Monday, October 25, 2010

Conrad Murray vs. Doctor #2

I first learned about Dr. Frank Fisher while reading a pharmacy law study guide. I decided to "google" his name and found a lot of information about his quandaries, including his own account of what happened to him. I discussed Dr. Davill Armstrong in my previous blog. I must say, Dr. Fisher's plight has been much, much worse than that of Dr. Armstrong, in my opinion. Whereas Dr. Armstrong is a Texas physician who had his license suspended for some deficiency in his practice of medicine, Dr. Fisher is a California physician--a physician who practices in the same state in which Michael Jackson was killed--and he was charged with murder for over-prescribing opioid analgesics (painkillers). For the record, he did not administer them to his patients personally. His case is in no way similar to Conrad Murray's situation, as you will see shortly.

As of today, 10/25/2010, Fisher's license is active though for 8 years his license was suspended.

Dr. Fisher was charged with not one, not two, not three, not four but FIVE murders. He was also implicated in the deaths of four other people as well. Unlike Michael, who was found deceased in the house under Murray's presumed "direct care"--authorities had to "go find bodies", as Fisher himself put it, in order to charge him with murder.

"In one case, for instance, Fisher was accused of causing the overdose death of a woman who actually had died of injuries sustained while riding in a vehicle that crashed. Another person succumbed to drugs apparently purchased from street sources after Fisher refused to write him a prescription."

Dr. Fisher discusses recalls the former case in his own words:

"Typical of my alleged murder victims was Rebecca Mae Williams, a 37-year-old who had suffered from incurable low-back pain. After exhausting alternative treatments, I had successfully controlled her pain with 80 milligrams of OxyContin twice a day, a dose that had allowed her to enjoy an active life. The day Becky died, she had taken her usual dose before going furniture shopping with her boyfriend. As their small truck rounded a curve, the driver's door flew open, and David, who was driving, fell out. The truck crashed into a tree, and the impact exploded my patient's heart, fractured her skull, broke her neck, and eviscerated her. Yet on the basis of an impossibly high level of oxycodone measured in a blood sample - later found to be contaminated - the county medical examiner asserted that Becky had died of a drug overdose."

I am still trying to understand how he was actually able to be charged with murder in Ms. Williams death. One would think it would be impossible, right? Right. I also say to myself, how could Dr. Fisher be charged with murder in the case above and Murray NOT be charged with it? Why is there a double-standard? I don't want to elaborate much on it but I do know that it was insinuated there may have been some issues concerning insurance reimbursements. Did $$$ have anything to do with why Fisher was so hotly pursued? I do not know and do not wish to speculate but I do know that money seems to always be an influencing factor in the vast majority of things.

I know many keep saying, regarding the possible trial against Murray, that "facts are facts". Facts are facts--but let's not forget how facts can be diluted with lies and misunderstandings, too. Dr. Fisher recalled of the trial he experienced:

"My preliminary hearing was the equivalent of a trial. The lead prosecutor was a career bureaucrat with a reputation for winning elder-abuse cases. His first witness was a family practitioner from a neighboring community health center who served as the primary source of the state's information about pain management. She had already articulated her formulation of the case against me for the local paper: 'The majority of patients were on doses that we had never seen before. Some of the doses we thought were incompatible with life.'

Soon after my attorney began his cross-examination, however, this witness admitted that she lacked even a minute's worth of training in pain management. He led her to repeat her public claim that each patient has a certain dosage of opioid analgesics that will surely kill him.

The trap had been set. Asked to read aloud several lines from the OxyContin product literature brochure, this witness read a statement asserting what all competent pain-treating physicians know - pure opioid agonists have no ceiling dose.

The trap was now sprung. Gesturing to the gallery of the courtroom, which was packed with my patients, my attorney identified the 'walking dead.' All very much alive, my patients began howling with laughter. The state's case had just sustained irreparable damage.

