Thoughts from Day Two of the Conrad Murray Trial

I want to highlight some points, in no specific order, from today's testimony that I was able to jot down.

Paul Gongaware claims he heard Michael yell in the background of a phone conversation "give him 150!!!"--he assumed Michael meant give Murray $150,000 a month--but Frank DiLeo (now deceased) claims he was the one who did the negotiating with Murray and was initially given a requested salary by Murray that was "enough to buy a hospital". It seems now we know that number was $5 million for his services. I am not completely sure I believe Gongaware, on the "150" comment, but regardless, Murray did not seem to like it, either. Kathy Jorrie, an attorney for AEG, said she was the one responsible for drawing up the AEG contract between Murray, Michael and AEG. She said she spoke directly with Murray and he directly negotiated with her--basically serving as his own attorney. She spoke to him June 23rd/24th either via email or phone. She said he had requested changes to previous drafts of the contract, such as the new request for a doctor rather than a nurse for assistance, in case he needed time off. (There was no mention of another doctor's name, such as David Adams who Murray claims was to go to London though Adams vehemently denies this.) Murray also requested that if his services were terminated he would not have to refund any of his last monthly income paid. He also lied and said he had four clinics he ran--he apparently had two, if even that. The contract that was to be signed by all three parties was only signed by Conrad Murray. Negotiations for the contract had began in May with Timm Wooley, I believe. There are emails available of the discussions between these two men. I will try to post them at some point.

Jorrie also spoke to Murray about Michael's medical records. She told Murray he needed to provide them for the last 5 years for the London insurance broker (Lloyd's of London). He stated he had been his doctor three out of those five years and given Michael's excellent health, he had few documents in his file for him. Come June 25th, however, Murray flatly denied Lloyd's any access to Michael's medical records, without reason. He denied all the media claims about Michael's health, as well.

Murray wanted to be paid even during months Michael was not actively touring. He also requested a "CPR machine" for the O2 venue, not for LA or the London home. A CPR machine, whether it be a machine that does compressions or a defibrillator, would not be the necessary equipment needed for what Murray was doing to Michael. He would have needed a ventilator, a manual pump, an EKG machine, a pulse-ox WITH an alarm, etc. etc. He needed equipment to sustain life, not attempt to revive someone who already has the odds set against them, which is typically what occurs when someone goes into respiratory or cardiac arrest. Murray needed to PREVENT such, not be ready to TREAT such.

Sadly, given AEG was to be paid their advancements before Michael was to receive his income from "This Is It"--and was basically responsible financially for everything--Murray stood to possibly collect more in income than Michael himself.

We know Michael had apparently known Murray since 2007 or so--he was introduced to Michael by one of Michael's bodyguard whose father was a patient of Murray's. Murray apparently first treated one of Michael's children with some minor ailment and then saw Michael for minor ailments. We know Michael had a prescription from Murray for Restoril (temazepam) for insomnia filled on 22nd December 2008. There were no other prescriptions filled from Murray for Michael until a prescription a lorazepam (oral, 2 mg) was filled on April 28th, again for insomnia. Murray lived in Las Vegas and Houston--Michael at this time now lived in LA since late 2008. When did Michael meet up again with Murray? Was it in March or April? We know Michael consulted with Cherilyn Lee in January and February about being tired (he, at that time, did not complain about insomnia). I ask this because Murray obviously knew Michael suffered from insomnia since at least December 2008, if not before. As stated earlier, Michael suffered from insomnia nearly his entire life, at least adult life. His insomnia became problematic when he went on tour because of the difficulty in "turning-off" after performing. Murray began ordering propofol well before Michael apparently asked him to administer it to him (Michael approached Lee and supposedly Metzger about propofol later on in April). On the same day Michael had the prescription for oral lorazepam filled (April 28th), Murray placed a call to Applied Pharmacy to order IV formulations of both lorazepam and midazolam--before Michael apparently ever consented for Murray to provide him with any intravenous medications. This is a very troubling situation.

We still do not know why Murray began ordering propofol on April 6th--a month before negations began for Murray to be Michael's doctor. Murray then ordered IV benzodiazepines April 28th--medications he would be more familiar with than propofol (and, overall are safer and can actually promote sleep though they still should not have been used for insomnia). We all now know about the taped conversation that took place on the morning of May 10th where it seems Michael may have been under the influence of midazolam and/or lorazepam. Two days later, Murray ordered flumazenil which reverses the sedative effects of benzodiazepines. Given his large quantity ordered, one has to wonder if Murray did not decide to sedate Michael with these benzos for "sleep" and then, in turn, to wake him up, use flumazenil to awake him and get his day started. Here is some information about flumazenil:

