAT SHE SAID TO ME?

3 THE COURT: I HEARD WHAT SHE SAD. SHE’S NOT

4 ATTACKING YOU. DON’T FEEL THAT THERE’S A PERSONAL

5 ATTACK.

6 MR. PANISH: THEY’RE CONSTANTLY ATTACKING ME,

7 YOUR HONOR. I’LL SHOW YOU THE E-MAILS THAT THEY WRITE

8 ALL DAY LONG BETWEEN MS. STEBBINS AND MS. STRONG; OKAY?

9 THEY MAY NOT BRING IT IN ALL THE TIME IN HERE,

10 BUT THEY CERTAINLY DO. SHE JUST SAID — WAS MAKING

11 COMMENTS TO ME AS WE’RE WALKING OUT OF HERE. I DIDN’T

12 SAY ANYTHING TO HER, AND I DON’T TALK TO HER BECAUSE OF

13 WHAT SHE’S DONE WITH ME BEFORE.

14 THE COURT: MAYBE THE BEST THING TO DO IS NOT

15 TO TALK TO THEM.

16 MR. PANISH: I DON’T. I DON’T TALK TO

17 MR. PUTNAM. RARELY. I SAY, “HELLO,” THAT’S IT, OTHER

18 THAN SOMETHING ON SCHEDULING. WE DO TALK ABOUT THAT. I

19 DON’T TALK TO ANY OF THEM. THAT’S THE WHOLE POINT. I

20 DON’T TALK TO THEM.

21 THE COURT: NO GESTURING, PLEASE.

22 MR. PANISH: NO GESTURING. I DON’T TALK TO

23 THEM.24 THE COURT: ANYTHING ELSE YOU WANT TO SAY?

25 MR. PUTNAM: NO, YOUR HONOR.

26 THE COURT: OKAY. ALL RIGHT. LET’S GO BACK

27 AND DO OUR THING.

http://abclocal.go.com/three/kabc/kabc/jackson-trial-sidebar.pdf

Not for a single moment do I believe that Mr. Panish resorted to such methods as showing Mr. Putnam the finger. Using “ugly stuff” as an argument is actually the trademark of AEG and its lawyers. The dirty provocations were first made against the Jacksons’ family and now they started against their lawyers. AEG actually adheres to the same rules in selecting their witnesses too and the contrast in the ethics of the two parties is visible even to the naked eye.

Thus Dr. Charles Czeisler retained as an expert by the Jacksons reminded me of Dr. Steven Shafer at Conrad Murray’s trial who impressed all of us by the highest standards a person can possibly adhere to.

And AEG lawyers called Dr. Paul Earley who by his mediocre research and arbitrary opinion reminded me of Dr. White who was opposing Dr. Shafer and completely lost to him during Conrad Murray’s trial. Dr. Earley’s testimony was heard on June 19, 2009.

Wednesday June 19, DAY 33

On day 33 after Kai Chase’s recross examination the AEG lawyers showed avideotaped testimony of their ‘addiction specialist’ Dr. Earley. Here it is, represented by the ABC7 Court News tweets:

	Wednesday, June 19 DAY 33
1	Plaintiffs played a video deposition to play of defendant’s retained addiction specialist, Dr. Paul Henry Earley.
2	Dr. Earley said he’s getting paid $300 an hour for research and $500 an hour for deposition.
3	Dr. Earley is an addiction medicine specialist, care for individuals with substance abuse and disorders.
4	He became board certified the first year the test became available. Dr. Earley first training was in neurology, then psychotherapy.
5	Kevin Boyle: Are you qualified to treat patients who have addiction?
6	Dr Earley: I am
7	The doctor has been working on this field for 28 years
8	Dr. Earley said he treated patients with Propofol addiction, and is qualified to treat patients with benzodiazepine addiction.

The wording “propofol addiction” did not look quite correct to me, so I had to do a short study on addiction, and as could be expected found that the term used by Dr. Eearley is not quite right. He is speaking of propofol “addiction” though propofol is not an addictive drug.

Propofol does not form an addiction as recreational drugs do because it does not have the receptors in the brain which react to this drug and change the dopamine level in our system.

What is dopamine? Wiki tells us that the dopamine system (also called mesolimbic system) is widely believed to be a “reward” pathway in our brain which can make the person “high” and gives him “pleasure”.

Only four classes of substances affect the dopamine system and anesthetic propofol is no way connected with any of them.

Wiki classifies the substances affecting the level of dopamine in our system into four categories: psychostimulants, opiates, alcohol (ethanol) and nicotine. These are addictive substances proper.

Drug addiction, the loss of control over drug use or the compulsive seeking and taking of drugs despite adverse consequences, with the four major classes of abused drugs (psychostimulants, opiates, ethanol, and nicotine) are due to increased dopamine transmission in the limbic system – each by different mechanism.

http://en.wikipedia.org/wiki/Mesolimbic_pathway

How is the addiction formed by these four types of substances?

The article below explains the mechanism. Its author refers to the latest studies though I personally read a similar research in my own language forty years ago and it taught me to never touch drugs in the whole of my life:

Addiction and Brain Circuits

The neurotransmitter dopamine acts on specific receptors in the brain to increase pleasure and reward. The image shows that dopamine produced in one nerve cell activates receptors in neighboring brain cells.

Creation Date: 15 April 2011 | Review Date: 15 Feb 2012

For a long time, society viewed addiction as a moral failing. The addict was seen as someone who simply lacked self-control. Today, thanks to new advances in brain imaging and other technologies, we know that addiction is a disease characterized by profound disruptions in particular routes — or circuits — in the brain.

