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Dr Ayan Panja

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The King of Pop, His Doctor, And Their Tragic Quest For Sleep

Posted: 08/11/11 00:00

I remember the day that Michael Jackson died vividly. For many in my generation it has become something of a JFK moment. I'll never forget where we were when we heard the news. We were on holiday with friends on a Greek island as we watched the story break on the BBC World News channel, having received a text which we thought was a joke from a friend in London. Our shock soon became sadness at the loss of someone so ludicrously talented - someone we'd grown up listening to on the radio, and done bad impressions of doing the moonwalk. I remember thinking how strange it would be that my son's generation would grow up never knowing MJ as a living person - a little bit like Elvis Presley was to me.

I wouldn't have said that I was a massive MJ fan, but as a huge music and Motown lover, I realised after his death that I had somehow managed to collect almost his entire catalogue over the last 30 years of music buying. I still have the original gatefold sleeve version of Thriller and remember catching him live in Paris on the Dangerous tour in 1992. He rocked.

As the story of his death unfolded after what seemed like weeks of global outpouring of grief, my medic friends and I became increasingly interested in the medical aspects of his care. Enter Dr Conrad Murray, a cardiologist from Las Vegas. Let me tell you that there is nothing pleasurable about watching a fellow medic being scrutinised and hauled over the coals in the media until a case has been to court, but this story was beyond unusual, making it bizarrely captivating. Even summarising it sounds ridiculous: a doctor had apparently given the King of Pop an intravenous anaesthetic in order to help him sleep of a night, after which he died.

My medical brain was curious on many levels. Pharmacologically, the whole thing was mind bending. How and why did Dr Murray end up giving MJ such powerful drugs in the first place? And if he was a cardiologist, how could he become a personal physician treating general medical conditions? And in terms of the doctor-patient relationship I wondered if the fact that Murray was hired with a huge fee in mind, pressured him into prescribing and administering drugs in a setting and for a reason where no other doctor seemingly would?

Certainly one could argue that the profit motive of private medicine could make a doctor want to give a patient what he or she wanted. And all Jackson wanted was to get a good night's sleep. Imagine it. You're the doctor responsible for the wellbeing of the most famous pop star in the world. Apparently Jackson had suffered with insomnia for years and, according to trial testimony, had asked several doctors to prescribe him propofol (an anesthetic agent which he referred to as 'milk' because of its white appearance). Murray obliged, and on the day of Jackson's death he had been given a cocktail of benzodiazepines - midazolam, lorazepam, diazepam as well as propofol.

There are so many causes for insomnia including stress, thyroid problems, depression, noise, light - in fact sleeping pills themselves can cause it. I do wonder whether Jackson had ever tried sleep hygiene, behavioural techniques, biofeedback or other measures as well as medication. What amazes me is that with all the money that Jackson had and the wealth of medical contacts Murray would have presumably had, that a sleep medicine specialist wasn't brought in to help. Had that happened maybe MJ would still be with us? Who knows. Sleep medicine as a discipline is really quite specialised, often with strict referral criteria here in the NHS, where it mainly focuses on the diagnosis and treatment of sleep apnoea and narcolepsy, but there are private clinics which deal with insomnia from other causes. Apart from the fact that this case is saddening from every angle with Murray facing up to four years in jail following the jury's verdict last night, it is a timely reminder that there isn't always a pill for every ill. Both doctors and patients ought to remember that.

As for The King of Pop, who chased sleep so much and will now sadly and ironically never wake up, he really was Gone Too Soon

This post has been modified from its original version.

 

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I remember the day that Michael Jackson died vividly. For many in my generation it has become something of a JFK moment. I'll never forget where we were when we heard the news. We were on holiday wit...
I remember the day that Michael Jackson died vividly. For many in my generation it has become something of a JFK moment. I'll never forget where we were when we heard the news. We were on holiday wit...
 