Adverse Reactions
>10%: Gastrointestinal: Vomiting, nausea
1% to 10%:
Cardiovascular: Vasodilation (1% to 3%), palpitation
Central nervous system: Dizziness (10%), agitation (3% to 9%), emotional lability (1% to 3%), fatigue (1% to 3%), headache (1% to 3%)
Gastrointestinal: Xerostomia
Local: Pain at injection site (3% to 9%)
Neuromuscular & skeletal: Tremor, weakness, paresthesia (1% to 3%)
Ocular: Abnormal vision, blurred vision (3% to 9%)
Respiratory: Dyspnea, hyperventilation (3% to 9%)
Miscellaneous: Diaphoresis (sweating)
<1%: Abnormal hearing, altered blood pressure increased/decreased, confusion, sensation of coldness, bradycardia, chest pain, generalized seizure, hiccups, hypertension, junctional tachycardia, shivering, somnolence, tachycardia, thick tongue, ventricular tachycardia, withdrawal syndrome
Postmarketing and/or case reports: Fear, panic attacks

Maybe this new regimen is what introduced the Valium to be taken daily (though it was not). Let's also not forget the ephedrine (from the ephedrine/caffeine capsules Murray asked for for himself) found in Michael's body which would have likely caused--you guessed it--insomnia.

An interesting note here is even though the reversal of sedation may sounds a bit traumatic, it does NOT reverse amnesia. From the same source above, "Amnesia: Does not consistently reverse amnesia; patient may not recall verbal instructions after procedure." In this case, Michael would likely have problems recalling his emergence from sedation each morning...

If Michael had been receiving propofol only, as in, a drip or even multiple boluses during the night, and survived by some miracle of God, he would have woken up with no hangover or ill-effect. However, he would have that "hangover" effect from benzos and be would likely need some recovery time whether reversed off the benzos or not. If any doctor were to cause withdrawal symptoms (which I do not think were present, somehow), it would have been Conrad Murray.

I cannot help but recall the marked improvement in Michael on June 23rd and 24th--this seems to indicate to me that it had something to do with Murray and his "treatment". If whatever he did then worked for Michael (Michael supposedly slept fine on the 23rd with lorazepam and/or midazolam only), then why did that suddenly not work on the 24th/morning of the 25th? Michael had energy on the 23rd and 24th, he was feeling good, he was nothing like he was a days prior when Ortega states Michael was "out of it" and cold. Murray had to have changed something and knows what he changed, and it seems he changed things for the better--what happened that made him change things so drastically on June 25th? I do not think he gave him more medications on the 23rd--so why did he literally pump Michael with medications less than 24 hours later?

I recall that Murray took a book to read while he was supposedly monitoring Michael (reading a book while serving as personal monitoring equipment would not be adequate). The book was a study guide to receiving his board certification in cardiology. I found this a bit odd given Murray was giving up his cardiologist practices to be with Michael for 1, maybe 3 years. Though he should not have been reading any books while sedating Michael, I think the best book for him to have been reading would be a book on insomnia and/or anesthetics. Seems more appropriate, does it not?

Arnold Klein was discussed...again. Please see my previous blog again for all the dates when Michael went to visit Klein and/or his associates. I keep hearing the media say Michael was going to see Klein 3 and 4 times a week in June. This is not correct. Michael saw Klein 6 times during the month of June. He saw him on the 16th and 22nd of June. There is some mention of Demerol being given on the 16th by the defense and this somehow had a part in Michael's death. One shot of Demerol on June 16th would in no way have an effect in any form and certainly no effect concerning his death on June 25th. Michael saw Klein on the 22nd but it seems that this date did not cause any problems for the 23rd or 24th.

I will say it again that Michael did not have any traceable opioids in his body when he died (Demerol, oxycodone, hydrocodone, Percocet, morphine, Dilaudid, etc. etc.). There were none in the house. This, by all scientific means, would indicate they had no direct or indirect cause in his death.

Love him or hate him, Arnold Klein willfully turned his records over to police (Murray on the other hand had nothing to offer for 2009); he was also visited by the DEA and they found no issues, Michael-related or not. The DEA means business, too, for the record.

I know Michael Amir Williams (Michael's personal assistant) and Faheem Muhammad both said that at times Michael would appear "slow" and speak slowly after leaving Klein's office. Both also said he did not, ever, sound like the conversation played during opening statements. I know some (Dr. Sanjay Gupta) have remarked that those who receive botox and fillers do not have to receive pain or anxiety medications. I am not a dermatologist--neither is Gupta. I know when people go to the dentist, some may be treated for anxiety and others may not for the same procedures. Numerous doctors have stated that Michael was needle-phobic, including Klein and Mark Lester. I cannot help but think that some sort of sedation would be required for someone who may not be calm or still during a process which requires needles being injected into the face and/or scalp. This is something I wish someone like Klein could elaborate on more. Also, as far as I know, no patients have died while under Arnold Klein's care.

I will post this one again, too:

http://www.thegrio.com/entertainment/jackson-judge-defense-spar-over-witnesses-in-case.php

"Flanagan said one defense expert is likely to claim Jackson was addicted to Demerol and was suffering from withdrawal when he died.