When a person takes an addictive drug — whether it be nicotine, alcohol, cocaine, heroin, or methamphetamine — chemicals travel swiftly through the blood stream into certain key brain regions known as the reward system, which regulates our ability to feel pleasure. With drug use, the circuitry of this system becomes flooded with dopamine. This brain chemical, or neurotransmitter, activates specific sites on brain cells called receptors to increase pleasure and reward.

Over time, the brain adjusts to the excess dopamine by decreasing the number of dopamine receptors and the overall amount of dopamine in the brain. Users must then consume more and more of the drug to achieve the same “high.”

Drugs also disrupt brain circuits involved in impulse control in the prefrontal cortex, making it more difficult for addicts to resist taking drugs. Conversely, research suggests existing deficiencies in prefrontal function increase the risk of drug addiction. This finding may help explain why adolescents are more susceptible to addiction — the prefrontal cortex does not become fully developed until people reach their mid-20s.

Environmental factors, including stress, also disrupt brain circuits in ways that increase vulnerability to drug addiction. Research shows that during withdrawal, the activity of a stress-related neurotransmitter called corticotropin-release factor increases in the amygdala, a brain region that plays a key role in processing emotions — including negative ones like anxiety, depression, and fear. This may explain why addicts often feel anxious and depressed when sober, and why they turn back to drugs so quickly.

However, addicts can recover. Although relapse remains an ongoing threat, the brain has a remarkable ability to mend from drug use. Imaging studies show dopamine levels eventually increase to near normal after months of abstinence. Better knowledge of how addiction disrupts brain circuits — and how genetics and environmental factors influence those disruptions — could help medical professionals develop more effective methods of getting addicts off drugs permanently.

For the full text please go to: http://www.brainfacts.org/diseases-disorders/addiction/articles/2011/addiction-and-brain-circuits/

The above explains how a recreational drug affects the brain and why it grows into an addiction.

First it increases the dopamine level (and makes a person “high”), but with continuous use of the drug the brain adjusts to the high level of dopamine produced by it and  lowers the original level of dopamine or reduces the number of dopamine receptors, which amounts to the same thing.

This makes a person increase the dose of the drug as it helps him to take the dopamine at least to the same level where it was before, but the more he takes the lower the natural level of dopamine is in the brain, and the higher the dosage is needed just to return to the level where he was before starting the drug-taking.

Now it is no longer the matter of feeling “high”  – it is more a matter of just returning to where you were before and feeling like those of us who have never taken drugs. The vicious circle was started and is taking the drug addict down the road of no return.

The four classes of substances forming an addiction are alcohol and nicotine, but mostly psychostimulants and opiates.

Leaving the alcohol and nicotine aside let us look a closer look at the two major drug categories that form an addiction.

Below is short information on what psychostimulants are. The light-hearted manner in which these drugs are treated by people in the medical profession is amazing as it shows their totally irresponsible approach to the matter:

List of Stimulants (PsychoStimulants)

Psychotropic medications stimulate the central nervous system (CNS) by boosting the release of certain chemicals in the brain. Adderall (amphetamine and dextroamphetamine), Dexedrine (amphetamine salts), and Ritalin (methylphenidate) are the most commonly prescribed brands of these drugs. These drugs achieve their beneficial effects by increasing the levels of dopamine in the brain. Dopamine, one of the most important neurotransmitters, is related to concentration, attention, and feelings of reward and pleasure. Some stimulant drugs also increase the level of glutamate, a neurotransmitter associated with behavioral control and inhibition. People with attention deficit hyperactivity disorder (ADHD)often have low levels of glutamate. http://www.goodtherapy.org/drugs/stimulants.html

I find the tone of the second piece totally outrageous:

Psychostimulants: Bringing Order out of Chaos

By THE CARLAT PSYCHIATRY REPORT

There are now no fewer than 14 FDA-approved psychostimulants… and counting. Yes, capitalism is in full swing in the stimulant world. But who’s complaining? Now we have multiple options from which to pick and choose.

There are two basic types of stimulants: methylphenidate (Ritalin and its knockoffs) and amphetamine (Dexedrine and Adderall). Within each of these large categories, there are subcategories, depending on the pharmacokinetics of the specific drug. The three typical subcategories are: (1) Short-acting—3-5 hours; (2) Intermediate-acting— 5-8 hours; (3) Long-acting—8-12 hours. Not too bad so far, but the story is more complicated than this, because within the intermediate and long-acting groups, you have meds that release the stimulant continuously, and others that release it in stages, often mimicking the action of taking an immediate-release stimulant twice a day.

http://pro.psychcentral.com/2013/psychostimulants-bringing-order-out-of-chaos/001371.html

The second big class of drugs affecting the dopamine level and therefore forming an addiction are Opiates:

What are Opiates?

Opiates, sometimes referred to as narcotics, are a group of drugs which are used medically to relieve pain, but also have a high potential for abuse. Some opiates come from a resin taken from the seed pod of the Asian poppy. This group of drugs includes opium, morphine, heroin, and codeine. Other opiates, such as meperidine (Demerol), are synthesized or manufactured.   http://www.linkinghumansystems.com/drugs/opiates.html

As you have noticed Propofol does not belong to any of the four classes of drugs affecting the dopamine level and therefore even in theory cannot be called drugs forming an addiction.

There is simply no mechanism for forming it as this anesthetic does not affect the dopamine receptors in the brain. Moreover it actually suppresses the concentration of serotonin, which is the second biggest system or pathway in the brain which is popularly thought to be a contributor to feelings of well-being and happiness.

Here is a picture from Wiki showing what parts of brain are called dopamine and serotonin pathways. From the picture we realize that there are no other but these two, and both of them are responsible for various functions including the feeling of pleasure and reward.