Next, the prosecutor called to the stand the founder of the pain management center at the University of California, Davis Medical Center. When asked about the quantities of OxyContin I had prescribed, the physician responded, 'The absolute numbers don't bother me a bit. I have cases of my own that I can show on higher doses than any patient that Fisher ever had in all the records that I've got.' The witness finished his testimony by stating that I appeared to have practiced medicine in good faith. Later, the bailiff chuckled as he escorted me to a holding cell. 'Sometimes it goes well in court,' he said, 'but never that well!'

Over the next several months, as the prosecution sent an army of investigators across the county to try to unearth evidence that would prop up their faltering case, the hearing stretched out to 21 days of testimony. During that time, my defense didn't have a single bad day in court. Each witness the prosecution called dug the hole they were in deeper.

As the prosecution's case fell apart, multiple incidents of police and prosecutorial misconduct surfaced. A witness was threatened in an attempt to coerce testimony favorable to the prosecution. A conspiracy to violate Miranda rights was exposed. A witness recanted, and the prosecutor was caught knowingly eliciting false testimony from one of his investigators.

During a cross-examination on the final day of testimony, my attorney lured the government's last witness, a police investigator from the attorney general's office, into remarking upon the atmosphere in my clinic. The agent wasn't supposed to have known what went on in my clinic because, until this point, the prosecuting attorneys had withheld the fact that they had sent agents to my clinic to scam for drugs.
After the agent's admission, my attorney walked behind me, placed his hands on my shoulders, and bellowed, 'And not one of them got anything, did they?' The agent just hung his head and muttered, 'Not that I know of.'

On July 15, 1999, the hearing finally ended. The judge dismissed all five murder charges, reducing three to man-slaughter. (One of the manslaughter counts was for a young man who wasn't even my patient, but the judge told me he suspected I had something to do with the death.) The judge dropped my bail from $15 million to $50,000 and told me not to practice medicine until the criminal charges were resolved.'


The point of what I have posted above is to look at what occurred during his trial. There were unqualified experts giving "expert testimony", there were "multiple incidents of police and prosecutorial misconduct" and we see from this that he was charged with murder which was then dropped to involuntary manslaughter.

Now, what you need to do with the information above is twist it around and see the reversal of it to see what I am getting at with this piece. Dr. Murray, no matter how you look at it, conducted no positive actions concerning Michael. Obviously not, Michael is deceased. I can say Dr. Fisher was treating patients who had pain with pain medication--I will not decide if he treated them overzealously or not. Murray was "treating" Michael's insomnia with a deep anesthetic that rendered him into a coma with no way to breathe for himself (on top of three benzodiazepines that can also cause one to stop breathing). That is not treatment--it is homicide.

What I want you to picture is the impending trial that may loom in Murray's future. Our victim here, Michael, is a real victim. He is not only a victim in death but a victim in life. Michael's life was scarred and made into a life of torment by the perjury of others who put him through the 2005 trial that should not have even happened (I will not get into why there should have been no trial now but this can be further explored in Lynton Guest's book "The Trials of Michael Jackson"). Those atrocities, the molestation allegations and now the drug abuse claims, could easily influence how Murray's trial, if he even faces one, will play out. We could see unqualified experts giving testimony on behalf of the defense (remember, in medicine not much is "exact"--people are still debating on whether or not vaccines cause autism). We do not know how badly the prosecution wants to convict Murray--we do not know the Los Angeles' district attorneys who will be handling the case's view of Michael--if they have any similar sentiments to that of former Santa Barbara D.A. Tom "Mad Dog" Sneddon then we can assume Murray will be the victor by far and Michael once again be defamed beyond recognition. So far Murray is sitting comfortably on involuntary manslaughter charges rather than murder charges when his story makes absolutely no sense even from an accidental point of view and, in my opinion, he should be facing strict liability like Eric Cropp and Rapin Osathanondh.

