Anesthesia represents: The Conrad Murray case

[Pooh & Annie]

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It sounds like for the most part everyone agrees at this point. Michael Jackson needed to get over his medication addictions and work on his general health before starting any experimental treatments. I think that's an appropriate conclusion, and I would hope that our other medical colleagues understand that as a specialty well-educated on the pharmacology and CNS effects of medicines like propofol, we would not currently endorse its use as a treatment for sleep-deprivation.

My guess is that we also mostly agree that some clinicians should continue to advance the specialty, following the footsteps of brilliant and innovative meticulous researchers/educators like Beir, Boyle, and Miller; some clinicians should stick to intubating and extubating.

 

[Gern Blansten]

The first spinal anesthetic. The untold story:


August Bier (following a cocaine binge): Hey! I wonder what would happen if we shot cocaine into our CSF.
August Hildebrandt: Dude!! That sounds awesome! Let's do it!
August Bier: Party on!!
August Hildebrandt: Excellent!!

 

[pgg]

i left it ambiguous for a reason

Well that's the problem when you're more schtick than substance.

I can only speak for myself, but I don't believe for a second that you were being deliberately amgibuous. You simply didn't expect to be challenged.


On the off chance that you really are sincere about being deliberately ambiguous, then perhaps we need a Jet corollary to Poe's Law.

Without a winking smiley or other blatant display of humor, it is impossible to create a parody of Fundamentalism that SOMEONE won't mistake for the real thing.

Without a winking smiley or other blatant display of humor, it is impossible to create a parody of outrageous anesthesia practice that SOMEONE won't mistake for the real thing.

Anyway - one more question, then I'll leave you alone.

What are you really here for, Jet?

Did you return to the forum to be worshipped and adored and unquestioningly admired no matter what you say, however controversial or outrageous or simply wrong - or do you want to engage in honest discussions and have your positions and beliefs challenged?

 

[pgg]

The first spinal anesthetic. The untold story:

excellent

Except this was self-experimentation, cocaine wasn't recognized as a drug with abuse potential in 1885, and there was no patient with a medical problem who was being denied treatment so they could profit.

 

[Gern Blansten]

excellent

Except this was self-experimentation, cocaine wasn't recognized as a drug with abuse potential in 1885, and there was no patient with a medical problem who was being denied treatment so they could profit.

Agree completely. Just saw Dr Bier referenced and wanted to pass along my theory of how it really went down.

 

[jetproppilot]

Well that's the problem when you're more schtick than substance.

I can only speak for myself, but I don't believe for a second that you were being deliberately amgibuous. You simply didn't expect to be challenged.


On the off chance that you really are sincere about being deliberately ambiguous, then perhaps we need a Jet corollary to Poe's Law.







Anyway - one more question, then I'll leave you alone.

What are you really here for, Jet?

Did you return to the forum to be worshipped and adored and unquestioningly admired no matter what you say, however controversial or outrageous or simply wrong - or do you want to engage in honest discussions and have your positions and beliefs challenged?

You've obviously got some personal beef with me man.

That's ok

This is a public forum,

YEARD' Me?


I can come and go as I please last time I checked.

If you wanna mentally masturbate about why I'm here,

well,

THAT'S YOUR GIG MAN.

If you don't like what I post,

I don't give a s h I t.

 

[Pooh & Annie]

It's not personal, because I know I agree with pgg, and I'm sure others do too (even if they don't want to admit it). If someone makes a clinical judgement that provides a good educational point for any of us, we should acknowledge it. Most importantly I think, we should point out potential mistakes if we don't want up-and-coming or practicing physicians to make those same mistakes in judgement.

It IS a public forum, and everyone should feel free to post as they'd like. I doubt that pgg disagrees.

 

[Trisomy13]

What are you really here for, Jet?

Did you return to the forum to be worshipped and adored and unquestioningly admired no matter what you say, however controversial or outrageous or simply wrong - or do you want to engage in honest discussions and have your positions and beliefs challenged?

I wonder about this too at times. Nothing personal, of course, because I don't know the entity known as Jet in person. But the tired routine more often than not makes me roll my eyes and skip to the next post. It's a pity considering the depth of knowledge and experience behind the shtick.

And with that, back to lurking!

 

[jetproppilot]

I wonder about this too at times. Nothing personal, of course, because I don't know the entity known as Jet in person. But the tired routine more often than not makes me roll my eyes and skip to the next post. It's a pity considering the depth of knowledge and experience behind the shtick.

And with that, back to lurking!

You need to watch the

Honey Badger video

for my response.

 

[Trisomy13]

You need to watch the

Honey Badger video

for my response.

I found this in Urban Dictionary, but I'm going to assume you mean something else, because I know you are well-versed in college football 😉

11. honey badger 7 up, 39 down
In the parlance of trendy gay men, a honey badger is an overbearing, very hairy gay male. A "honey badger" is most often seen talking far too close to his friends and gentlemen callers and exhibits extreme chest/arm/back hair in public.