Propofol does not affect any of these two pathways:

The blue area  in the brain is a dopamine pathway , and the brown area is the serotonin pathway. Functions of Dopamine are: Reward, Measure and euphoria, Motor function, Compulsion, Perseveration. Functions of Serotonin are: Mood, Memory, Sleep, Cognition

A medical site devoted to anesthesia specifically notes that Propofol does not affect dopamine receptors and as regards the  concentration of serotonin even reduces it. This means that in neither of the ways Propofol can give the feeling of being “high”.

It relaxes the system and creates the impression of a good sleep, but it is not a stimulant like the above four classes of substances and does not enhance the feeling of happiness and reward (except for the feeling of a good night’s sleep and some freshness after it):

Propofol reduces the concentration of serotonin and 5-hydroxyindoleacetic acid in the area postrema. Propofol does not affect dopamine D2 receptors.

http://www.nurse-anesthesia.org/showthread.php/1663-Propofol

In short propofol is not a recreational drug, and no addiction to it can be formed on a physical level.

After this short discourse into addictive and non-addictive drugs let us return to what else AEG’s witness Dr. Eearley has to tell us:

9	Dr. Earley is now involved in long-term treatment of physicians with addiction problems.
10	Dr. Earley explained what “Enabler” is, when someone is feeding the addiction of an addict.
11	Addiction is disease of secrecy, often times enablers don’t see it Dr. Earley testified. “I think Dr Murray was trying to help MJ sleep”
12	Boyle: Was it ok for Dr. Murray to give Propofol to MJ at home?
13	Dr. Earley: No, that was medically incorrect
14	Dr. Earley said he would not have done it. “Propofol is not an appropriate agent for sleep induction.”
15	Dr. Earley testified that under the circumstances, he doesn’t think he could’ve done a better job with MJ in terms of recovery.
16	Dr. Earley explained in hospital if patient goes into deep sleep, there are machines to help the patient breath and control blood pressure.
17	When asked if he thought MJ had substance issue, Dr. Earley was adamant: “In 2009, he did have an addiction, yes.”
18	I think he clearly had an addiction to opioids, that class of drugs, Dr. Earley said.
19	Dr. Earley: I don’t think there’s sufficient evidence from the record reading to ascertain he was addicted to Propofol or benzodiazepine
20	Dr. Earley: The primary drug of his (MJ) addiction was Demerol, by far the most common opioid he took.
21	Dr. Early: MJ’s death wasn’t caused by Demerol directly, there’s a question if Demerol created synergy with Propofol and benzodiazepine

1. First of all he suggests that Demerol played a part in Michael’s death though the autopsy report completely refutes this point of view. The cause of death was the high level of Propofol in Michael’s blood which arrested breathing and this eventually brought about a heart arrest.Those of us who are familiar with the autopsy results will be stunned by all conclusions made by this doctor testifying for AEG.

As to Demerol they did not even find a trace of it in his system.

2. Secondly, Dr. Earley says that MJ “clearly had an addiction to opioids” (in 2009) though there is absolutely nothing to confirm this point of view. Technically Michael can be attributed to addicts as all people whose dopamine level has been irreversibly affected are considered addicts – only some are controlling themselves and others are not.

If Michael was treated for Demerol addiction in 1993 it means that he did unfortunately develop an addiction to it.Using the drug was never his choice – they kept giving it to him to dull the pain from the scalp surgery that followed the burn. The surgery was unnecessary and even harmful as it did not solve the problem and only led to further baldness, but the terrible side effect of it was the addiction to Demerol.

However Michael stoically fought and beat it, turning into a recovered addict as he was not seeking the drug and was free from a compulsive use of it. His dopamine level must have been low but he still managed to stay away from the drug.

Michael never asked for Demerol as Dr. Klein said in his interview with Harvey Levin, so all questions regarding the use of Demerol during the cosmetic procedures in 2009 should be addressed Klein and Klein alone. With a recovered addict such games are indeed dangerous and reckless to play – Michael could easily relapse into the old state. However Klein always insisted that Demerol during those facial procedures was the drug of his choice, and he never exceeded the dosage.

This is what I actually like about Klein – given the amount of hate he had to deal with he never succumbed to the temptation to shift the blame for the Demerol usage onto Michael. And the whole problem of Demerol could indeed be taken out of proportion as the autopsy report showed no trace of Demerol or any other recreational drugs in Michael’s system.

3. The third thing Dr. Earley is saying is partially correct. He says that “there is no sufficient evidence to ascertain that MJ was addicted to Propofol”.

The general idea of it is okay, only the focus is misplaced again – propofol is not an addictive drug in principle and does not form any physical addiction.

A psychological dependence is a different matter and is something like us taking coffee. The psychological dependence on either of them is similar – we habitually use coffee to brace ourselves up and he used propofol to make himself sleep. If tea helps us better we can change to it tomorrow, same as he would change to something different if doctors found something better for his sleep.

In both cases there is no physical addiction and this is all that matters.

Fortunately at this point the video testimony of Dr. Earley ended. It did not explain anything but only confused us and muddied the waters further, but no one expected anything different from these AEG’s guys:

22	Judge then adjourned session until tomorrow 10:30 am PT. They will resume playing Dr. Earley’s deposition.
23	We are told next witness is probably plaintiff’s sleeping disorder specialist Doctor Charles Czeisler. Karen Faye is back on Friday.
24	Alternate juror 6 was taken into chambers with judge and attorneys. He’s moving to Atlanta, there’s indication he was excused.
25	Judge sealed the record of the conversation in chambers with alternate juror 6. We’re told neither juror nor attys are to talk to the media.
26	That wrapped up Day 33 of testimony. We hope to see you tomorrow.