Four years passed from the time Dr. Fisher was arrested until his trial began--this is rather typical. Murray received involuntary manslaughter charges rather swiftly and a possible trial is to begin soon. Are authorities even looking into other avenues as to what happened to Michael or do they just want to get this case over and done? Michael deserves justice--whether you like him or not. If this had happened to your family member who was desperate for sleep so they could keep what fed their children and kept them sheltered (see my blog regarding the AEG contract if this statement does not make sense to you), and all other treatments for insomnia had failed, and there was a critical misunderstanding that a supposed previously-used "safe remedy" was neither useful nor safe, but a doctor chose to utilize it anyway in the most illogical of scenarios and then failed in every way possible to keep them alive when they would have remained alive had simple precautions been available and used--you would be crying out murder and conspiracy, too. Involuntary manslaughter does not say "conspiracy"--it says freak, deadly but minor, accident.

I ask all readers to please take the time to read the sources listed below not only to compare Dr. Fisher's dilemma to the (almost lack of) Murray's dilemma but I also would like for everyone to get a better understanding of some of the patient cases discussed by Dr. Fisher and why he says authorities went after him so aggressively as well.

Sources:
http://www.doctordeluca.com/Library/WOD/WPS7-Fisher/PainKillerFisher06.htm
http://articles.sfgate.com/2004-05-20/news/17427801_1_fisher-case-pain-sufferers-patients-with-chronic-pain

Saturday, October 23, 2010

Conrad Murray vs. Doctor #1

Dr. Davill Armstrong has been an internal medicine doctor in the state of Texas since 1979. He was previously board-certified in internal medicine before his license was subjected to disciplinary action. He has his own clinic, dubbed Armstrong Medical Clinic, that is located in Houston, Texas. Another physician by the name of Conrad Murray, whom we have all come to know, has been known to see patients at Armstrong Medical Clinic. He resumed his practice at this clinic after the death of his patient Michael Jackson. Armstrong Medical Clinic is not Murray's clinic. Murray's clinic in Houston is Acres Homes Heart and Vascular Institute. I am not sure why Murray has a practice or visiting role at Armstrong Medical Clinic along with another practice in Las Vegas by the name of Global Cardiologist Associates. "Global" seems to be a fitting term since Murray seems to go wherever the wind blows him.

It was brought to my attention that Dr. Armstrong has ran into some problems with his license in the past so I decided to look into the matter for kicks. I have tried to summarize the findings below as swiftly as possible:

Medical Board Order #1:

http://reg.tmb.state.tx.us/TMBPublicWebSite/BOARD%20ORDERS/e00/00/89/00008904.pdf

On August 13th, 2004 Armstrong's license was place under disciplinary action by the Texas State Board of Medical Examiners. Disciplinary action was sought because in late 2002 he saw a patient referred to as "C.H.". The chief complaint (problem) for C.H. was listed by Armstrong as "? seizures". He noted on the physical exam that all basic vital signs were normal. He diagnosed the patient as having seizures and asthma. He wrote prescriptions for albuterol for the asthma and Dilantin (phenytoin) for the questionable seizures. Armstrong did not follow-up with the patient, determine what the cause of the seizures were and failed to check serum blood levels for the Dilantin. Those aforementioned actions violated the standard of care in his treatment of C.H. thus disciplinary action was taken forth on his practice of medicine.

Due to his violation of the standard of care mentioned above, his practice of medicine was to be monitored for three years by the Compliance Division of the Board. Also, Armstrong was forced to allow the Compliance Division to review his patient records, up to 30 records every 90-day period for the duration of his monitoring. After 3 years, he was to enroll and successfully complete 30 hours worth of courses related to record-keeping and/or risk management.

Medical Board Order #2:

http://reg.tmb.state.tx.us/TMBPublicWebSite/BOARD%20ORDERS/e00/00/8b/00008b5f.pdf

On June 2nd, 2006 another court order took place against Armstrong. Recall Armstrong was to be monitored for 3 years. The Board found he again violated the standard of care for 15 patients by "treating only specific patient complaints at each office appointment without completing a history and physical on the patient and without monitoring chronic medical conditions, such as diabetes." He is also said to have violated the standard of care by not documenting enough, failing to provide "preventative medicine and disease management, and failure to evaluate patients for acute medical conditions in each of the 15 patients". He also hospitalized many patients for extended durations without justification.

