By The Last Tear (Lou)
If I had an hour to solve a problem I’d spend 55 minutes thinking
about the problem and 5 minutes thinking about solutions
Soon the AEG Live trial will be over. There is no doubt that during the trial we have learned new facts. These facts have and will help us to understand Michael Jackson’s life especially during the days before his death.
Nevertheless, there are still several questions and ambiguities about Jackson’s passing which make us to believe that we have a long way to go before finding the whole truth. Undoubtedly, some facts have been kept away from the public eye; and not knowing all the elements of the events makes us incapable to understand what really happened to the star.
We can of course speculate or follow our guts and say this and that. We can also check if science has any tool to offer. And by that I mean the problem solving approaches.
The science of problem solving has become a powerful but also a useful knowledge; sometimes it is like a weapon and sometimes like a gadget. Regardless the name, you are better off if you are able to use it. In fact, the young children learn the art of solving problems in their schools. There are many scenarios and several games with cool design that make the problem solving a highly intellectual and funny activity.
But to solve a problem, we need to take some steps:
First we have to recognize the problem. The next step is to describe the problem in every possible way and from every point of view. This part is “the 55 minutes” mentioned by Albert Einstein.
And then “the 5 minutes” step comes which consists of finding some solutions or some scenarios that will help us to solve the problem. If we are lucky, we can even evaluate the solutions or the scenarios.
Let us see if we manage to study the unfinished business of Jackson’s death in a new light, in “Albert’s” light!
The problem: The death of Michael Jackson; the big question is: how did he die?
We know that Jackson was at least the victim of manslaughter. This blog will not question all the truth and the facts that the manslaughter case, Conrad Murray’s trial, brought into the light. The work done by the district attorneys, David Walgren and Deborah Brazil was astounding and gave us several leads.
The reason that the DA’s office charged Conrad Murray with manslaughter and not with the first degree murder, was the lack of strong evidence which could increase Murray’s chance to win the case and to go free; it was better to send him to the jail for manslaughter than to see him to be free. And we agree with this. However, the facts brought up during the AEG Live trial imply to review everything one more time. This blog is a first attempt toward this goal and it needs to be reviewed and completed several times later.
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Let us brainstorm a while and see what will happen!
One thing that echoed in my head was Kenny Ortega’s testimony at AEG Live trial and what he said about the June 23th and 24th. He said that on these two days, a strong and relaxed Michael Jackson came back to the rehearsals at Staples Center. Ortega was so amazed that he could not believe it! The Michael that he saw in these 2 days had nothing to do with the one he saw on June 19th. Ortega thought that a miracle had happened.
Karin Faye and Travis Payne acknowledged almost Ortega’s statements about June 23th and 24th and the miraculous recovery of Jackson.
Several days after Ortega, Debbie Rowe came to the stand and gave us a strong testimony. She told us about the last days in HIStory tour in Germany when Jackson was exhausted; two German doctors with full equipment came into the hotel to help the star “to sleep” by using Propofol. For the first time, Rowe and Katherine Jackson’s lawyers talked openly about how Propofol is used in other countries to treat the insomnia.
Before examining Propofol as a possible remedy for insomnia, let us focus a while about “the miracle” that happened on June 23th and 24th.
We have always assumed that Murray’s tale about Jackson’s last months and days is true. He said to LAPD that he administrated Propofol to the star for 60 nights. Let us say that “60 nights” is a lie. But why did Murray think his statement about “60 nights” would be believable? Jackson is dead, no one else has yet debunked Murray’s statement by showing solid evidence; besides, during 20 years, the tabloids and the media have written many stories about the star’s “addiction” which has helped Murray of course. The confusion is so big that a portion of his fans believes the addiction stories.
But could “the 60 nights” statement be really true? Then how can we explain the phone calls that Jackson used to make to Ortega and Phillips in the middle of the nights? Both Phillips and Ortega have talked about these calls and how Michael woke them up at 2 or 3 am and talked about the tour and about this or that idea! Should not Jackson “sleeping” at these hours according what Murray said to LAPD?
During both trials, several doctors told us that keeping the right dosage of Propofol is a difficult task and the patient who uses this anesthetic outside the hospital setting can die at any time. Our question is why Jackson did not die before June 25th? If Murray was that “clever” to keep Michael alive during 59 nights why did he kill his patient on the 60th night? People who believe the Murray’s tale about “60 nights” have to explain this conflict. During Murray’s trial, several doctors and specialists debunked any “self injection” and / or “suicide” theory and I agree with them.
