Nineteen years ago, I was in my twelfth year of practice in plastic surgery where I shared a surgical suite with Michael Jackson's plastic surgeon. Though I never personally treated Jackson, I observed his possessiveness over his patient. At this point of his career, Jackson had reached the height of his popularity with international fame and recognition for his incredible talent. Though Jackson had undergone numerous plastic surgeries in the mid eighties, he still retained the facial characteristics and likeness of who he was -- which is far from what can be said about his condition at the time of his death.
With the many surgeries that followed, Jackson was left as the shell of who he used to be. The excessive and overly frequent plastic surgical procedures and the use of skin bleaching agents destroyed his physical appearance. You didn't need a medical license to see that.
In my opinion, the accompanying prescription of narcotics destroyed his stamina, spirit and health. After every plastic surgery, there is a recovery and with every recovery there are pain relieving drugs. In Michael's case, these drugs became an escape from the disappearing man in the mirror.
Eighteen years ago when I suspected that this was the beginning of Michael Jackson's path to destruction, my colleagues, as well as many on the California Medical Board, and even the media shied away from accepting this as a reality. Instead, my relationship ended on less than cordial terms with my colleague and I received a menacing letter from a high profile attorney who warned me about discussing any aspects of Michael's care. It was not until 2002, when I was asked to do an analysis of Michael's facial photographs for "Dateline, NBC" that I was able to bring some of these issues to light. Even then, I was brought before a committee of the American Society of Plastic Surgeons (where I had been a member for approximately 25 years) because of a complaint filed by an anonymous member alleging that I had violated my privacy oath. This charge was dismissed on a number of grounds.
The most pressing dilemma for doctors, medical regulatory agencies and politicians is how to distinguish between those who serve the needs of patients truly benefiting from medication and those who engage in overprescription and the enabling of individuals on the path to addiction. There must be a middle ground between overzealous prosecutors and regulatory agencies and the "blind eye" approach that was taken in Michael Jackson's case. Accommodating Michael's desire for relief from his emotional pain with drugs and surgery did him no service. The failure to investigate the physicians who contributed to Michael's demise along the way is a disservice to society and to my profession. Attorney General Jerry Brown's decision to investigate the trail of prescription narcotics in the Anna Nicole Smith case is a step in the right direction.
I am now in my 32nd year of practice. Watching the medical profession suffer from years of losing our autonomy (and perhaps our dignity) to insurance carriers and government regulators has given me perspective. In many ways, Dr. Conrad Murray's plight symbolizes the decline of our profession. On one hand, he represents the physician today who is strangled by debt resulting from diminishing reimbursement, large malpractice premiums, and high overhead costs. Many doctors today can empathize with him on these grounds. It's understandable why a doctor would want to seek out a niche in concierge medicine, with less oversight and more profit. On the other hand, that very doctor can contribute to the decline of the profession when unethical treatment leads to, say, the death of an individual who has been addicted to drugs for many years stemming from surgeries -- some warranted and some reckless. We read about these stories only when an international celebrity is involved. But it is a far more prevalent problem. Convicting Dr. Conrad Murray may appease the public's anger and sadness over his role in a beloved icon's death. But unless there is true and effective regulation and oversight, not from government officials, but amongst doctors themselves, such a conviction will not help prevent history from repeating this all too common tragedy.
Regulatory reform is needed in several areas. State government regulation of physicians is currently wasteful and ineffective. Investigations should be carried out by individuals with medical knowledge and training. The solution lies in early and impartial investigation. It also calls for overhauling the regulatory system which bankrupts physicians for poor record keeping and ignores real abuses. It calls for medical malpractice reform. The current system drives up medical costs for patients and causes physicians to practice defensive medicine spending more time with their charts than with their patients. Finally, regulation of the insurance industry itself is required in order to end its immunity from competition and its ability to write its own rules its own rules. Recent events in Haiti and Chile have reinforced the idea that doctors' most important function is care giving and not compiling time consuming and excessive documentation for insurance companies and the attorneys.
Most importantly, we must conquer the selfish aspect of human nature that distances us from concern for the common good. If we do not, statistics from drug related deaths will continue to mount, hospitals will continue to shut down en masse, and the quality of medical care in this country -- once the best in the world -- will continue to decline.
It is really criminal to go so far as actually administering over and over again, plastic surgery knowing full well it will do the person no justice but to only depend further on the surgeon. It hurts even further because Michael was extremely handsome. There was nothing wrong with his face other than the need to fix a broken nose which he was ridiculed as having a nose like Peter Pan. To further injury as Michael suffered lupus and vitilgo to further perform more plastic surgery, skin depigmentation - in my opinion, destroy a beautiful man. Now I admit that what I just wrote is not everything that the doctor states in his article, but he is quite right to out the unjust from the medical profession who cannot be trusted. You should agree with that if you are doctor, because all of these other doctors will put your career in jeopardy.