 

[jetproppilot]

I found this in Urban Dictionary, but I'm going to assume you mean something else, because I know you are well-versed in college football 😉

11. honey badger 7 up, 39 down
In the parlance of trendy gay men, a honey badger is an overbearing, very hairy gay male. A "honey badger" is most often seen talking far too close to his friends and gentlemen callers and exhibits extreme chest/arm/back hair in public.

No man,

WRONG CONTEXT.😱

 

[Per4mer8]

I found this in Urban Dictionary, but I'm going to assume you mean something else, because I know you are well-versed in college football 😉

11. honey badger 7 up, 39 down
In the parlance of trendy gay men, a honey badger is an overbearing, very hairy gay male. A "honey badger" is most often seen talking far too close to his friends and gentlemen callers and exhibits extreme chest/arm/back hair in public.

LOL......i'm gonna guess he's referring to the Honey Badger YouTube vid, "oh whats that? A Cobra? Honeybadger don't care."

 

[WholeLottaGame7]

Definitely a reference to the YouTube vid. "Honey badger don't care." Great reference.

pgg, I'm surprised you of all people got sucked into a throwdown with jpp. You're way too rational for that kind of thing. My sense of up and down, left and right in the SDN anesthesia world is getting all out of whack...

 

[PMPMD]

Yeah go tell Tyrann Mathieu that Urban Dictionary version. Lemme know how that works out...

 

[Trisomy13]

PMPMD, is your avatar from the movie "Audition"? What a great film... rented it on a whim and turned into one of my recent favorites.

 

[PMPMD]

PMPMD, is your avatar from the movie "Audition"? What a great film... rented it on a whim and turned into one of my recent favorites.

Yes - nice pickup. I wonder how many people on SDN assume I'm an Asian girl?

 

[Gern Blansten]

I found this in Urban Dictionary, but I'm going to assume you mean something else, because I know you are well-versed in college football 😉

11. honey badger 7 up, 39 down
In the parlance of trendy gay men, a honey badger is an overbearing, very hairy gay male. A "honey badger" is most often seen talking far too close to his friends and gentlemen callers and exhibits extreme chest/arm/back hair in public.

I guess Jet needs to be a bit more careful when using the honey badger reference. I've seen the youtube honey badger but never heard this reference. I plan to keep this definition in my back pocket for the next person who describes themselves as a honey badger. Thanks for the laugh.

 

[Per4mer8]

I guess Jet needs to be a bit more careful when using the honey badger reference. I've seen the youtube honey badger but never heard this reference. I plan to keep this definition in my back pocket for the next person who describes themselves as a honey badger. Thanks for the laugh.

Careful, that sounds MUCH worse than asking if someone likes football.😀

 

[homeobox_genes]

uhhhh, he was addicted to those medications to help him sleep...does that make you feel any better? he was also getting demerol and other opiods from his doctor Arnie Klein. Why comment on the case if you don't know much about it?

@dooderino
I'm only interested in propofol and the benzos and that's what I was referring to in the post.

Interesting comment on the opioid prescribing. Was he prescribed the opioids for a legitimate reason--pain? If not, why isn't Dr Klein in jail?
From a quick news search :"Michael Jackson was dependent on regular Demerol shots in the months before his death, according to a doctor knowledgeable on the topic of addiction who testified at the manslaughter trial of the singer's physician, Dr. Conrad Murray, yesterday. Waldman stopped short of characterizing Jackson's dependency on Demerol as an addiction, and noted in cross-examination by prosecutors that he is not officially certified as an addiction specialist."

"Addiction is both a biological and psychological condition whereby a person exhibits compulsive behavior to satisfy their craving for pain medication even when there are negative consequences associated with taking the drug. An opioid-dependent pain patient has improved function with the use of the drug while an opioid-addicted patient does not."

Now, with regard to propofol and benzos, I am not sure that it is "certain" as someone claimed, that he was an addict. Are you?

 

[jetproppilot]

@dooderino
I'm only interested in propofol and the benzos and that's what I was referring to in the post.

Interesting comment on the opioid prescribing. Was he prescribed the opioids for a legitimate reason--pain? If not, why isn't Dr Klein in jail?
From a quick news search :"Michael Jackson was dependent on regular Demerol shots in the months before his death, according to a doctor knowledgeable on the topic of addiction who testified at the manslaughter trial of the singer's physician, Dr. Conrad Murray, yesterday. Waldman stopped short of characterizing Jackson's dependency on Demerol as an addiction, and noted in cross-examination by prosecutors that he is not officially certified as an addiction specialist."

"Addiction is both a biological and psychological condition whereby a person exhibits compulsive behavior to satisfy their craving for pain medication even when there are negative consequences associated with taking the drug. An opioid-dependent pain patient has improved function with the use of the drug while an opioid-addicted patient does not."

Now, with regard to propofol and benzos, I am not sure that it is "certain" as someone claimed, that he was an addict. Are you?

A substance abuse addict cannot pick and choose between substances.