What if “the miracle” that Ortega mentioned was caused by Propofol? What I am saying is that from May10 until mid June 2009, Murray administrated Propofol to Jackson once and a while and not every night as he said to the LAPD. The artiste worked hard to create the shows and then he had to rehearse as well. He was under pressure from everyone: AEG Live, some members of his family. He could not sleep enough; he was tired, lost weight and was not in a good shape. But Jackson had to “take the reins” as he said to Ortega and Phillips. On June 22 and probably 23, he could “sleep” with Propofol and “got his rest” something like what happened in Germany in 1997. Then he was back to the rehearsals as a new person.
Is there any fact which could back up this theory?
Recently, some of Jackson’s notes have been posted on the Internet. There is one that tells us that Jackson was apparently not happy with Murray; he believed that Murray needed to “practice” because he felt tired after the “procedure”. Probably, Jackson taught that Murray needed to learn how to administrate the agent like the German doctors did.
This unhappiness also means that Jackson was aware of Murray’s incapacity and insufficiency and consequently, he was watchful. Please do remember that on June 13 or 14, 2009 MJ called Dr. Klein’s office to find an anesthesiologist. Unfortunately, his attempts to hire Doctor Adams or another anesthesiologist were aborted by Murray and AEG. He was left alone with Murray!
It seems that on June 22 and 23, Jackson taught that Murray had learnt enough and was capable to give him “a deep sleep”. Please remember that Jackson did not want to get high but to sleep; he also believed that the anesthetic Propofol could cure his insomnia because it was used in Europe and other places to remedy this disorder. Besides, the anesthetic is known to be non addictive. Having experienced the addiction in 1993, Jackson avoided the risk to suffer from it again. In his eyes, Diprivan was a perfect candidate to cure his insomnia.
Jackson knew that the doctor giving Propofol has to have medical equipments to observe and possibly to resuscitate the patient. Even he did not have a deep medical knowledge, he had seen it in Germany and also in the dental practices when an anesthesiologist was present and gave him the anesthetic before the dental procedures (4 or 5 times). Before Murray, Jackson was always watched by a trained anesthesiologist who knew what to do. During the AEG Live trial we have heard them testifying about it. This is also what Jackson said to nurse Cherilyn Lee; he said “it’s safe” as long as the patient is watched. But Murray had not the right equipment for this kind of treatment. That is why we have to check one more time the material that Murray bought from Seacoast and Applied Pharmacy.
I have compiled a list where you can see that the last thing needed, the Ambu Bag, was ordered on June 1, 2009. It was probably delivered some days after that.
Jackson would not let Murray to put him under “deep sleep” in May because he did not have even a minimum of the required equipments for this treatment. If “the miracle” on June 22 and 23 was caused by Propofol, according to our theory, it seems that Jackson let Murray put him under “deep sleep” only at these nights. At that time, Jackson probably thought that Murray had “practiced” enough to not kill him. Also, at that time Murray had a minimum of “equipments” for this kind of procedures. Please look at the compiled list:
March 25, 2009:
Murray is trying to order the Safsite IV tubing that should be used in conjunction with a pump.
April 6, 2009:
Also Conrad Murray sent his first order to Applied Pharmacy:
10-100 ml bottles of propofol
25-20 ml bottles of propofol
9-1 L bags normal saline
10-30g tubes of benoquin
Out of this order he removed several bottles of propofol in his Las Vegas office and requested the rest be shipped to Santa Monica.
April 14, 2009:
April 28, 2009:
Murray sent his second order to Applied Pharmacy:
4 boxes of 10-100 ml of propofol (40 bottles in total)
1 box of 25-20 ml of propofol
1 tray of 10-10 ml vials of lorazepam
2 trays of 10-2 ml vials of midazolam
May 1, 2009:
May 12, 2009:
Murray sent his third order to Applied Pharmacy:
4 boxes of 10-100 ml of propofol
1 box of 25-20 ml of propofol
2 trays of 10-2 ml vials of midazolam
1 tray of 10-5ml vials of flumazenil
60g of 2% lidocaine cream
May 12, 2009:
May 14, 2009:
Murray sent his forth order to Applied Pharmacy:
60g of 4% lidocaine cream
1 tube of benoquin 20% in HRT base
1 tube of benoquin 20% in Lipoderm base 1 tube of benoquin 20% in APLO base
Murray discussed with Lopez the base formulation of the benoquin cream and Lopez agreed to provide 3 different samples. He said he needed stronger lidocaine cream, requested 4% and again discussed an energy formulation. He placed an order. Lopez offered to deliver to him in Santa Monica, Murray said ship it.