Armstrong was reviewed by the Center for Personalized Education for Physicians and was found to have judgment and reasoning below acceptable standards as well as gaps in his medical knowledge. A neuropsychological exam was recommended.

Armstrong's license was then suspended.

Medical Board Order #3:

http://reg.tmb.state.tx.us/TMBPublicWebSite/BOARD%20ORDERS/e00/00/90/00009000.pdf

On May 29th, 2009 Armstrong asked that his license be reinstated so he could be allowed to practice medicine in order to complete the obligations in which he had to undertake to get his license and practice back. His request was granted under very limited limitations, under the scope of the Center for Personalized Education for Physicians.

Medical Board Order #4:

http://reg.tmb.state.tx.us/TMBPublicWebSite/BOARD%20ORDERS/e00/00/92/0000921e.pdf

This order details information from a document of complaints dated on November 23rd, 2009 which discusses multiple alleged violations of the Medical Practice Act along with a rundown of alleged violations of the orders placed against his license. His license is currently valid but only in order for him to meet the necessary requirements to have his license fully reinstated so that he may practice medicine again.

I am not by any means trying to vilify Armstrong for his actions or alleged actions but I feel his plight serves as good comparison against his fellow physician Conrad Murray.

The single Board Order for Murray:

http://reg.tmb.state.tx.us/TMBPublicWebSite/BOARD%20ORDERS/e00/00/91/000091bf.pdf

The order states that Murray is facing charged related to possible "non-therapeutic prescribing" that resulted in the death of a patient (Michael Jackson). It mentions that he is part of a "criminal investigation". Could non-therapeutic prescribing qualify as misbranding which is a strict liability action? If so, then why is Murray not facing such liability which should strip him of a defense in his trial? (I will highlight on strict liability in another blog.) I am not sure we could call what he did "prescribing" as he did not prescribe propofol--he administered it against all logic and reason--to a man rendered unconscious and powerless as soon as it hit his vein. He did not give the bottles of propofol to Jackson and say, "here you go, use it as you please."

All that is required of Murray in this order is a) he not administer sedatives normally given by an anesthesiologist and b ) that he not personally administer or prescribe general sedation BUT he may be part of a team that provides such services. THE END. These requirements are valid until further notice, basically.

Though not clearly established it appears C.H., Armstrong's questionable seizure patient that initiated his downfall from the practice of medicine, did not die from his failure to meet the standard of care. Apparently none of Armstrong's patients died from his deviation from the standard of care. Murray "allegedly" did not meet the standard of care either, according to experts in the autopsy report, yet it appears his competency, reasoning, knowledge of medicine and the law are all intact with respect to the Texas State Board of Medical Examiners. At least, that is the message I am receiving from them by their lack of what I deem as appropriate action. Murray provided the means to use propofol for insomnia by his own admission though he lied saying that he did not obtain the propofol himself initially (http://febone1960.net/febone_blog/?tag=dr-conrad-murray )--a receipt from Applied Pharmacy in Las Vegas shows he did in fact order propofol at least once. He administered propofol for insomnia by his own admission. This enough is a blaring statement to the medical community that something is wrong with this man and his judgment, be it medical judgment and/or conscionable judgment.

As far as the public can tell Murray failed to keep records of Michael's "care" while he tended to him during the last few weeks of his life. What doctor would want to keep records of his treatment in this case anyway? It would have been a "Diary of Death" in my opinion.

Now to my main point--why is it Murray has not been subjected to the same types of disciplinary actions as Armstrong, or at least anything close?