Lastly and what I am really wanting to say is, as a black female, who saw Michael as a handsome black male really am appauled at what the doctors had done to him.
Dr. Bruce Speiss, Professor of Anesthesiology, who didn't' treat Michael Jackson, tells CNN:
"The levels of propofol in the toxicology report are considerably higher, perhaps by factors of 10 to a 100 time higher."
Murray told police that he administered 25 ml of propofol after three other drugs failed to help Michael sleep.
Dr. Bruce also highlights some other inconsistencies.
Murray says he stayed with Jackson for 10 minutes after administering propofol, in which case he should have noticed something was wrong.
Michael should have been adversely affected with seconds of being given the drug.
"If he was going to stop breathing he should have stopped breathing within 30 secs to 2 mins after the propofol went in," says Dr. Bruce.
Also, a quantity as small as 25 ml should have been injected, not administered using IV, Dr Bruce points out, sinc the IV tube itself would take up 25 ml
Watch the CNN video report here:
http://www.sawfnews.com/Gossip/63323.aspx
It’s a shame that comments like yours so conveniently portray Jackson as someone with oddities when he was actually a sufferer of what your statements never address. Your tone definitely sounded accusatory about Jackson bleaching his skin and undergoing surgeries. Do you know the reasons why Jackson felt compelled to submit to plastic surgery?
An ordinary blogger may not conduct any research and learn about the pain of people who suffer, as Jackson did, from vitilago and lupus. They carelessly blog their petty opinions about his facial changes. A plastic surgeon like yourself, however, could have provided insight about these problems to the public. You could have discussed the influence these skin disorders have on one's emotions and physicality. Would vitiligo and lupus require plastic surgery to keep one’s face from becoming unbearably disfigured? In many cases, yes. As a person knowledgeable about health issues, you could have done society a favor by educating your fellow man about Jackson’s life of extreme health challenges.
http://www.thesmokinggun.com/archive/years/2010/0208101jackson1.html
NPDB data show that in most states only about 2 to 3 percent of physicians are responsible for over half of all malpractice payments. Yet mos often these few physicians have multiple payments in their records and no action to restrict their practices by licensing authorities or peer reviewers. There would be a lot less malpractice if licensing boards and peer reviewers took action against the very few physicians causing the bulk of the problem.
The IOM estimates there are 98,000 malpractice deaths each year. But in 2009 there were only 3,537 malpractice payments for death. What is the real problem -- Too much malpractice or too many malpractice payments? Obviously the real problem is malpractice. Taking action to reduce the amount of malpractice would lower premiums more than tort reform could.
Reducing the extent of malpractice would save lives and prevent injuries, not just shift costs from malpracticing physicians and their malpractice insurers to victims, health insurers, and taxpayers.
The focus of reform needs to be on reducing malpractice. Tort reform is merely a distraction from the real
But unless there is true and effective regulation and oversight ... such a conviction will not help prevent history from repeating this all too common tragedy."
Good advice, and also true of the financial meltdown and the search for scapegoats there.
Don't waste anger on individuals, fix the system.
Didn't you people read or hear about the autopsy report, haven't you heard about what Michael died from?
It wasn't an overdose of pain killers again he died from a so-called Doctor ADMINISTERING sleep agents and propofol.
What you Nurses and Doctors should be commenting on is the incompetence and unethical actions of this Doctor and how he is a danger to the public seeking health care. ALL MEDICAL PROFESSIONALS SHOULD BE ANGRY THAT A DOCTOR COULD TREAT A PATIENT THIS WAY.
Ponder over the fact that this Doctor did NOT prescribe his patient medication and the patient inadvertently took an overdose, this Doctor ADMINISTERED the overdose and inappropriate medication to this patient on purpose because as a Doctor he should have known that this would kill the patient. ALL MEDICAL PROFESSIONALS SHOULD BE WRITING LETTERS TO HAVE HIS MEDICAL LICENSE REVOKED. THAT WOULD BE THE START OF OVERHAULING THE MEDICAL SYSTEM.
Doctors are perfect, our health care system is perfect, this is just one rogue doctor, so fry 'em, right?
Typical, and it's why things never change. Getting even is more important to most people.
Everyone else who died from drugs were prescribed the drugs and inadvertently took an overdose or mixed the drugs together causing their own death and later on it was found that the majority of the celebrities were addicted to the drugs.
PLEASE PAY ATTENTION TO THIS IMPORTANT POINT.
