When Doctors Kill: Who, Why, and How
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The group started out working in Gary but then began to tour the Midwest, often opening stripteases and other adult acts in a string of black nightclubs known as the
“chitlin circuit.” Joe was constantly “motivating” the children to perform their best.
In 1968, Berry Gordy, the founder of the legendary Motown recording company, signed them to a contract which lasted until 1975. After that, the Jackson 5 then contracted with CBS records and changed their name back to The Jacksons. They soon embarked on a blazing trail of shows with Michael Jackson serving as their lead song writer and singer. Their appeal crossed over many racial barriers –
Michael was a star, but not yet a superstar.
In 1978 Jackson dabbled in the movies, playing the Scarecrow in The Wiz, an African American version of The Wizard of Oz. Michael’s close relationship with Diana Ross, who played Dorothy, lasted up until his death. In many ways she served as a big sister/mother to him, especially in the more troubled moments of his life – eventually, he even began to physically resemble her. Although his performance in The Wiz was cute, he was to attain immortality through singing and dancing rather than acting.
Jackson’s first solo album, Off the Wall in 1979, eventually sold more than 20
million copies worldwide. It was a synthesis of funk songs, disco, soul, soft rock, jazz and pop. And it was very danceable (or so I am told by those who can dance).
The “King of Pop” earned his crown in 1982 with Thriller, the most commercially successful album of all time with well over a 100 million copies sold. The hit MTV
music video was an ingeniously choreographed horror/pop/mini-movie with Michael morphing from an innocent, young man into a monster, leading a cast of zombies through a mesmerizing, ritualistic dance. Even if you weren’t a Jackson fan at the time (trust me, I know because I wasn’t one) when you saw the video you had to acknowledge his genius. Within a few short years, the planet was filled with Jackson wannabes, emulating his every robotic movement and signature Moonwalk (a dance move based on one of Marcel Marceau’s mime routines).
For the next two decades, Jackson became one of the most recognized figures in the world. He amassed hundred of millions of dollars in profits and, although he was a profligate spender, he also was a benevolent philanthropist, raising and donating many millions of dollars to charitable organizations. He also became increasingly weird, both in appearance and behavior. By the present decade, he had earned the sobriquet “Wacko Jacko.”
Let’s begin by analyzing his increasingly alien appearance. During a 1993 television interview with Oprah Winfrey he admitted that he had taken skin bleaching medications because he had been diagnosed with vitiligo in 1986, a disorder 220
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associated with the presence of irregular, patchy, whitish discolorations of the skin caused by a loss of melanin (the normal skin pigment). He had two treatment options, one which would darken the pale areas and the other that would lighten the surrounding skin. Jackson chose the latter alternative, and ended up with a pale, ghostly and ghastly appearance. This choice led some to accuse Michael of trying to become more “white”, in a sense disavowing his black heritage. Then there were the surgeries. A lot of them.
In 1979, Jackson had his first facial surgery after breaking his nose during a complex dance routine. However, the surgery was not a complete success, with lingering breathing difficulties leading to a second rhinoplasty (“nose job”) in 1980. In 1984
Michael had his nose slightly narrowed and his eyebrows arched. Over the next decade permanent eyeliner was tattooed around his eyes and he underwent additional plastic surgery procedures on his nose, cheeks, lips and chin. His last plastic surgery was done by a German surgeon who took cartilage from Michael’s ear to repair his nose, which had been damaged by the prior surgeries. In the end, Jackson was transformed from a handsome, African American man into a sexually ambiguous, sort-of-white, sort-of-person. Dr. Deepak Chopra, a friend of Jackson’s for 20 years, said: “What became his compulsion with cosmetic surgery was an expression of self-mutilation, a total lack of respect for himself.” Other medical professionals believe that Jackson also had “body dysmorphic disorder,” a psychological condition which would cause him to never be satisfied by his own appearance and have no concept of how he is perceived by others.
Despite their beauty and many gifts, many celebrities are afflicted with this mental condition. As a matter of fact, so are many everyday folks who believe that they are too fat, too thin, too short, or too tall despite looking just fine.
In addition to mental anguish, Jackson was not a stranger to physical pain or to pain medications. In 1984 he was filming a Pepsi commercial when a pyrotechnic explosion resulted in a shower of sparks landing on Michael’s head, setting his hair on fire and causing severe scalp burns. The injuries left him in severe pain requiring treatment with pain medicine and laser therapy. During the 1990s, Jackson became increasingly dependent on prescription drugs, mainly painkillers and strong sedatives, and his health deteriorated dramatically. In 1993, with the help of Elizabeth Taylor and Elton John, Michael entered a rehabilitation clinic but his addiction persisted. And there were doctors willing to provide the King of Pop everything he needed to keep going.
Jackson’s emotional pain probably ran deeper than his physical discomfort.
Michael was obsessed with clinging to childhood, likely due to the loss of his own youth which was sacrificed for the good of the Jacksons. This manifested itself by surrounding himself with young children, his love of children’s games and his habit of speaking in a soft falsetto voice like a child. Michael himself explained that this behavior was prompted by a deep sense of loneliness and deeply rooted feelings that he had been robbed of his childhood and that he was trying (in vain) to recapture it. Jackson’s obsession with youth and children eventually lead to a great deal of trouble for the singer.