Thursday June 20, DAY 34

The next day in the courtroom was absolutely fantastic. This time Dr. Charles Czeisler , the Jacksons’ witness was testifying.

Dr. Czesler is a specialist on sleep disorders. Among several reputable institutions he works for NASA and the poor astronauts who have a sunset and sunrise every 90 minutes and therefore experience huge problems with sleep.

In short this doctor was just the right kind of a specialist to consult Michael on his sleep disorder and if anyone had taken care to find him in June 2009 Michael would be alive now.

His testimony is the first time I hear a clear explanation why the sleep induced by Propofol is absolutely not the same kind as natural sleep. The doctor explained that sleep is the time used by the brain to repair and maintain its cells, and recover its functions:

• “Sleep is the repair and maintenance of the brain cells.”

During natural sleep the brain repairs its cells which are not generated by the body and are given to us just once. And sleep under propofol does not perform this function – the person is in a coma during which the brain is not recovering. Therefore the propofol ‘sleep’ does not fulfil the biological functions performed by natural sleep. The two conditions look similar only on the surfance but in their essence they are totally different.

The difference between natural sleep and propofol induced coma was explained by the doctor in a marvelous a way:

• “It would be like eating some sort of cellulose pellets instead of dinner. Your stomach would be full and you would not be hungry, but it would be zero calories and not fulfill any of your nutrition needs.”

Without sleep the brain slowly deteriorates and gradually dies. The most rats could survive with no sleep in some cruel experiments was 21 days, and those partially deprived of sleep died in 37 days. Sleep deprivation is actually considered one of the worst types of tortures. And Michael was living under this continuous torture for the past several months of his life!

Michael actually set a world record for going without sleep. According to Conrad Murray he was given propofol for 2 months and this means that Michael went without proper biological sleep for at least 60 days. The coma he was in on those nights only created the impression that he had had a rest, while in reality the biological needs fulfilled by natural sleep were not satisfied and it had a toll on his body and mind.

All those strange symptoms Michael was displaying in June 2009 were not the result of propofol usage per se – it was the result of his brain not recovering and slowly deteriorating due to the loss of a crucial stage in sleep which is called REM sleep.

Animals deprived of sleep are  unable to keep their body temperature and this is exactly what was happening to Michael.The icy cold he felt in his legs and arms, his inability to maintain the body temperature, all that ‘obsessiveness’ and talking to himself, lack of concentration and slowness he occasionally displayed were the signs of not “taking drugs” or a psychiatric condition as everyone thought of him, but were the grave signs of a huge damage to his brain from a continuous lack of natural sleep.

Sleep is a biological need and Dr. Czeisler convinces us that it is necesary for our system in the same way as we need food, water and oxygen to survive. If we do not have sleep our brain slowly decays and dies. Dr. Czeisler’s lecture impressed me so much that upon reading it I even went to bed in a decent hour – probably the first time in the four years of all this blogging.

Another crucial idea I gathered from Dr. Czeisler’s testimony is that even if Michael had not been taking propofol he would have died anyway – just because of sleep deprivation and the damage to the brain. Unless the necessary measures were immediately taken and the sleep disorder was treated.  Rats die of sleep deprivation and humans too, only no one has yet conducted so terrible an experiment on  human beings  – Michael is actually the first and probably the last one, and all this owing to these AEG beasts.

So it was lack of sleep which was the ultimate reason for Michael’s death, and not propofol which was simply an inadequate way to treat it. Thus Dr. Charles Czeisler’s testimony dotted all I’s and crossed all t’s in the propofol mystery – propofol was the immediate reason for Michael’s death as an inadequate remedy to treat the main problem, but this main problem was lack of sleep.

And these Dr. Charles Czeisler’s words actually point to AEG as the main cause of Michael’s death because the reason why Michael was not sleeping was the extreme bullying and terrorizing they subjected him to beginning with the rehearsal stage. The show had not yet started but Michael was already overworked, fatigued and exhausted from all that incessant training and excessive demands put on him by AEG.

If you come to think of it those several months of incessant training were like several months of daily shows with Sunday as the only day of rest between them. Considering that for the previous tours Michael never rehearsed how many shows did he give during those rehearsals? 50 or even more?

If Michael had been getting ready for the show in a regimen comfortable for him and not for the AEG bosses, there would have been no need for propofol at all – at least at the rehearsal stage when no concerts yet started. He would have enjoyed at least some natural sleep and would have survived.

But by all their bullying they fully deprived him of his sleep and therefore doomed him to a terribly torturous manner of death.

And even when everyone sent signals to AEG that something was terribly wrong with Michael’s health – just five days before he died –  AEG chose to not help him and denied others the chance to render any medical help. Remember that e-mail from Randy Phillips that “it is critical not to become amateur psychiatrists or physicians”? The essence of that message is mind your own business and leave the matter to the doctor though this was the doctor of his qualifications and skills they themselves were absolutely not sure of.

Now they say they never checked up on him and pride themselves on it. Then why leave Michael in his hands further if they know nothing of him and everyone sees that he has already driven him to a terrible state?