Brazil said there was no evidence of that, and Pastor questioned how an expert could come to that conclusion without making any notes."

I was shocked today that the prosecution did not really allow Williams to elaborate more on why he chose to lie to Murray when Murray asked to go back to the house to pick up some creams that "Michael did not want the world to know about". Well, for starters, now that Michael was deceased, Michael was not here to care anymore about creams and what not. It was made clear in the January hearing that Williams lied to Murray about police taking the keys because he did not trust Murray and felt the situation was odd. Recall from Cooper's testimony in January that if Murray wished to resume care of Michael (this is after EMTs were given approval to pronounce him dead at the home) Murray HAD to accompany Michael to the nearest hospital--he could not stay behind at the house. Even after he attempted to get back to the house for "creams" he made the comment that he needed to get something to eat--I believe food would be the last thing on my mind after someone had just died, and died on my time. This sounds like another way of Murray trying to retrieve his supplies but regardless, the mention of food after Michael's death was not only appalling but disgusting, whether he was really hungry or not. We know Murray went back to Houston, the same town he had called two workers to remove items from a storage shed. Take your pick on what they removed since the two cannot agree on what was taken. Seems the police were looking for medications, but if any had been there, it was too late. They did find, at his office, 27 tablets of phentermine (a weight loss drug) and a tablet of clonazepam (another benzodiazepine). I cannot imagine Murray using all those propofol vials and would think they had to had been stored somewhere, obviously other than Michael's home or even Nicole Alvarez's apartment.

One point that is continuously hit home is that Murray failed to call 911. He calls Williams and tells him to call him back right away and in closing has the time to tell him "thank you". Murray had at least 2 cell phones with him, but again, no call to 911. Williams calls him back and Murray says he has had a "bad reaction". Murray tells EMTs Michael is "fine" and apparently he was "just talking to him" (wrong, he was talking to others on the phone and Michael supposedly died...instantly...remember?). We also recall the cardiologist from UCLA stating Murray "witnessed the patient arrest"--but wait!? Chernoff said Michael died...instantly.

For starters, if Michael died instantly, where are his fingerprints syringes and bottles? They were not on the syringe by the table. Neither were Murray's but he should have had on gloves. How did Michael end up in the supine position in the bed if he died...instantly? How did he get up and move about with an IV pole on the other side of his bed and with a condom catheter on (and a full, distended bladder)? Why were his limbs blue, as was reported earlier by EMTs (which likely means there was low blood pressure some time before cardiac arrest)? Why would Michael mix lidocaine and propofol together in a syringe to drink it? Would he actually drink it from a syringe? What kind of timeframe did Michael supposedly pull this off? Where did those tablets in the stomach supposedly go? Wow, there are so many inconsistencies I could just keep on going but I am already getting a headache so I will stop on this topic.

Whatever Murray did that morning was obviously very different than before, because this time, Michael died. He had survived whatever had happened before, without any use of any equipment, not even so much as blood pressure monitoring. Whatever Murray may have done may not have been safe, but something must have dramatically changed for Michael to go from vibrant and alive to dead just hours later.

To close this blog out, I wanted to go back and mention Kenny Ortega's email to Randy Phillips (recall his name being said over and over by Chernoff?). I believe most people know who Randy Phillips is (CEO of AEG Live) and know he is certainly a shady figure in this scheme of things-as in, Michael's death. Instead of becoming concerned, Phillips apparently tells Murray what Ortega has said regarding his concerns about Michael's mental and physical health (and the possible cancellation of the tour). I would have thought that Phillips may have wondered about Murray's "care", if there was by chance something about his care that was causing Michael health problems. Instead, this meeting is called and Ortega is told to back off--it was the complete opposite of what should have occurred. Why did Phillips apparently "side up" with Murray in regard to Michael feeling unwell and possibly being ill? If I were Phillips, I would have been thinking of having Murray's services terminated and having Michael choose a new doctor. It still makes no sense to me whatsoever that people who, by all means, witnessed Michael's health deteriorating from excellent to dead did not do anything to stop the deterioration but rather paved the way for it--those people being Conrad Murray, Randy Phillips and possibly others. It is not that these people did not see it or were in denial--they saw it and refused to do anything about it and refused to let others intervene--with one of them, Murray, actually causing the deterioration first-hand. Instead of getting rid of Murray, it was Klein who was subjected to being banished though he had no ties to AEG whatsoever and Michael was about to stop seeing him anyway as he was about to depart to London in days and had not even been seeing him that often anymore. If AEG and/or Murray could tell Michael not to see Klein anymore, they certainly had enough control to tell Murray to take a hike. It also seems odd that the role of "personal assistant" seemed to shift from Williams to Murray, with Murray now scheduling things for Michael (per Gongaware). This just makes no sense--well, no sense in court but it seems to make sense to those who have investigated Michael's death for two years and will continue to investigate to search for the truth.