First, let me say I am by no means going to imply the Texas State Board of Medical Examiners is being paid to let Murray off. I do not think that is the case by any means. I do realize that I do not know all the information here, but I do know a lot more about Murray's "pickle" than Armstrong's predicaments. I cannot help but say that it seems like the actions taken forth upon Armstrong is the Board's way of trying to protect the public from him accidentally hurting a patient. That is a good thing. With what we know based on Murray's own words--should we not worry about what Murray will do to a patient, especially if monetary gain may be involved? In Murray's case it is evident that he has lied, he admits to giving four respiratory depressants to one individual in one night for "sleep" including one heavy anesthetic agent that induces a coma, NOT sleep. His patient died likely due to his actions though he does claim he gave "nothing that should have killed Jackson". I beg to differ.

I cannot help but say--is Murray facing such leniency because of WHO his patient was and what has been said about Michael Jackson regarding both the molestation allegations AND his purported drug addictions, both of which are unfounded? If this were the president who was killed, would Murray still have his license and furthermore would it have been renewed as Murray's was this past August? What if it were Joe Blow? Though highly unlikely, what if it were a homeless man? All of these people should be seen as equal in the eyes of the medical world, especially concerning disciplinary action. None of them are more important than the other. I know it is common to be indifferent when a serial killer is dies but that is just it--Michael Jackson was a kind, caring, compassionate man who had his life and image destroyed by others. I cannot help but say that I feel because of the lies out there about him many are indifferent to his death. There is no evidence that he ever did any criminal wrongdoing to anyone. I have said before that all the events that occurred to Michael were chain events. Everything really started in 1993 when Evan Chandler accused Michael of molesting his son Jordan. Almost, if not every event in Michael's life after that was in some way tied to those baseless allegations. His financial situation was controlled by it, his career was controlled by it, maybe even his medical treatment was controlled by it because of the stress and pain it brought to his life, his image was controlled by it, his joy in life was diminished by it. Michael was a man who most could not relate to on a personal level before the allegations but after the allegations he was turned into a mirage of a man. He so desperately wanted people to relate to him and his way of living. Now people look to his tattered and torn image to judge him inappropriately and one cannot help but think that that automatically gives Murray the upper hand. Not only do the allegations hurt him but what about the drug abuse claims that are swirling?

Michael died from acute propofol intoxication--a drug. When people discuss his past drug use they are adding salt to the wound though some think they are just being "honest" or that "facts are facts". Regardless of facts, those sort of "facts", if that is what one thinks they are, do not help rebuild a reputation which should be the goal of anyone who loves him. We have very few "facts" about how Michael died as it stands and it will likely always be that way. Drug use, especially addiction, is a very complex subject that many do not understand and it is easy to mislead yourself on what you think you "know". I can equate the topic of drug use to the allegations of molestation. Would stating Michael shared his bedroom with children help defend him against the allegations of molestation? No. People do not understand the reasoning and facts behind such a statement. It is likely this statement alone, which was revealed in the Bashir documentary, led to the further destruction of his life in 2005. His statement, like many, were taken out of context and not allowed an explanation. The same principle applies to his drug use or implied addiction. No one currently understands the full reasoning and facts behind his use of medications, either.

People should not be so naive. If they do not think there is a relation between the actions taken forth upon Murray's license and the implied notion that Murray was duped by a spoiled celebrity addict who "demanded" propofol you are sorely mistaken. This is blatantly obvious as it is not Murray's apparent competency, reasoning or medical knowledge that has been questioned, as Armstrong's was, but instead Michael's reasoning is being judged and insulted when he did not have a medical license. He was "crazy", he was "warned"--so what? He was a lay person and a person desperate to sleep who likely been misled before by doctors regarding the use of propofol. The moment Murray bought the propofol and administered it he was approving Michael's mistaken theoretical treatment for insomnia--Murray justified it, he approved it, and he is the one with years of hands-on medical practice under his belt, not Michael. If Michael had bought propofol off eBay and gave it to himself (as one individual did and subsequently died) then we would have a different problem to discuss and blame shifted upon someone else. Murray KNEW what he was doing. We just cannot prove, yet, what his desired outcome for Michael was that morning on June 25th.

