The “55 minutes thinking”- Part 2

By The Last Tear (Lou)

Do not worry about your difficulties in Mathematics.

I can assure you mine are still greater.

Albert Einstein

As we saw in the first part of this blog, on June 25, 2009, Conrad Murray spent a lot of time using his two cell phones. During Murray’s manslaughter trial, the prosecutor David Walgren showed a list over Murray’s phone calls and text messages.

Several bloggers published this list, Gatorgirl was one of them. We do not know if this list is complete; at that time, Judge Michael Pastor excluded AEG and AEG Live from People vs Conrad Murray case. If there have been calls between Murray and AEG people especially Randy Phillips, the prosecutors did not mention it. To refresh your memory, please review the summary of the calls one more time:

5:54am – AT&T iPhone email from Bob Taylor, London insurance broker, specifically enquiring about MJ’s health and requesting confirmation Murray was the only doctor who was being consulted, had records back to 2006 and requested release of those medical records

6:31am – Text

7:01am – Sprint phone call from Murray to Andrew Butler (patient/friend) in Nevada, 25 seconds.

8:36am – Text from Texas

8:49am – Sprint phone call to Murray from Antoinette Gill. (patient/friend) in Nevada; she was calling re: letter received from Murray regarding a possible replacement doctor, 53 seconds

9am – Text/Texas

9:11am – Text/Texas

9:23am – AT&T iPhone call to Murray from Marissa Boni (she says friend of Murrays daughter who acknowledges she placed calls to that number in June 2009 which she confirmed as her ”girlfriend Chanels’ number”) in Nevada, 22 minutes

10:14am – AT&T iPhone call to Murray from Acres in Houston (Murray’s Texas practice), 2 minutes

10:22am – Sprint phone call to Murray from Dr. Joanne Prashad in Houston regarding a patient and medications, said Murray had excellent recollection of his patients procedure and medications, she was impressed with his memory and recall, 111seconds

10:34am – Sprint phone call from Murray to Stacey Ruggles-Howe (Murray’s personal assistant) in San Diego, allegedly to discuss a document to be drafted to the London medical boards indicating his impending arrival and what facilities would be available to him, if needed (Murray did not and does not have a UK medical license); Ruggles confirmed Murray was directing her and requesting her to draft a letter and Dr. Murray was not distracted, 8.5 minutes

10:36am – Text/Texas

11:07am – AT&T iPhone call to Murray from Stacey Ruggles-Howe in San Diego, 1 minute

11:17am – AT&T iPhone email to Bob Taylor, London insurer, answering questions from an e-mail received earlier about MJ’s health, refuting the stories heard and saying he was denied authorization to disclose MJ’s medical records back to 2006

11:18am – AT&T iPhone call from Murray to his Las Vegas practice in Nevada, 32 minutes

11:26am – Sprint phone call to Murray from Bridgette Morgan in California, 7 seconds (not answered)

11:49am – AT&T iPhone call from Murray to Bob Russell in Nevada, left voice-mail regarding treatment update and asking him to remain his patient although he may be away overseas, 3 minutes

11:51am – AT&T iPhone call from Murray to Sade Anding in Houston, 11 minutes

12:03pm – Text/Texas

12:04pm – Text to Texas

12:12pm – AT&T iPhone call from Murray to Michael Amir Williams in California, left a voice-mail, 1 minute

12:15pm – AT&T iPphone call from Michael Amir Williams to Murray, 1 minute

12:53pm – Text/California

1:08pm – Sprint phone call from Murray to Nicole Alvarez in California, 2 minutes(while in the ambulance)

1:23pm – Text/Nevada

Now we show this data in a chart:

dia3

Please keep in your mind that on June 24th, Jackson left Staple Center in a positive spirit; he said to Randy Phillips that he (Jackson) was taking the responsibility of the shows, that he would put a door in the building that Phillips had made.

During his interview with the LAPD on June 27, 2009, Conrad Murray described his patient as “a desperate” man which did not fit with the way Jackson left the rehearsals. Murray told the police a story about what he did to Jackson and how he “treated” his only patient. All he said are probably lies. Nevertheless, let us look at his tale and then put it in a chart:

cuts1

cuts2

cuts3

cuts4

cuts5

cuts6The graph below shows Murray’s “treatments” or “interventions”:

dia4Let us now merge the two graphs:

dia1

dia2The two graphs have an intersection which is approximately at 9:30 am on June 25, 2009. On the phone calls’ list which is verified, we see that at that moment Murray was talking to Marissa Boni for 22 minutes:

9:23am – AT&T iPhone call to Murray from Marissa Boni (she says friend of Murrays daughter who acknowledges she placed calls to that number in June 2009 which she confirmed as her ”girlfriend Chanels’ number”) in Nevada, 22 minutes.