Here is Dr. Charles Czeisler’s testimony:

	Thursday June 20 DAY 34
27	Hello from the courthouse in downtown LA. Day 34 of Jackson family vs AEG trial is underway. Jurors are not in the courtroom yet.
28	Attorneys spent the last 20 minutes discussing with the judge boundaries for testimony of upcoming sleeping disorder expert.
29	Katherine Jackson is in court today wearing a black and white floral long jacket.
30	Judge said alternate juror 6 has been excused, since he moved. Judge said with the move came financial hardship. Thus, she let him go.
31	New witness on the stand: Dr. Charles Czeisler, plaintiff’s retained Sleeping Disorder Specialist.
32	Jackson’s attorney Michael Koskoff doing direct examination.
33	Dr. Czeisler lives in the Boston area, Massachusetts, grew up in Chicago. He detailed his extensive background in the medical field.
34	Dr. Czeisler graduated from Harvard and went to StanfordMedicalSchool. He became a professor at Harvard medical school.
35	The doctor said our internal clock regulates the timing we are awake and asleep.
36	Dr. Czeisler began studying the internal clock in the brain that controls our sleep while in undergraduate school.
37	After lunch time, the drive from the internal clock to stay awake becomes stronger and stronger, Dr. Czeisler said.
38	Light is the most synchronizing sleep pattern, Dr. Czeisler explained. When it’s light out, it’s time to stay awake. Dark, time to sleep.
39	Changes in the regular sleeping pattern sends confusing signals to the brain, which suppresses the release of hormones, Dr. Czeisler said.
40	People who work night shift have difficulty going to sleep right away when they get home, since they are still wired up.
41	The first sports team Dr. Czeisler worked with was NBA Portland Trail Blazers. They contacted him to help the team just through time zones
42	The doctor also worked with the Minnesota Timberwolves and Boston Celtics, the Bruins and now the Red Sox.
43	Dr. Czeisler said musicians can also have sleeping problems when they are traveling through time zones.
44	Musicians on tour have altered schedule, Dr. Czeisler said. They perform late, are on a different country with different time zones.
45	Dr Czeisler has worked with The Rolling Stones and Shaquille O’Neal. Shaq allowed doctor to videotape exam to evaluate if he had sleep apnea
46	The doctor said Shaq wanted help educate the public about sleeping problems. They published entire film of episode of him going through exam
47	Dr. Czeisler worked with astronauts for 25 years to help them adjust their sleep while in space.
48	They trained the astronauts how to set up the recording system so they could see different stages of sleep they were in while in space.
49	Dr. Czeisler said there are about 800,000 physicians in the US. He was elected one of the members of the Institute of Medicine.
50	Dr. Czeisler belongs to several professional societies. He testified before Congress in a panel of shift workers discussion.
51	Dr. Czeisler published over 120 original reports in peer review journals, which are all new researches.
52	The doctor works with industries that typically work around the clock and workers who have problems sleeping during the day/work at night
53	Dr. Czeisler has worked with nuclear power plants workers, police forces, firefighters, federal air marshals, CIA, secret service, others.
54	He worked with pilots in the operation desert storm, where most flights were at night.
55	Dr. Czeisler has served as expert witness before, testified in less than a dozen cases.
56	Dr. Czeisler is being paid $950 an hour. He’s one of Jackson’s retained experts.
57	Sleep is a very active process, but it’s characterized by, and fulfills basically biological needs, Dr. Czeisler explained.
58	Sleep is controlled by the brain, Dr. Czeisler said.
59	Signs of sleep:
60	Reversible loss of conscious
61	Reduction in sensitivity, but not a complete loss
62	Eyes closed
63	Posture
64	Reduced activity
65	Dr. Czeisler created slides showing how the brain works to help the jury understand how sleep happens.
66	There’s a lot going on in the brain while we sleep, Dr. Czeisler said, explaining it’s the time for repair/maintenance of the brain cells.
67	The average person should obtain 7-8 hours asleep every night, Dr. Czeisler said.
68	Sleep cycle takes about an hour and a half to two hours, Dr. Czeisler explained. You go through a progression between sleeping stages.
69	Sleep has an architecture to it Dr Czeisler said. We keep brain cells for life, the brain has to go through offline maintenance process.
70	Dr. Czeisler: That period of repair and maintenance is called sleep.
71	The brain uses 20% of glucose (energy) a day, Dr. Czeisler said. At night, we purge things that are not important and keep the ones that are
72	Dr. Czeisler explained sleep is essential to consolidate the memory of what we learned during the day in our brain.
73	We sleep in order to fulfill a series of basic biological needs, Dr. Czeisler explained.
74	Dr. Czeisler: We keep our brain cells for life, we need to repair and maintain the connections because we don’t have enough room
75	Doc: While we sleep, we consolidate our memory, integrate learning, refuel the tank, store energy in cells, which requires brain to be off
76	The doctor said it was believed that sleep was just necessary for the brain, but it was learned sleep is also necessary for the body.
77	Regulation of metabolism doesn’t go well if we are sleep deprived, Dr. Czeisler said. “If we don’t get enough sleep, we are hungrier.”
78	The doctor said if we sleep only 4-5 hours a night we use more energy, but because we are awake longer, we eat more and gain weight.
79	Even fat cells need sleep to metabolize properly, Dr. Czeisler said.
80	Dr. Czeisler said lack of sleep increases appetite, among other things.
81	Sleep is necessary for life, just like the same way eating or drinking fluid is necessary for life, the expert said.
82	It takes 17 days before an animal dies if deprived of food, Dr. Czeisler said.
83	Study shows that rats sleep deprived became scrawny, disheveled, unable to maintain body temperature, Dr. Czeisler testified.
84	Rats deprived of all sleep died on 21 days, rats selectively deprived of sleep died in 37 days. Recovery occurred in 1-3 days in those rats.
85	If deprived, animal is no longer able to maintain body temperature, Dr. Czeisler explained.
