Dr. Murray Guilty

Doesn't everyone take their doctor on vacation?

Maybe if Dr. Nick had been tried in court instead of in front of the Tennessee State Medical Licensing board, he would have gone to jail for killing Elvis – and Michael Jackson, Corey Haim and other doctor shopping celebrities might be alive.

But doctors are rarely held to the standard that mere morals are held to – so Dr. Conrad Murray, who was just the last in a string of pusher doctors, is found guilty at trial rather than be fined by the medical board for poor ethical standards.

Will Murray be the latest victim of celebrity excess and the greed that surrounds celebrities, or will he herald a change for doctors to really do no harm to their celebrity patients?

What’s most interesting to me is how much easier it seems to be for doctors to be blamed when their patient is a dead celebrity – because having worked some years ago on a medical malpractise complaint against a doctor, it is astonishingly difficult to establish guilt.

In the Vancouver case, a doctor who specialized in AIDs patients, was using liquid nitrogen to burn off anal warts – a common opportunistic infection. But think about that for a moment: Liquid nitrogen, anal spincter.

If you aren’t squirming in your chair, you probably haven’t had to have liquid nitrogen applied to your skin. Having had liquid nitrogen used to remove planter warts from my toe and some moles on my arm, I can assure you that liquid nitrogen is nothing that you want on anything as sensitive as your anus.

Of the three doctors who reviewed the treatment, one stated that the application of liquid nitrogen to the anal area was inappropriately agressive, with the other two indicating that it was unconventional but not unthinkable as a treatment option.

That four of the five patients that we represented didn’t even have anal warts, didn’t factor into the assessement of the appropriateness of the treatment.

So, here, we had a case of a doctor, using unconventional aggressive treatment for an ailment that the patients don’t have and isn’t warrented for what they do have. But these are just five gay guys and not dead celebrities, so the case falls apart in the face of doctors standing together – and it doesn’t matter what reality or evidence demonstrates.

So while Dr. Conrad Murray didn’t get Jackson addicted to drugs, he stepped into a situation that Jackson’s death was inevitable and gambled that he could do what he was paid to do and get out before things went too wrong. He gambled and lost.

Is it fair he go to jail?

In that jail is intended as a deterrent to crime and insofar as Murray’s actions were criminally negligent in that he was not trained to administer the drug at issue, which was further being done in an improper setting, yes, Dr. Murray, as a medical doctor, knew or ought to have known, how dangerous the situation was.

Despite that Jackson himself should have been in jail and not unconsciously preparing for a concert tour (can you call it a tour when it’s just the one location?),  no matter Jackson’s failings and shortcomings, Dr. Conrad Murray contributed to his death.

But it’s the actions after that are the most telling – Murray did not immediately call for help and he hid information from medical responders. There was never doubt about Murray’s contributions – but there is some doubt as to whether he should shoulder the full burden.

But, as with Elvis, the biggest share of responsibility lies with Jackson himself. Celebrity seems to be it’s own reward as well as punishment.

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Disclaimers:

1. Doctors and police should never investigate themselves for misconduct, because there’s an inherent conflict of interest.

2. I am not now, nor have I ever been, a Michael Jackson fan. I believed him to be guilty of The Charges years in advance of any claims being made. That taints my observations of the current events, and I just wanted to admit my bias.

Book Review: Death of Elvis

Published in 1991, this book remains the definitive account of Elvis’ last year and the aftermath of his death.

Written by Charles C., II Thompson and James P. Cole, who produced  the 20/20 news program that exposed Dr. Nick and other doctor’s  excessive prescription writing.

This book is not for the faint of heart, as it contains very graphic autopsy descriptions, which can be disturbing on their own – but are more distressing when it’s about a person for whom you have strong feelings. Even when it’s a celebrity rather than a family member.

With the exception of Peter Gurlanick’s two volume masterpiece, Last Train to Memphis and Careless Love: The Unmaking of Elvis – this book may have the widest range of interviews than most Elvis books.