MICHAEL JACKSON WAS NOT PRESCRIBED DRUGS WHICH HE INADVERTENTLY TOOK
ACCORDING TO THE AUTOPSY REPORT HE WAS HEALTHY AND AT THE TIME WASNOT ABUSING DRUGS
THE DOCTOR ADMINISTERED THE DRUGS WHICH WERE NOT PAIN KILLERS
THE DOCTOR BOUGHT AND ADMINISTERED TO HIS PATIENT AN ANASTATIC AS A SLEEP AGENT
THE DRUGS THIS DOCTOR ADMINISTERED CAUSED MICHAEL JACKSON'S DEATH BUT AGAIN MICHAEL DID NOT GIVE HIMSELF THOSE DRUGS THE DOCTOR DID SO THE DOCTOR IS THE ONE WHO KILLED MICHAEL JACKSON.
Why do you people continue to try and put Michael Jackson's case in the same category as other celebrities? IT IS NOT THE SAME.
Why things never change especially in the case of star struck, drug pusher Doctors is because the justice system see no need to dispense or dole out REAL JUSTICE TO THESE MENTALLY ILL DOCTORS.
But this *is* a country based on liberty, not regulated social norms. I hope we're not transitioning away from our principles.
While Dr. Goodstein may have genuine concerns about bad plastic surgery, he had no right to "analyze" Michael Jackson's face on television, for the titillation of NBC's viewing audience. NBC didn't care about MJ's well-being - they wanted to ridicule him.
Michael Jackson gets condemned for the choices he made in life, but it wasn't painkillers or plastic surgery that killed him. It was a lousy doctor who didn't know what the hell he was doing, and evidently didn't care. Conrad Murray chose to wantonly father more children than he could afford to support. He chose to use a dangerous anesthetic that he was unqualified to administer. And he chose to watch MIchael Jackson die, rather than call for help.
It is a travesty that Conrad Murray is still allowed to practice medicine. Physicians should be the ones demanding that Murray lose his license. Characterizing Murray's legal troubles as his "plight" is an insult to Michael Jackson and his family.
You are also correct that Murray killed Jackson and Jackson had hired Murray to protect him and take care of him.
Also, I believe the autopsy results confirmed that Jackson's kidney and liver were healthy and normal. That doesn't mean he didn't do drugs, but it certainly argues against long term abuse or addiction which Goodstein insinuates.
Having said this, I do believe Jackson had body dysmorphic disorder and someone should have helped him. He would not have realized (no one would have) that his desire for more and more surgery was really a mental illness.
While there does need to be lots of reform in the medical field there also needs to be some reform in the judicial system when dealing with these star struck Doctors who kill their patients with overprescribing drugs but in Murray case he just didn't prescribe the drugs he administered them which is even worse.
Also untrue it the statement this doctors makes in this article that Michael was addicted to drugs stemming from his many surgeries which he has no idea how many surgeries Michael had, but Michael's death was not due to pain killers it was due to an incompetent, greedy, unethical Doctor using sleep agents and propofol NOT pain killers.
http://www.thesmokinggun.com/archive/years/2010/0208101jackson1.html
However, I was an RN, Advanced Nurse Practitioner and Certified Registered Nurse Anesthetist for almost 25 years until I was serioulsy injured in an accident and then they discovered that I suffered from a genetic primary immunodeficiency. As a medical professional, I was an excellent historian and could truthfully and correctly address the symptoms...that DID NOT HELP. I finally had to research and demand that the correct tests be done and the ANSWER was right there. THE DOCS JUST DON'T LISTEN.
As for MIchael and his stituation, Michael was seriously mentally ill, and it was obvious or should have been obvious, but he was super wealthy and had all this publicity and the power of prestige if he chose to work with a doctor. THE DOCS WERE AT LEAST FIFTY PERCENT AT FAULT.
As for the pity me TORT REFORM AT THE END....this doctor is a selfish, butt of a person who is using his platform to harm patients. I saw so much malpractice, negligence and horrible care which led to one in 1000 suits.. TX did the tort reform thing several years ago, and it is practically a kill and get out of jail free situation because of it. THEY DID IT AND MALPRACTICE PREMIUMS DID NOT GO DOWN. .
I cannot for the life of me understand how having had benzodiazepenes would result in anaphalais every time someone eats. Once drugs are out of the sytem, those receptor sites are free to act as they should act.
I just read an article regarding two obstetricians who started a C-section on a woman who had been in their care for TWO DAYS, who they had tried to induce labor in for two days, and they had failed to pick up on the fact that she WAS NOT PREGNANT. She had a "hysterical" pregnancy, and appeared pregnant, but they had not done a proper exam on her during those two days, and had not ordered proper monitoring or other steps, and did not know she was not pregnant until they had made the abdominal incision. They both got a probationary period, INSTEAD OF LOSING THEIR LICENSE. It took the Board almost three years to come to that conclusion. Any doctor who didn't even examine a patient and failed to perform tests to determine that she really was pregnant, and then started a C-section SHOULD NEVER, EVER TOUCH ANOTHER PATIENT.