86	Rapid eye movement sleep (REM) is necessary, Dr. Czeisler said. Its deprivation affects cognitive function, ability to consolidate memory
87	Adverse impact of sleep deficiency on cognition:
88	Slowed reaction time; slowed reflexes, Impaired balance
89	More impact: Increased distractibility, Impaired judgement, Impaired memory, Impaired creativity, Increased risk of lapses of attention
90	More impact: Increased risk of automatic behavior, Increased risk of falling asleep, Fast and sloppy (speed/accuracy trade off).
91	250,000 people a day fall asleep at the wheel, Dr. Czeisler said.
92	People take chances they would not take when sleep deprived, Dr. Czeisler explained.
93	Dr. Czeisler said even if someone has taken a shower and put on make up, we can recognize lack of sleep by looking at their picture.
94	Adverse impact of sleep deficiency on mood:
95	Increased emotional volatility, difficult focusing sustained attention
96	Impact on mood: increased risk of burnout, depression and suicidal ideation, euphoria/slap-happy, somatic complaints, anxiety, paranoia.
97	Dr. Czeisler described the brain and what each area does.
98	You may not be able to hold your emotions in check, Dr. Czeisler explained.
99	They will make 10 times as many mistakes if they are sleep deprived, Dr. Czeisler said.
100	When we are sleeping, we’re going through and replaying the events, Dr. Czeisler explained. “We are actually practicing what we learned.”
101	You need to sleep the night after you learned a task in order to absorb it, Dr. Czeisler said.
102	Dr. Czeisler testified sleep deprivation is used as a method of torture to get confessions.
103	It’s so exhaustive and so painful to be sleep deprived, Dr. Czeisler explained. Some say it is by far the worse type of torture.
104	Koskoff: Sleep deprived people look for ways to get sleep?
105	Dr. Czeisler: Yes
106	Insomnia is a complaint of difficulty of sleep in either falling asleep, staying asleep or waking up too early, Dr. Czeisler explained.
107	They may have negative associations with bedroom or sleep that may prevent them from sleeping, Dr. Czeisler explained about insomniac.
108	Dr. Czeisler said there are 3 billion hours a week of video game playing, which affects the sleep because of over activity in the brain.
109	If irregular sleeping, it’s necessary to look into sleep hygiene: Poor sleeping environment, caffeine usage (16 hour half life), darkness
110	70% of parents put TVs in children’s room to help them asleep but it actually interfere with sleep, Dr. Czeisler said.
111	Insomnia could be secondary to medicine use or substance abuse.
112	Dr. Czeisler: Once you’re taking sleeping pills for a series of nights, now you can’t sleep without them. Your sleep is actually worse
113	Dr. Czeisler said cognitive behavior therapy is used to treat insomnia, where a psychologist identifies the problem.
114	The expert said this is a multi-week therapy with personalized approached. It’s proven effective, even more than drugs, Dr. Czeisler said.
115	If it is secondary to anxiety, doctor might consider give some anxiolytics, Dr. Czeisler explained.
116	In order to treat insomnia, the first step is to figure out what the disorder is, Dr Czeisler said; sleeping disorder is a treatable disease
117	Propofol is not sleep medicine, Dr. Czeisler said. “It is an anesthetic.”
118	Even though it’s the brain they are anesthetizing, they have not been monitoring the brain, Dr. Czeisler said about anesthesia.
119	Dr. Czeisler: There are a series of experiments to understand the extend from which its similar or different from sleep.
120	Propofol appears to dissipate the drive for sleep, Dr. Czeisler testified.
121	AEG atty said there’s no reference in Dr. Czeisler’s 78 pages resume of Propofol study, asked judge to not allow his testimony.
122	Attorneys discussed extensively about Dr. Czeisler’s competence to testify on Propofol vs sleep. Judge admitted his opinion conditionally.
123	Genuine sleep: Actively generated by the brain; Fulfills biological needs; Readily reversible reduction in sensation;
124	Genuine sleep: Readily reversible loss of conscious awareness, Can be easily awakened
125	Genuine sleep: Cycles between two behavioral states: REM and non-REM sleep, Sensitive to pain
126	Propofol anesthesia: Drug-induced coma, Doesn’t fulfill needs, Profound unresponsiveness, No consciousness, Cannot be awakened until gone
127	Propofol anesthesia: No REM sleep, NREM sleep abnormal, Isoelectric EEG in deep, Insensitive to pain
128	Propofol anesthesia: Dissipates the sleep drive without fulfilling the sleep need
129	When you go under anesthesia, you are going into induced coma, Dr. Czeisler said.
130	There’s no FDA approved reversal to Propofol, you need to metabolize it in order to wake up, Dr. Czeisler explained.
131	If you didn’t get REM sleep yesterday, you’ll have REM rebound tonight, you might fall directly into sleep, Dr. Czeisler said.
132	Dr. Murray: Ironically, Propofol anesthesia in sleep deprived animals, they don’t have rebound, it destroys the drive for sleep.
133	They wake up feelings refreshed, it has dissipated their sleep drive, but not their sleep need, Dr. Czeisler said about Propofol.
134	They feel like they had a great night, but they haven’t had any sleep at all, the expert said.
135	Genuine sleep fulfills biological needs, but Propofol sleep dissipates the sleep drive, the doctor explained.
136	Dr. Czeisler said there are no intravenous medication approved to treat insomnia.
137	Dr. Czeisler: Demerol is an opioid and it increases sleep propensity. It’s not the same as anesthetic.
138	The sleep that you are getting is generated by the brain, not by the drug, Dr. Czeisler explained.
139	Demerol is a sedative, normally used in association with surgical procedure to address pain.
140	Demerol dissipates some of your biological drive for sleep, if slept for hours during the day it will be more difficult to sleep at night.
141	Withdrawal of Demerol is a secondary type of insomnia. “It can increase insomnia,” Dr. Czeisler explained.
142	Koskoff gave a very long hypothetical using all the examples that happened with MJ. Defendant’s objected, judge held another long sidebar.
143	Judge adjourned session until tomorrow 9:15 am PT. Dr. Czeisler resumes testifying tomorrow. Karen Faye won’t return until next Friday.
144	That wraps Day 34 of testimony. We hope to see you tomorrow. For all the latest, watch @ABC7 and http://www.abc7.com