 
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Juanne Michaud
Proud Canadian, loony lefty
05:31 on 24/11/2011
I am curious and perhaps someone can answer this question. Does propofol give the patient natural sleep. By that I mean, does the person experience all stages of sleep, including REM? The reason I ask is because IIRC, people who are deprived of dreaming become quite unwell. If MJ did not have natural sleep, the lack of REM may have contributed to his poor condition.
06:44 on 13/11/2011
Right before everyone's eyes. He died because no one really cared about him as anything but a commodity and his family had given up on him or were financially dependent on him. Sadly he died alone with the best care money could buy. He died an addict, who wet his bed, lived in filth, and all alone forgotten in the next room. He died because he was compulsive, he died because his doctor wasn't. He paid for what he got. Or did he pay at all?
06:40 on 13/11/2011
What I've read is that Micheal Jackson drank excessive amounts of Pepsi and Red Bull all day and night, that he drank so much he carried around a liter bottle to urinate in rather than use a bathroom, oh what that house must have been like for the children to witness a grown man, a parent walking around with a bottle full of urine because it was just to much trouble to relieve himself behind closed doors in a rest room. No wonder he couldn't sleep, but rather than change his intake of stimulants Micheal wanted to be put to sleep. Not go to sleep but be put to sleep. Day in and day out to be rendered unconscious rather than sleep. The outcome could never be anything other than what it was, a doctor drowning in debt with more personal problems than Micheal himself it would seem with multiple families, failing practices, bad business and that was the exchange, illegal treatment for the promise of vast amounts of money that would make the good doctor financially solvent once again. No bad deed goes unpunished. The doctor should have treated his patient with a change in stimulant intake and relaxation techniques, the patient a hopeless drug addict, a long term one whose body was desinigrating right before
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Marzipan29
03:53 on 22/11/2011
The bottle you're talking about that he urinated in was for the anesthesia induced sleep. When you're under you can't control that. Otherwise he wasn't walking around with bottle of urine. I don't know where you've heard that. His bedroom was messy but to call it "filthy" is not accurate.
01:24 on 13/11/2011
Murray, apparently administered propofol to MJ for 50 days before his death. He must have known that it was very risky but the fact that he had been able to do it for such a prolonged period without adverse consequences must have inspired him with confidence that he could control the situation. And, of course, the money was really good. But Murray could not control the situation, and his reckless behaviour led to MJ's death. I have insomnia but I wouldn't take propofol to cure it and I don't know of a doctor who would administer that to me. I don't doubt that Murray didn't mean to kill MJ. But, by way of example, if I am a racing driver and I decide to drive down the motorway at 200 mph because I am confident that I can handle the situation and I will not out anyone at risk: if things go wrong and I kill someone it is never an excuse to say "it was an accident" or "I didn't mean it". If you take the risk then you live with the consequences and don't expect that it is merely an oops moment. Doctors must always put their patients first. Sadly I don't think that Murray did that. He put money first, he was MJ's employee and it ended in taking unjustified risks and death.
04:35 on 09/11/2011
Well it sure put me to sleep !
lastpost
see biography
13:33 on 08/11/2011
"interested in the medical aspects of his care."
Without a contract to spell it out, how did either of them expect to know exactly what the other expected of them?
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Marchmont
09:52 on 08/11/2011
When one considers Michael Jackson’s dysfunctional family and twilight-zone collection of friends and soul-mates, it is amazing he was survived as long as he did. First there was his violent, abusive thug of a father, a failure at everything he tried from boxing to guitar playing, who thrashed his children into the musical business. His “friends” included archetypal weirdo-luvies such as Liz Taylor and Liza Minelli and self-obsessed, manipulative celebs like Princess Diana, Madonna and Diana Ross. Then there were “civil-rights” chancers like Al Sharpton and Jesse Jackson, such outright shysters as Larry King and Mohamed Al Fayed and brazen frauds like Uri Geller. Dr Conrad Murray was unlucky to be chosen as fall-guy for this noisome pestilence.
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Marzipan29
03:56 on 22/11/2011
Those were not his friends. None of these people except Liz Taylor. Liza Minelli haven't seen him since 2001.