The usual suspects – Memphis Mafia members, Linda Thompson and Ginger Alden are interviewed – but also Dr. Nick and other health care providers, Memphis Baptist Memorial Hospital staff, Medical Examiner’s office staff and the autopsy team.

For me, the most shocking aspect was the Pharmacist who filled Elvis’ final prescriptions – he participated in the 20/20 investigation and initially expressed concerns that he deflected onto Dr. Nick.  So it was a bit of an about face when the 20/20 team discovers that this man had concerns about the drugs and failed to make any report to the State medical board. He even said that knowing what happened to Elvis – he wouldn’t see himself doing anything different.

Several theories of the specific causes and contributing factors are considered in the book from the obscure to the sensational. The most likely cause was not genetic heart problems or straining to go to the bathroom or regular heart attack; but the drugs.

Elvis had long been addicted to prescription drugs which resulted in a variety of health problems which increased the stress load on his body and it’s ability to function.

There are many claims about illnesses that Elvis had, yet, the drugs he used were not used to treat illnesses. The pills were for symptoms of illnesses – pain, insomnia and uppers for energy.

Elvis’ drug use was not on display like other musicians of the era who developed their public image around recreational drug use.

Elvis, keeping to the prescription drugs, could justify his using as medication and probably obtained a far better high with pure pharmaceuticals than the so called street drugs of the 1970’s and earlier.

While it’s only been 30 some odd years, the public attitudes towards drugs, understanding of drug use is very different now than in the pre-Betty Ford Centre, Celebrities revealing their own drugs use, childhood abuse and other matters that were previously kept on the down low as a rite of passage or a badge of credibility.

Elvis had been using drugs for a long time – possibly starting with Gladys’ amphetamines that was prescribe for weight loss well into the 60’s – and then the drugs supplied to him in the army.

Elvis received the stamp of approval for drug use from three authority sources – his Mother, the Army and Medical Doctors.

That Elvis doctor shopped and knew the pharmaceutical reference manual inside and out was beside the point.

Elvis died with a cocktail of drugs, many at toxic and even lethal levels – however, as a long time user, likely had a higher tolerance than a person just starting out.

What the most likely culprit that Aug 15th and leading into Aug 16th was a drug that Elvis didn’t take often – as Linda Thompson tells the authors, Elvis appears to have had an allergy to codeine.

The dentist Elvis saw that night gave him codeine and some additional pills. Mixing this drug into multiple so called “attack” packs of his more usual drugs stressed his breathing and his body too much.

Elvis took three sets of drugs, which likely began to work all at once and when combined with the codeine that caused respiratory distress, he couldn’t breath, tossed the book he was reading and fell to the floor.

He landed face down, but not flat – his knees were bent, meaning his weight was pushed onto his head, shoulders and chest – compressing and making his breathing even more difficult. He also threw up, making breathing near impossible.

A body in distress from multiple sources – drugs, body position –  combined with restricted breathing – the unattended Elvis had no chance of rescue.

That there was no coroner’s inquest also supports the death by drugs, as Memphis was very aware of it’s tourist status being directly related to Elvis. Further, Elvis’ image was not yet tarnished – the body guard book had been released a scant 6 week prior and most fans were resistant to the book.

Elvis’ death ensured it would be a best seller through multiple printings.

The 1980’s became a bad decade for Elvis – punished by the public for the drug use and then the various people claiming to be a secret offspring.

With thirty plus years passed and a far more drug/addition sophisticated public has lowered the scorn that has been heaped on Elvis. Even Elvis’ weight issues seem fairly minor compared to the obesity problems faced by most North Americans today.

It’s taken those 30 years for Elvis – who electrified the world, who topped the music, movie and television charts – to be taken as a serious artist. Perhaps he was just too exciting a performer during his life for the focus to be on the work rather than on the man.

This book reveals that man in trouble and unwilling to accept help.

I recommend the book to the full range of Elvis fans and general readers – who aren’t squeamish about autopsy level details.

Perhaps not for the fans who are in denial about the drugs, though.

Elvis clowning with Parker - click to see 1957 home film, 41 seconds in