Alan Duke wrote a perfect article about Dr. Charles Czeisler’s testimony which helps us understand things even better:

 Expert: Michael Jackson went 60 days without real sleep

By Alan Duke, CNN

June 21, 2013 — Updated 1403 GMT (2203 HKT)

Los Angeles (CNN) — Michael Jackson died while preparing to set a world record for the most successful concert run ever, but he unknowingly set another record that led to his death.

Jackson may be the only human ever to go two months without REM — Rapid Eye Movement — sleep, which is vital to keep the brain and body alive. The 60 nights of propofol infusions Dr. Conrad Murray said he gave Jackson to treat his insomnia is something a sleep expert says no one had ever undergone.

Propofol disrupts the normal sleep cycle and offers no REM sleep, yet it leaves a patient feeling refreshed as if they had experienced genuine sleep, according to Dr. Charles Czeisler, a HarvardMedicalSchool sleep expert testifying at the wrongful death trial of concert promoter AEG LIve.

If the singer had not died on June 25, 2009, of an overdose of the surgical anesthetic, the lack of REM sleep may have soon taken his life anyway, according to an opinion by Czeisler.

Lab rats die after five weeks of getting no REM sleep, he said. It was never tried on a human until Dr. Murray gave Michael Jackson nightly propofol infusions for two months.

Czeisler — who serves as a sleep consultant to NASA, the CIA and the Rolling Stones — testified Thursday that the “drug induced coma” induced by propofol leaves a patient with the same refreshed feeling of a good sleep, but without the benefits that genuine sleep delivers in repairing brain cells and the body.

“It would be like eating some sort of cellulose pellets instead of dinner,” he said. “Your stomach would be full and you would not be hungry, but it would be zero calories and not fulfill any of your nutrition needs.”

Depriving someone of REM sleep for a long period of time makes them paranoid, anxiety-filled, depressed, unable to learn, distracted, and sloppy, Czeisler testified. They lose their balance and appetite, while their physical reflexes get 10 times slower and their emotional responses 10 times stronger, he said.

Those symptoms are strikingly similar to descriptions of Jackson in his last weeks as described in e-mails from show producers and testimony by witnesses in the trial.

Jackson’s mother and children are suing AEG Live, contending the company is liable in his death because it hired, retained or supervised Dr. Murray, who was convicted of involuntary manslaughter. They argue the promoter pressured Dr. Murray to get Jackson to rehearsals, while failing to get Jackson help despite numerous red flags warning that he was in trouble.

AEG Live lawyers contend it was Jackson who chose, hired and supervised Murray and their executives had no way of knowing about the dangerous propofol treatments administered in the privacy of Jackson’s rented mansion.

A very long question

Czeisler is back on the witness stand Friday to answer a question that was asked just as court ended Thursday. Jackson lawyer Michael Koskoff asked his expert what may also be a record breaker in a trial — a 15-minute-long hypothetical question.

He was asked to render an opinion based on a long list of circumstances presented so far in the trial about Jackson’s condition and behavior, including:

— That Murray administered propofol to Jackson 60 consecutive nights before June 22, 2009.

— That Murray began to wean Jackson from propofol on June 22, 2009, and gave him none of the drug on June 23.

— That a paramedic who tried to revive him the day he died initially assumed he was a hospice patient.

— That show producers reported  Jackson became progressively thinner, paranoid and was talking to himself in his final weeks.

— That the production manager warned Jackson had deteriorated over eight weeks, was “a basket case” who he feared might hurt himself on stage and could not do the multiple 360 spins that he was known for.

— That show director Kenny Ortega wrote Jackson was having trouble “grasping the work” at rehearsals” and needed psychiatric help.

— That Jackson needed a teleprompter to remember the words to songs he had sung many times before over several decades.

— That show workers reported the singer was talking to himself and repeatedly saying that “God is talking to me.”

— That Jackson was suffering severe chills on a summer day in Los Angeles and his skin was cold as ice to the touch.

Lawsuit evidence: Michael Jackson lost dance moves in last days

AEG Live lawyers objected to the question because the information about Murray’s nightly propofol treatments was derived only from the doctor’s statement to police after Jackson’s death. The judge previously ruled that statement was inadmissible. It was a ruling made earlier in the trial when Jackson lawyers objected to AEG’s use of Murray’s statement that he believed he was Jackson’s employee, not AEG Live’s.

The statement could be used if Murray, who is serving a prison term, is brought into testify. But that is unlikely since the doctor has said he would impose his constitutional protections against self-incrimination as long as the appeal of his conviction is pending.

Jackson lawyers could clear the way for use of the statement by withdrawing their objection, something they are now considering.

Koskoff told the judge that his expert would testify that Jackson’s symptoms perfectly matched what he would expect from someone who had been given long-term propofol treatments.

The jury is likely to hear his answer Friday.

A lecture on sleep

Jurors appeared quite interested as Czeisler lectured them Thursday on his sleep research, including an explanation of circadian rhythm — the internal clock in the brain that controls the timing of when we sleep and wake and the timing of the release of hormones

“That’s why we sleep at night and are awake in the day,” he said.

Your brain needs sleep to repair and maintain its neurons every night, he said.

Blood cells cycle out every few weeks, but brain cells are for a lifetime, he said.