May 19, 2009:
June 10, 2009:
Conrad Murray sent another order to Applied Pharmacy:
1 tray of 25-30 mL lidocaine 1% vials (this is the first time lidocaine for injection was ordered–lidocaine cream would not have helped with the burning sensation from the propofol)
4 boxes of 10-100 mL of propofol 2 box of 25-20ml vials of propofol
20 tubes of 60g hydroquinone 8% cream
20 tubes of 60g benoquin 20% cream
30 capsules of the ephedrine/caffeine capsules requested by Murray for Murray
June 15, 2009:
Another order was sent from Murray to Lopez:
1 tray of 10-10 mL vials of lorazepam
2 trays of 10-2 mL vials of midazolam
12-1 L bags of normal saline
June 22, 2009:
We have shortly talked about Propofol as a possible cure for insomnia. Let me tell you that I do not have any medical competence in this matter and I believe the doctors who forbid the use of this anesthetic outside the hospitals and medical facilities. However, this is one side of the story. In our study, we have to look from every possible angle. And if we do so, we find out that in fact there are some who believe that Propofol can remedy the insomnia even during a short period of time.
A friend of mine, from a blog, sent me two links that I paste here. No writer of these articles denies the danger that Propofol can cause to the patient. It appears that the doctors and the specialists do not know exactly what Propofol does to the brain; while some say that this is a fake sleep with no REM, there are some who say that this agent stimulate the part of the brain which takes care of our sleep and actually can help some of the people who suffer from severe insomnia.
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.
Department of Neurology, Daping Hospital, Research Institute of Surgery, Third Military Medical University, Changjiang Branch Road # 10, Chongqing 400042, People’s Republic of China.
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.
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).
Clinical trial subjects receiving a two-hour infusion of propofol for five consecutive nights showed improvement in sleep onset latency (i.e., amount of time needed to fall asleep), quality of sleep, ease of waking up, and behavior after awakening. These improvements persisted for six months, suggesting that the benefits of propofol could continue long after the initial treatment. In addition, the subjects showing no response to traditional agents such as zopiclone or zolpidem before study treatment were able to effectively use them on occasion after treatment, suggesting that propofol restored the brain’s response to conventional sleep aids (Xu 2011). The study showed that using propofol for a short period of time (at the same time each night) could help reset the body’s natural circadian rhythm, providing long-term benefits for people with chronic refractory insomnia.
Life Extension is funding a propofol sleep study, but there are no sleep centers currently offering propofol, which requires strict medical vigilance and adherence to safety protocols to avoid dying of a propofol overdose as Michael Jackson did. The therapeutic use of propofol, administered under carefully controlled clinical conditions, is separate and distinct from the irresponsible use of propofol by incompetent healthcare personnel without adequate cardiopulmonary monitoring.
From what we read above, I would write this recap:
Mid April 2009, when Jackson found out that Cherilyn Lee and Doctor Metzger could not help him with his insomnia, he was left alone with Conrad Murray. And Murray was ready with the medications he had already bought (his first order to Apply Pharmacy was sent on April 6, 2009) to do whatever he had to do keep his wealthy client.
Due to Murray’s incompetence in administrating Propofol and the lake of the minimum required equipments which would allow a somewhat “safe” treatment by Propofol, “the 60 nights” statement made by Murray to LAPD is very questionable.
Before Murray, Michael Jackson had been treated by competent medical personnel; he knew the anesthetic was dangerous; he also knew what was required to assure patient safety. The fact that Jackson’s health deteriorated especially in June was because of the work pressure, the conflicts with AEG and other people around him, the lack of the sleep and the inadequate medical care given to him by Murray.
About Propofol as an agent for sleep, it appears that the doctors and the specialists do not have the whole knowledge about this anesthetic. And even if they have it, they do not agree with each other. These issues do not help laypersons like me and most of us to see further than what has been said. But from the Chinese study mentioned above, we should remember that Propofol has helped some people with severe insomnia when no other medication could help them. Perhaps Jackson also was like one of these patients who got help from Propofol. Hopefully, in the future scientists will do more research about this agent and will answer all the questions. Unfortunately, during the AEG Live trial we could not hear the details of the treatment that the German doctors gave to Jackson in 97 to cure his insomnia. It was the AEG’s lawyers who objected a deeper talk about this matter and the judge agreed with them. However, this is one of the things that we have to dig up after this trial.