This is just the first blog of many where I will be comparing Murray to other physicians who have not been so lucky. Maybe then people will see just how much injustice Michael and his family are being dealt with regarding not only his life, but very much so his death as well, and there is only a slight glimmer of hope that anything will be done about it as it currently stands.

Monday, October 4, 2010

A Plea to the Voices

After hearing this and that on various social outlets today I felt the need to toss this piece together. It went from an angry rant into somewhat of a heartfelt yet eager plea to many people out there that actually have an audible voice for Michael. I would give anything to be his voice. I can only hope that some who are his voice will, after reading this if they even find it, realize what really does lie within their power.


First, this is not an argument as to whether or not Michael Jackson was a prescription drug addict. You are free to believe what you want though as far as I am concerned his autopsy report and the prescriptions at his house seriously dispute such notions. But, when those who knew Michael call him an "addict" or even insinuate such (which is fairly easy to do) in interviews or what not--you are damning him, his legacy and any hope of justice in his death. When I hear or read such information I literally feel like I am being stabbed in the heart. You may think you are being honest and open but is it worth it? Look how many out there are NOT honest and merely using him and his name for personal gain. There are so many lies out there, defaming ones, so why even try to be honest about the very confusing and complex subject of drug abuse when the hint of such is being used by people (ex. the media) who do not care about him to further commit him into a hell he experienced while alive? Murray's defense, in whole if not part, is banking on Michael being deemed an "addict" even though a) propofol is not recognized by the DEA as an addictive drug/drug of abuse, b) it does not cause withdrawal and c) it does not create tolerance--key factors in a medications being addictive. Even though Murray reported no addiction issues to UCLA staff (as reported in the wrongful death suit), Murray later changed things around and claimed in the Las Vegas search warrant:


"Jackson remained awake and at approximately 1040 hours Murray finally administered 25 mg of propofol diluted with lidocaine, via IV drip to keep Jackson sedated, after repeated demands/requests from Jackson." (FYI, you do not dilute propofol with lidocaine.)


This statement is Murray's attempt at establishing Michael as a hardcore drug addict that manipulated and pressured him (yes, poor Murray) into feeding his addiction by using monetary persuasion. Wait, who is the victim here? I thought it was Michael Jackson, the one who was ripped from our lives too soon.


The statement in the search warrant is crucial. Notice the phrase "after repeated demands/requests". That is one of the major tell-tale signs of addiction. Murray knows this of course. However, when most people discuss Michael's previous abuse they cannot name the substance, cannot admit to seeing him take or administer anything and then insinuate his addiction must have been to prescription painkillers which is understandable given he suffered from real physical pain due to differing ailments that required him take pain medications from time to time. Also, it is natural to assume an addiction (or moreover abuse) may have developed from stress he faced in the later years of his life. What people fail to acknowledge in good faith is his legitimate complaint of pain that would have need to have been treated, and the possibility of dependence rather than addiction, being a scenario that may have played out over the years coupled with or without malpractice. There could be other factors, too, that are not even drug-related. Regardless of what may or may not have occurred, there is no reason to even discuss a problem with painkillers when they had absolutely no role in his death. Those medications are irrelevant. Those medications have been irrelevant since June 25th, 2009. What good does it to bring them up? What good does it do to discuss what he may or may not have taken or why? What does any of this have to do with promoting Michael's artist achievements, his humanitarian spirit, his caring soul or his playful personality? Answer--nothing. The general public knows more about the molestation allegations and now drug abuse and addiction claims than they do about his charity contributions of over $300 million dollars and his wickedly funny sense of humor. That is all they will ever know if something is not done and not done soon.


Referring back to the key statement from the search warrant above, Murray was, "keep(ing) Jackson sedated". Dr. Murray--was he awake or sedated? How did he remain awake (and demanding no less) if he was being kept sedated? Maybe I can answer my own questions.