“Like a computer, the brain has to go offline to maintain cells that we keep for life, since we don’t make more,” he said. “Sleep is the repair and maintenance of the brain cells.”

CNN Health: Sleep

An adult should get 7-8 hours of sleep each night to allow for enough sleep cycles, he said.

You “prune out” unimportant neuron connections and consolidate important ones during your “slow eyed sleep” each night, he said. Those connections — which is the information you have acquired during the day — are consolidated by the REM sleep cycle. Your eyes actually dart back and forth rapidly during REM sleep.

“In REM, we are integrating the memories that we have stored during slow eyed sleep, integrating memories with previous life experiences.” he said. “We are able to make sense of things that we may not have understood while awake.

Learning and memory happen when you are asleep, he said. A laboratory mouse rehearses a path through a maze to get to a piece of cheese while asleep.

A basketball player’s area of the brain that is used to shoot a ball will have much greater slow eyed sleep period since there is more for it to store, he said. They shoot better after sleep.

The Portland Trailblazers consulted with him after they lost a series of East Coast basketball games, he said. He was able to give their players strategies for being sharper when traveling across time zones.

He’s worked with the Rolling Stones on their sleep problems, he said. Musicians are vulnerable since they are traveling across time zones and usually “all keyed up” to perform at night, he said.

Czeisler developed a program for NASA to help astronauts deal with sleep issues in orbit, where they have a sunrise and sunset every 90 minutes.

Other clients include major industries that are concerned about night shift workers falling asleep on the job, the CIA, Secret Service and the U.S. Air Force, he said.

Jackson lawyers argue that AEG Live should have consulted a sleep expert like Czeisler for Jackson instead of hiring Murray — a cardiologist — for $150,000 to treat the artist.

The trial ends its eighth week in a Los Angeles courtroom Friday. Lawyers estimate the case will conclude in early August.

http://edition.cnn.com/2013/06/21/showbiz/jackson-death-trial/index.html?hpt=hp_t1

The next day Dr. Charles Czeisler continued his testimony but no cross-examination by the AEG lawyers could change the eye-opening effect his testimony produced on all of us earlier. This time he confirmed what we knew all along – if Michael’s sleep disorder had not been aggravated by AEG he would have done the shows without any problem. The ABC tweets say:

• In his opinion, if he had been properly diagnosed for his sleep disorder, it would not have interfered with his tour or many in the future.

• Dr. Czeisler believes that a fit and competent Doctor would have gotten MJ help and he would have made it through the tour.

Of course he would have made it through the tour if it had not been for these beasts from AEG. If he could survive under those impossible conditions for full two or three months and still make those splendid rehearsals on June 23d and 24th, it means that he could have done the impossible and done even 50 shows.

All he needed was a proper treatment for his sleep disorder.

Friday June 21, DAY 35

145	Testimony started this morning with Dr. Czeisler back on the stand being questioned by the Jackson side.
146	He told the jury he had been working on reviewing the records since January for 1/2 day every week.
147	Dr. Czeisler testified that Dr. Conrad Murray had ordered over 4 gallons of Propofol during April, May, and June.
148	He further stated that a common dose for surgery was 20 to 30 cc’s.
149	In Dr. Czeisler’s opinion the autopsy shows MJ’s level of propofol to be that of a person going through major abdominal surgery.
150	In reviewing correspondences between members of the crew, the Doctor believes MJ is showing signs of chronic sleep deprivation.
151	Those symptoms include weight loss, confusion, memory difficulties, paranoia, and anxiety.
152	He said it was astounding that MJ couldn’t remember the words to his own songs.
153	Total sleep deprivation can kill a lab rat in 80 days and he said he doesn’t know and hopes to never know how long in a human.
154	In his opinion, if he had been properly diagnosed for his sleep disorder, it would not have interfered with his tour or many in the future
155	Finally, Dr. Murray clearly was not fit or competent to diagnose or treat MJ’s sleep disorder.  Jackson side rested.  AEG takes over.
156	Dr Czeisler continues cross examination after the lunch break.  He testified MJ’s Doctor had a conversation with MJ about the stress of tour
157	In that conversation they talked about his problems sleeping
158	The Doctor also said no one could make MJ get treatment – not his children or his business partners.
159	The Doctor said the relationship between anesthesia and sleep is a new area of study.  Much info has come out since MJ died.
160	Each of the symptoms MJ was experiencing – weight loss, paranoia, memory lapse, etc can all be caused by something other than no sleep
161	Mrs. Jackson is not in court today.
162	AEG Attorney Questioned Dr.Czeisler that he did not know exactly how often or what manner MJ was given propofol in the last 2 months of life
163	Dr. Czeisler conceded that the only night he knows MJ was given propofol was June 24th, 2009.  He died the next day.
164	AEG Attorney asked the Dr. what was the cause of death on the autopsy report and it was propofol intoxication…not sleep deprivation.
165	Dr. Czeisler did however interject after the AEG Lawyer finished questions that in an NTSB investigation there are contributing factors
166	Dr. Czeisler believes that a fit and competent Doctor  would have gotten MJ help and he would have made it through the tour
167	On recross the Doctor said he believed MJ got Propofol every night all night for the 2 months before his death. https://twitter.com/ABC7Courts

So all of our previous conclusions have been confirmed.

But why is it so SAD to see it?

The top specialist on sleep disorders is telling us that we were right all along but it does not make any of us a single moment happier….

*  *  *

Below is the full transcript provided by the heroic TeamMichaelJackson (they are in constant need of funds to buy the transcripts, so if you want to make history too please go here and help).

The first day of Dr. Czeisler’s testimony:

View this document on Scribd

The second day of Dr. Czeisler’s testimony:

View this document on Scribd

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