But in his interview on June 27, Murray said to the LAPD detectives that at that time, Jackson and he were talking because Michael could not sleep! Actually, Murray said to the detectives that from 7:30 am he was talking to MJ who was complaining and asking for “milk” until 10:40. Then Murray gave Jackson his famous “25 ml” Propofol injection at 10:50 am. But this is a lie because the call records show that he was all this time busy talking or texting. This means that Jackson was not awake at least between 8:30 to sometime after 10:36.

The lies:

cut 2

The truth:

8:36am – Text from Texas
8:49am – Sprint phone call to Murray from Antoinette Gill. (patient/friend) in Nevada; she was calling re: letter received from Murray regarding a possible replacement doctor, 53 seconds
9am – Text/Texas
9:11am – Text/Texas
9:23am – AT&T iPhone call to Murray from Marissa Boni (she says friend of Murrays daughter who acknowledges she placed calls to that number in June 2009 which she confirmed as her ”girlfriend Chanels’ number”) in Nevada, 22 minutes
10:14am – AT&T iPhone call to Murray from Acres in Houston (Murray’s Texas practice), 2 minutes
10:22am – Sprint phone call to Murray from Dr. Joanne Prashad in Houston regarding a patient and medications, said Murray had excellent recollection of his patients procedure and medications, she was impressed with his memory and recall, 111seconds
10:34am – Sprint phone call from Murray to Stacey Ruggles-Howe (Murray’s personal assistant) in San Diego, allegedly to discuss a document to be drafted to the London medical boards indicating his impending arrival and what facilities would be available to him, if needed (Murray did not and does not have a UK medical license); Ruggles confirmed Murray was directing her and requesting her to draft a letter and Dr. Murray was not distracted, 8.5 minutes
10:36am – Text/Texas.

There is another question: did Murray himself not sleep that night? It is hard to believe that he did not sleep at all. He was using his two phones actively after 5:45 and even in the ambulance which took Jackson’s body to the hospital; the only time Murray had the possibility to sleep was between 2:00 am on June 25 and sometime before 5:54 when he received an email from Bob Taylor. In fact, Jackson came home around 1:00; he took a shower and was ready to go to bed around 1:30.

An observation: Since Michael wanted to “sleep” 8 to 9 hours he must have “slept” between 2:00 and 2:30 am. As Randy Phillips said in his testimony at Murray’s trial, he was supposed to pick up Jackson at Carolwood on June 25th, and bring the star to Staples Center. Jackson was supposed to “wake up” around 11 am on June 25th.

Conclusion

The biggest part of what Conrad Murray said to LAPD on June 27, 2009 – if not all of it – was lies! We believe that we demonstrated that Jackson was not awake at least between 8:30 am and sometime after 10:36 am on June 25, 2009 therefore the patient did not have the reason to complain and ask for Propofol at 10.40 as Murray said to the detectives. This also means that the propofol which killed Michael was probably injected to him before 8.30 am on June 25, 2009.

At 12:26 pm, paramedics were in Michael’s room and they began to revive him. As paramedic Richard Senneff testified in both Murray and AEG Live trials, Jackson had died long before they came: “When I first moved the patient, his skin was very cool to the touch, his eyes were open, they were dry and his pupils were dilated,” Senneff said. “When I hooked up the EKG machine, it was flatlined.” (from Senneff’s testimony at Murray’s trial).

As we know Murray did everything possible to prevent the paramedics to declare Jackson dead at Carolwood – he said that he felt a pulse in Jackson’s body and asked the paramedics to continue to revive the patient. The paramedics had to follow his “instructions” because he was “the doctor” in the room and was in charge. Unfortunately, Murray managed to sabotage the calculation of algor mortis. There are several mathematical formulas which calculate the approximate time of death with the help of body temperature but we have to have the postmortem rectal temperature. Senneff did probably not measure it because of Murray forcing him to revive Jackson. Later in his testimonies, Senneff said that Jackson was at least dead around 11:26, one hour before they came in. Can we estimate the at most time of death?  Since we came to the conclusion that the propofol which killed Michael was injected to him before 8:30 am, Jackson could have died sometime after that, at anytime between 8:30 and 11:26.

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To understand Jackson’s death, we have to know more about Propofol and how it was and is used in medicine. In the first part of this blog, we read about a medical study done in China:

http://www.ncbi.nlm.nih.gov/pubmed/21107748

Cell Biochem Biophys. 2011 Jul;60(3):161-6. doi: 10.1007/s12013-010-9135-7.