They're potentially addicted to everything so they can't use anything if they wanna stay clean.

 

[doctor712]

Judge is ripping into Murray. Just declined probation and am curious to see this sentence...
My guess is 4 years. Max.

D712

Edit: no state prison.
Edit: 4 year term. Another prison system I guess.
Case closed?
Edit: county jail. Much less time due to crowding. TBD.

 

[kazuma]

I heard the judge mention that "there will be no medical experimentation." I wonder what legal precedence this sets for off label usage of drugs. Obviously CM was way out in left field and compounded everything by delaying treatment, attempting to cover up the mistakes and lying etc.

 

[doctor712]

yeah, i heard that too, kazuma. it was the only thing that i thought the judge said that could be potentially construed in a bad way. that is, OF COURSE there will always be experimentation, there's no way one judge can stiffle research and off label use. the experimentation he was referring to could be understood to that of, propofol, in a home setting, with no monitoring, for example. but, big picture, murray got the book thrown at him, and is lucky to be in CALI or he'd serve the full 4.

D712

 

[aneftp]

I felt both the verdict and now the sentence was wrong.

Can't believe the Judge gave him the max sentence. This is someone who never had a run in with the law. Judge is just trying to make a name for himself.

There have been other doctors who have been conviccted of similar crimes. (neg homicide) because of drug overdose. But those docs didn't get more than 2 years.

With the Casey Anthony 4 misdemeanor convictions. Most common people would get a max of 1 year but Judge gave her 4 years. It's like these Judges are trying to act tough crime. While repeated probation violations by Paris Hilton and Lindsay Lohan get slaps on the wrist.

 

[jwk]

I felt both the verdict and now the sentence was wrong.

Can't believe the Judge gave him the max sentence. This is someone who never had a run in with the law. Judge is just trying to make a name for himself.

There have been other doctors who have been conviccted of similar crimes. (neg homicide) because of drug overdose. But those docs didn't get more than 2 years.

With the Casey Anthony 4 misdemeanor convictions. Most common people would get a max of 1 year but Judge gave her 4 years. It's like these Judges are trying to act tough crime. While repeated probation violations by Paris Hilton and Lindsay Lohan get slaps on the wrist.

Seriously?

This is one of the few times in recent history that the jury has gotten it right on big cases. Is he being used as an example to others? I sure as hell hope so.

 

[matt30]

I felt both the verdict and now the sentence was wrong.

Can't believe the Judge gave him the max sentence. This is someone who never had a run in with the law. Judge is just trying to make a name for himself.

There have been other doctors who have been conviccted of similar crimes. (neg homicide) because of drug overdose. But those docs didn't get more than 2 years.

With the Casey Anthony 4 misdemeanor convictions. Most common people would get a max of 1 year but Judge gave her 4 years. It's like these Judges are trying to act tough crime. While repeated probation violations by Paris Hilton and Lindsay Lohan get slaps on the wrist.

Ever crime has mitigating and aggravating circumstances. Causing a drug overdose because you didn't bother to check is bad. Giving someone a lethal dose of a drug because you want money is worse.

 

[pgg]

I felt both the verdict and now the sentence was wrong.

Can't believe the Judge gave him the max sentence. This is someone who never had a run in with the law. Judge is just trying to make a name for himself.

We're talking about a guy (Murray) who was giving interviews and expressing outrage that anyone would dare suggest he did anything wrong. No remorse, not even self-awareness.

He'll be out well before the 4 is up anyway.

 

[CambieMD]

I felt both the verdict and now the sentence was wrong.

Can't believe the Judge gave him the max sentence. This is someone who never had a run in with the law. Judge is just trying to make a name for himself.

There have been other doctors who have been conviccted of similar crimes. (neg homicide) because of drug overdose. But those docs didn't get more than 2 years.

With the Casey Anthony 4 misdemeanor convictions. Most common people would get a max of 1 year but Judge gave her 4 years. It's like these Judges are trying to act tough crime. While repeated probation violations by Paris Hilton and Lindsay Lohan get slaps on the wrist.

Conrad Murray lied and attempted to hide the evidence of what went on in Michael Jacksons' bed room. He delayed calling EMS in order to cover his tracks. Conrad Murray was hoping to make enough money to pay off some of his bills and support his unsustainable life style. Conrad Murray will probably spend just 24 months incarcerated due to over crowding in the California prison system. Jacksons' kids lost their dad forever.

Physicians are held to a high standard by the public. Murray did not have any run ins with the law prior to his causing the death of MJ.That may be true but a man died and Murray pushed the drugs that killed him.

As physicians we are asked to do things that may not be in the best interest of our patients. We have to exercise good judgement and do the right thing.

When I was a PCP I found dealing with drug seekers to be difficult. They can be manipulative and over bearing. I can only imagine the tremendous pressure that MJ placed on Conrad Murray. If Murray exercised good judgement and did what was in MJs' best interest he would still be bankrupt but he would be a free man today.

Cambie