Michael apparently was "under the influence" at times, according to some witnesses, during rehearsals. In Katherine Jackson's law suit against AEG, it is said AEG said Michael was "too sleepy". Well, the only medications that he had apparently been administered were a) benzodiazepines, b) propofol and c) the ephedrine/caffeine/aspirin capsules (aka ECA Stack capsules). Any and all other medications, taken or not, are irrelevant. Remember again there were no painkillers (opioids or opioid narcotics) in his house or in the released toxicology results. Such usage, whether abuse or not, is not relevant to his death which is an ongoing homicide investigation (at least, it should be) but if his purported abuse/addiction continues to be brought up it will be somehow used to justify Murray killing a man who was constantly persecuted and tortured in life for being a child-at-heart. Remember Murray being handcuffed last year? Oh yeah, he was not handcuffed. His bail was essentially nothing. He is enjoying frolics on the beach and pumping iron at the gym yet before Michael died he was supposedly broke. Does his life seem ruined? Michael lost his life due to this man's actions yet Murray is the one who is getting indirectly defended even by those who love Michael. Something has to be done if we ever want to see a shred of justice for Michael. Something has to be done if we want Michael to be remembered as something more than a drug addict, and I hate say it, but also a child molester when anyone who can read can read the information that proves he never, ever did anything like that to any child. He was not even capable of such acts! But, people who do not know him and who cannot see past the molestation and drug abuse claims (or do not want to see past them because those claims turn them away from the truth) will never understand him if all they ever hear about him are comments that assassinate his character and make him out to be something horrible.


Knowing Michael had no pain medications in his body when he died and none in his house (and it seems none written for home use in quite some time), this rules them out as being a source of him being "under the influence", at least, while at rehearsals, especially concerning the last week of his life. If he came out of Klein's office "under the influence" then so be it--he was no doubt having procedures done to his face as the photographs do not lie. Those procedures would have required some pre-medication to treat anxiety/pain. Regardless of what Klein did or did not use, anyone addicted to pain medications would almost certainly not only have a positive drug screen for opioids (Michael's urine and blood tests were negative) but also need to have the medications in the house to avoid withdrawals. Addiction is an ongoing process that requires constant use of the substance, especially concerning opioids, most of which have very short duration of action.


Propofol does not cause one to appear as if they are "under the influence". After awaking, the hangover effects last approximately 30 seconds then there is no signs of drug usage at all. ECA capsules do not make one high. They might leave you anxious, tense, stressed, suffering from INSOMNIA, if anything. That leaves only one class of drugs left to have been causing him problems--benzodiazepines.


Benzodiazepines work in the body in a similar fashion to that of alcohol. They do have the potential of addiction but addiction to these drugs is rare, as is abuse of these drugs, too. These medications, if taken (or in Michael's case are administered by another) in excess amounts they can cause a hangover effect. They can cause drowsiness, confusion and amnesia--some symptoms Michael reportedly suffered from at rehearsals. The effects of benzodiazepines can last hours, depending on the medication. Excess use (or administration) can lead to tolerance and dependence over time. However, given Michael seemed to be exhibiting signs of excess use from these medications that leads me to believe they were in fact sedating him the night he died, contrary to Murray's claim that he was up all night demanding propofol yet he was supposedly being kept sedated while demanding. After all, Murray admits Michael slept the entire 8 hours the night before just on lorazepam and midazolam. So, how did he suddenly fail to be sedated by those to medications plus diazepam? I am not buying it. The medications had an effect on Michael and it was obviously profound enough to be visible at rehearsals.


Let's break down Table 3A from the autopsy report concerning the benzodiazepines:

Michael had a prescription for clonazepam from Dr. Metzger in April. Metzger gave Michael a 30 day supply. Twenty-two tablets were apparently taken during a 68-day period based on the date on the bottle. That seems to be the only prescription for a benzodiazepine written for Michael by any other physician--besides Murray.