Propofol-induced sleep: efficacy and safety in patients with refractory chronic primary insomnia.

Xu ZJiang XLi WGao DLi XLiu J.

Source

Department of Neurology, Daping Hospital, Research Institute of Surgery, Third Military Medical University, Changjiang Branch Road # 10, Chongqing 400042, People’s Republic of China.

Abstract

Insomnia, defined as difficulty in falling asleep and/or staying asleep, short sleep duration, or poor quality sleep, is a common sleep disorder affecting 30-40% of adult population. We have conducted a randomized, double-blind, placebo-controlled study to test if anesthesia is therapeutically beneficial in patients with refractory chronic primary insomnia. We have assessed the efficacy and safety of propofol-induced sleep in these patients. This study comprised of 103 patients with refractory chronic primary insomnia (including 59 non-pregnant, non-lactating women; 28-60 years) and the participants were randomized to receive either physiological saline (placebo) (n = 39) or 3.0 g/l propofol (n = 64) in a 2-h continuous intravenous infusion for five consecutive nights. The Leeds Sleep Evaluation Questionnaire was used for the subjective assessment of sleep, and polysomnography was used for the objective measurement of sleep architecture and patterns. The assessments were done prior to and at the end of the 5-day treatment and 6 months after treatment period. The adverse effects of the treatment were also recorded. A 2-h continuous intravenous infusion of 3.0 g/l propofol for five consecutive nights improved the subjective and objective assessments of sleep in 64 patients with refractory chronic primary insomnia. This improvement occurred immediately after the therapy and persisted for 6 months. No serious adverse events were noticed during the period of drug administration or 6 months after the treatment. Propofol therapy is an efficacious and safe choice for restoring normal sleep in patients with refractory chronic primary insomnia.

There is another article that we saw in the first part:    

http://www.lef.org/protocols/lifestyle_longevity/insomnia_06.htm#about-menu

Novel Use of an Anesthetic to Reset Sleep Rhythms

Propofol is a rapid, short acting anesthetic that is often administered intravenously for the induction and maintenance of anesthesia.

Electroencephalography (or EEG, a technique that measures the brain’s electrical activity) confirms that there are distinct differences between sleep and sedation. Anesthetic agents (e.g., propofol) can induce activity in areas of the brain important for regulating sleep, particularly in people with insomnia (Xu 2011) []. Please read the rest of the article here http://www.lef.org/protocols/lifestyle_longevity/insomnia_06.htm#about-menu

Recently, I saw another study published in The Journal of Neuroscience, September 12, 2012. This study is done in Germany. It has a more difficult vocabulary but we understand that the result of this one confirms what has been said in the two articles above.

The researchers doing the study have used 11 healthy persons (all males, all ages); with the help of functional MRI, the doctors have investigated different parts of these people’s brains when they were awake and when they were under Propofol. The results show that the brain, especially the parts of brain that regulate sleep, have less activity under anesthesia and consequently have some “rest” during it. Even if this “rest” is not exactly like the natural sleep, it “mirrors” the NREM and has more local effects than global. More research is needed of course:  

12832 • The Journal of Neuroscience, September 12, 2012 • 32(37):12832–12840

Behavioral/Systems/Cognitive

Spatiotemporal Reconfiguration of Large-Scale Brain Functional Networks during Propofol-Induced Loss of Consciousness

Manuel S. Schröter,1,2,3 Victor I. Spoormaker,1 Anna Schorer,2 Afra Wohlschla¨ger,4 Michael Czisch,1 Eberhard F. Kochs,3 Claus Zimmer,4 Bernhard Hemmer,2 Gerhard Schneider,3,5* Denis Jordan,3* and Ru¨diger Ilg2*

1Max Planck Institute of Psychiatry, 80804 Munich, Germany, 2Department of Neurology, 3Department of Anesthesiology, and 4Department of Neuroradiology, Klinikum rechts der Isar, Technische Universität München, 81675 Munich, Germany, and 5Department of Anesthesiology, Witten/Herdecke University, HELIOS Clinic Wuppertal, 42283 Wuppertal, Germany

Applying graph theoretical analysis of spontaneous BOLD fluctuations in functional magnetic resonance imaging (fMRI), we investigated whole-brain functional connectivity of 11 healthy volunteers during wakefulness and propofol-induced loss of consciousness (PI-LOC).After extraction of regional fMRI time series from 110 cortical and subcortical regions, we applied a maximum overlap discrete wavelet transformation and investigated changes in the brain’s intrinsic spatiotemporal organization. During PI-LOC, we observed a breakdown of subcortico-cortical and corticocortical connectivity. Decrease of connectivity was pronounced in thalamocortical connections, whereas no changes were found for connectivity within primary sensory cortices. Graph theoretical analyses revealed significant changes in the degree distribution and local organization metrics of brain functional networks during PI-LOC: compared with a random network, normalized clustering was significantly increased, as was small-worldness. Furthermore we observed a profound decline in long-range connections and a reduction in whole-brain spatiotemporal integration, supporting a topological reconfiguration during PI-LOC. Our findings shed light on the functional significance of intrinsic brain activity as measured by spontaneous BOLD signal fluctuations and help to understand propofol-induced loss of consciousness [].