Something that we have to keep in our mind is that Jackson never sought Propofol (nor other medications) for pleasure. He wanted to sleep during the shows and the tour. As Doctor Metzger said in his testimony, in his ordinary life, Jackson could sleep with a simple Tylenol mp. Doctor Metzger also added that when Jackson created music and shows, his sleep was deteriorated completely.
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Doctor Finkelstein and Doctor Metzger testimonies revealed that Paul Gongaware knew about Jackson’s struggle with insomnia. In 93, Finkelstein and Gongaware had long conversations about Jackson and how he became addicted to pain killers. Later during HIStory, Doctor Metzger who followed the star to supervise his health had also some talks with Gongaware about Jackson’s insomnia and how it should be treated to not cause harm to the artist. Certainly, Jackson did not want to experience again the nightmare he suffered from in 93. The two German doctors who came with all their equipments to the hotel and treated Jackson’s insomnia with Diprivan was a common knowledge of the crew and even for Gongaware.
Paul Gongaware did not need to use his knowledge about Jackson’s medical condition in 97 but he certainly did in 2008-09 when he discussed tour plans with Jackson as AEG Live’s agent. Surely, he shared his past experiences in Dangerous and HIStory with Randy Phillips. It was clear for Gongaware and AEG that Jackson needed a doctor to take care of his insomnia. Gongaware hoped to have Dr. Finkelstein in London because AEG wished a total control over Jackson. But Jackson who wanted to avoid “93” wished to have a doctor not connected to the promoter, AEG Live.
Nevertheless, Murray was hired by AEG (Murray’s contract was not signed by Jackson nor AEG) and Jackson’s attempts to find a competent doctor who could accompany Murray was sabotaged by Murray and AEG. In June 09, Phillips got closer to Murray and established a relationship with him. Please read Prince Jackson and several other experts who testified during the AEG trial. All of them talked about the close relation between Phillips and Murray. Indeed, if I was a concert promoter who had invested 40 million $$$ on an artist and wanted back my money plus 10 times more, I would want to know every detail of the artist’s life especially someone like Jackson who suffered from insomnia during tours. I would want to know what the doctor does to keep my artist on his feet and ready to perform! As we know, the details of this relationship had been kept from the public!
What about June 25, 2009? Let us say that Murray’s statements to LAPD were all lies. What do we know for sure about this day?
We know that on June 24, 2009, Jackson went home in good spirit. He had done two successful rehearsals on June 23 and 24 and people were hopeful again. It seemed to the artist and his crew that TII was possible. Ortega, Dileo, Turkle and Branca were all there and this team reminded Jackson his glorious years in the 80’s and the 90’s. There is a conflict between the Jackson who left the Staples Center in a positive spirit with the one who Murray described to the police.
We also know that on June 25, Murray left his patient to make many many phone calls and to send messages from his two telephones. Several of these calls were not urgent and could have done later. Murray acted like he wanted to look busy. Why? Did Murray leave the room to let somebody else to come in? If this is the case, this person must have been known to the security! What did this person do to Jackson? If there was not a third person in the room, did Murray leave his patient to die? Or hoped that he would stay alive but go into deep coma?
The next thing that we know for sure is that Murray came downstairs talking to Kai Chase and asking for Prince Jackson. Murray did not say: Call 911!
And we know about Murray’s “CPR”, on the bed and with one hand; the Ambu bag was on the floor. In fact, during the AEG trial some experts told us that Jackson could be saved if Murray had turned him on one side and opened his mouth.
Murray never said even once: Call 911!
On June 25, 2009, after the press conference at UCLA hospital, Conrad Murray disappeared; his car (actually it was his sister’s car) was still at Carolwood and some bags containing medical supplies were inside a closet next to Jackson’s bedroom. The police searched for him but he did not call back. He reappeared on June 27 and went to the police with his lawyer.
Did Murray disappear on June 25, 2009 because he was panicked? Or did he want to draw all the attention to himself? In this case, for whom did he cover?
On June 27, 2009 during his chat with the police, did Murray intentionally draw the detectives’ attention to the closet and the bags which did not contain the IV tube but other medical supplies enough for a manslaughter case?
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Is our “55 minutes thinking” over? Is the job done? I doubt about it. We need to dig deeper and to come back with more facts. Only then we can write our scenarios.