Murray wrote for three benzodiazepines prescriptions--not including the vials of IV benzodiazepines he purchased illegally (without the use of his medical or DEA license number) and administered to Michael. The first prescription was for temazepam, filled in December of 2008. Temazepam is a benzodiazepine commonly used for insomnia. It was written for 30 capsules--a month's supply. Michael still had three tablets left after six months. Then in April Murray apparently wrote a prescription for lorazepam. Again, a month's supply of this medication was written for Michael. Nine tablets of that month's supply remained after approximately sixty days had passed. Only days before Michael died Murray apparently wrote for a 15-day supply of diazepam. I can only assume this was the first time he had received a prescription for diazepam unless a previous bottle had been thrown away which seems unlikely. He wrote for him to take 1/2 or one tablet every six hours. Three tablets were missing over the course of four days--he could have officially taken up to four tablets in one day. This is extremely large dosing for a patient though who, in the past, was given benzodiazepines to take either at night or at night as needed only--indicating use for insomnia which in itself seems pretty amazing given Michael's life of recurrent stress. I cannot say with certainty what Michael's complete medication profile looks like. It would seem that what was found in the house was a pretty accurate description of his drug use given the dates on the bottles.


The biggest problem concerning benzodiazepines does not lie with Michael but with Murray. Murray's administration of IV benzodiazepines at night was not okay nor was it ever necessary given Michael could (when awake, at least) take tablets or capsules. Michael had no control over the situation once sedated by Murray by not one, not two, but three different benzodiazepines, two of which were given IV. Add propofol, no resuscitative equipment and a failure to call 911 and you have a dead patient who had no control over what happened to him. You have a case of homicide.


Remember, it was not "pills" that killed Michael. He did not even have one "pill" in his stomach. It was not addiction that killed Michael. It was another human being's actions that killed Michael. I do not think Michel even asked for those medications that night, personally. No healthy person should die under a doctor's direct care. No doctor would "care" for a patient like Murray "cared" for Michael. Not only did Murray provide the medications, he set up the means to give them and pushed them into his vein which put him there seeing everything that was happening to Michael. I mean, people kill others using their cars and what not, but Murray actually used his skills, mind, debit card, hands, equipment and substances to do what he did to Michael. How does that equate to manslaughter?


Many believe others have blood on their hands concerning Michael's death. If you believe that then realize if Murray is not put on trial or found blameless due to the pressures of a drug-addicted celebrity, then all other parties will walk away unscathed as the blame for Michael's death will always, according to the courts, be Michael's fault and Michael's fault only. Surely to God those who love this man do not want this to happen to him. It will either be a chain reaction of justice or injustice with the latter currently the most probable. If a loved-one was shot with a gun and killed by someone else, would it make sense to say, "well, (my loved one) did own firearms, though." No, of course not. A statement like that implies wrongdoing on the part the loved-one when they had nothing to do with their own death. The case with Michael really is no different. He is the victim, not Murray. Michael is dead, not Murray.


I have tried to break this down as much as possible for people to understand because it is literally eating at my core. I am begging people who have a voice for Michael to PLEASE think before you speak. I want people to speak out for him but I do not want the media getting what they want--a martyr who makes them money. Yes, he suffered, but so did the numerous children he tried to help across the world. What I am trying to say is do not feed into the ploy of Michael being another "doomed story", another celebrity that drugged themselves into oblivion from their fame and self-pity. Fame does not kill people. Michael fell victim to sociopathic liars who either lied and/or manipulated him. Do not let them now manipulate YOU into saying something that does not help this precious yet misunderstood man. Please, help him, help those of us who never knew him to know the real him. I am not asking to paint him into a perfect light but there is too much at stake to make statements that do not promote something better than what is being said out there about him now.


~Every person in the United States is innocent until proven guilty though I may seem to speak on the basis of guilt. Too bad the media forgot in innocence until proven otherwise when Michael was forced into a trial that should have never been that ultimately destroyed his career and his life.~