On page 37, we read:

Effects of PI-LOC on topology of brain functional graphs (Last Tear: PI-LOC means propofol-induced loss of consciousness) [] Our data also suggests that anesthetics particularly affect functional connectivity hubs, as found during normal wakefulness (Tomasi and Volkow, 2011), showing a decreased incidence of high-degree nodes and a significant reduction in connectivity strength for structures such as thalamus and multimodal association cortices during PI-LOC. These findings were also accompanied by altered whole-brain integration, that is, a higher spatiotemporal decomposition of the functional network. Similar results have been reported by high-density EEG studies during deep NREM sleep (Massimini et al., 2005) and midazolaminduced sedation (Ferrarelli et al., 2010) [].

Conclusion

Our findings emphasize the significance of brain functional networks as measured by spontaneous BOLD fluctuations during resting fMRI. They support the notion that PI-LOC may be associated with a disintegration of the spatiotemporal architecture of brain activity. Results indicate that PI-LOC is associated with decreased subcortico-cortical connectivity and a breakdown of connectivity within higher-order association cortices and between higher-order association and primary sensory cortices. Mirroring observations during deep NREM sleep, topological results indicate that intrinsic activity during PI-LOC is more locally segregated and less globally integrated.

Let us go back to the AEG trial and Debbie Rowe’s testimony; in the first part of this blog, we mentioned Rowe who said that Jackson’s insomnia was treated with Propofol by two German doctors in Munich in 1997. 

Doctor Metzger who arranged this treatment in Germany, testified on September 18, 2013 and recognized a letter sent to him on July 13, 1997 by Doctor Christian H. Stoll:

“Dear Mr. Metzger, following please find the laboratory data from Mr. Omar Arnold dating” (sic) “July 5th, 1997. There were some heavy discussions about continuing medical assistance of Mr. Arnold. Finally, after your talk to Professor Peter, the head of our department and of the medical facility of the Ludwig Maximilians University, we decided me continuing in joining Mr. Arnold during his European tour. I think it would be useful to keep in contact with you to discuss medical questions. Secondly, I would appreciate to learn about the medical history of Mr. Arnold []”.

The medical facility connected to the Ludwig Maximilians University is called Klinikum Großhadern. This medical and research center collaborates with another one called Klinikum Rechts der Isar. Both clinics were and are reputable and respected centers. The study and the treatment of sleep disorders is one of the specialties in these two medical facilities. The specialists in these clinics collaborate with other European and American medical centers.

We have not found the exact treatment that Jackson received from the doctors in Munich in 1997 – probably Katherine Jackson’s lawyers have the details about this treatment; and they wanted to show it to the jury but AEG lawyers disagreed and the judge approved their objection. Nevertheless, we can conclude that in 1997, Jackson’s insomnia was professionally handled by specialists. As usual the tabloids and other media try to manipulate the facts and give a dark and almost criminal image of this treatment in Munich.

Referring again to doctor Metzger’s testimony during the AEG Live trial, Michael suffered from insomnia only when he was on tour and when he had to work hard. That is why Jackson asked Dr. Metzger in April 2009 to help him even during TII – like he did during HIStory. Metzger promised Jackson to find professional help in London. Unfortunately, he could not help this time; unknowingly, Metzger left Michael alone with his problem. But Murray was there, waiting.

Please remember that Jackson wanted a team of two doctors to take care of his health. He wanted to hire an anesthetist but Murray sabotaged his plan. Ten days before his death, Jackson called Klein’s office and asked for an anesthetist.  

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Since the jury in Katherine Jackson vs AEG Live has declared that AEG Live hired Conrad Murray, we need to review again the relationship between Murray and AEG Live people especially with Randy Phillips. Hopefully another blog will come up in a few weeks. And after that MJ-EO series will continue.

This entry was posted in Michael's Passing and tagged , , , , , , , , . Bookmark the permalink.

4 Responses to The “55 minutes thinking”- Part 2

  1. Fabulous! Posting part 2 on sidebar of my blog. Much love.

  2. nasa100 says:

    No matter how many years it has been, MJ’s death is still so shocking and so hard to get over. Thanks for the analysis.

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