In 1988, Jackson purchased land near Santa Inez, California where he built his Neverland Ranch. His guests were almost exclusively young children, including Moonwalk
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many who were disabled. Unfortunately, this benign attachment to children extended to sleeping with them in the same bed, which is considered unusual for a man in his 30’s. In the summer of 1993, Jackson was accused of child sexual abuse by a 13 year-old boy named Jordan Chandler and his father, a dentist. The young boy told a psychiatrist and later police that he and Jackson had engaged in acts of kissing, masturbation and oral sex. The case was eventually settled out of court, allegedly at a cost of about 22 million dollars. Jackson was never charged, and the state closed its criminal investigation, citing lack of evidence.
Two short-lived marriages followed in short succession; many believed these were only efforts at shoring up Michael’s public image. The first marriage in May 1994 to Lisa Marie Presley, the daughter of Elvis’ Presley, ended in divorce in January 1996. The second marriage in late 1996 to his dermatologist’s nurse, Debbie Rowe, ended 3 years later. This marriage resulted in two children, Paris Katherine and Prince Michael I. Jackson’s third child, Prince Michael Jackson II (nicknamed “Blanket”) was born in 2002. In November of that year, Jackson brought his newborn son onto the balcony of his room at the Hotel Adlon in Berlin, as fans stood below. Jackson briefly extended the baby over the railing of the balcony, four stories above ground level, holding him only by his little arm.
This thoughtless and immature act (though innocent in Michael’s mind) triggered allegations of child endangerment. Jackson later apologized for the incident, calling it “a terrible mistake.” He is lucky he didn’t dangle a puppy instead – PETA would have been all over him.
Jackson’s reputation took another hit in 2003 when he was charged with moles-tation of a minor, four counts of intoxicating a minor, one count of abduction, and one count of conspiring to hold a boy and his family captive at Neverland Ranch.
Jackson denied all counts and asserted that he himself was the victim of a f
ailed extortion attempt. On June 13, 2005, the jury found Jackson not guilty on all charges. The physical and emotional stress associated with exhausting, relentless tours as well as his growing personal problems took their toll, resulting in depression and severe insomnia. He was a classic case of SIDDA. He was also in constant physical pain from years of dancing.
In the waning years of the first decade of this century, Jackson had become a living legend. In fact, in some ways his professional career had died several years before and only the walking freakshow remained. But Michael was ready to change all of that. In July 2009, Jackson was booked to perform a series of major comeback concerts in London entitled This Is It, which he suggested was going to be his “final curtain call.” Although initially planned for 10 dates, it was increased to 50 concerts after record-breaking ticket sales to more than a million people. However, the shows had to be cancelled because of Michael’s unfortunate and premature biological curtain call, at age 50, on June 25, 2009. That was it.
By most accounts, at least one doctor allegedly contributed to Michael Jackson’s demise. On the day of his death, Los Angeles Fire Department paramedics responded to a 911 call from the home he was renting at about noon. The unidentified caller stated that Michael Jackson was not breathing and unresponsive with resuscitation being performed by his doctor (ineffectively on a bed, it turns out). When they 222
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arrived, within no more than 2 minutes, they were met by Dr. Conrad Murray who identified himself as being Michael Jackson’s personal physician. The paramedics placed Jackson on the floor and performed CPR and then took Jackson to UCLA Medical Center, about a 6-minute drive from his home. By the time they arrived at the hospital Jackson was in full cardiac arrest. Dr Murray declined to sign the death certificate and left the hospital shortly after accompanying Jackson to the facility.
The hospital notified the Los Angeles County Coroner of the death and they accepted jurisdiction of the body and planned an autopsy. Meanwhile, the Los Angeles Police Department’s (LAPD) Homicide Division started an investigation into the circumstances surrounding the fatality. The next day the forensic pathologists of the Coroner’s Office conducted a 3 hour autopsy on the body of Michael Joseph Jackson. Initially, the cause and manner of death were left “pending” citing that the “anatomical findings showed no evidence of trauma to the body or evidence of foul play” and that toxicological and tissue studies were required before the case could be finalized. The LAPD conducted an in-depth investigation, interviewing dozens of individuals, including Jackson’s multiple doctors and serving many search warrants both locally and out-of-state. The LAPD also had the assistance of federal, state and local agencies including the United States Department of Justice, Drug Enforcement Administration (DEA), California Department of Justice, Bureau of Narcotics Enforcement (BNE), the Houston Police Department and the Las Vegas Metropolitan Police Department. Within days of the death, Michael’s father Joseph was alleging “foul play” while family friends and lawyers were working the talk show circuits and spewing out “drug overdose.” One of Michael’s closest friends (it is amazing how many “closest friends” a celebrity has after they have died) said he had even warned the family that Michael was going to end up like Anna Nicole Smith. He was right.
The depth and breadth of the LAPD’s and Coroner’s investigations are not unusual given the high-profile nature of this case. Imaginative plots and wild scenarios pop up frequently after the death of a superstar and many avenues of inquiry must be traveled prior to dismissing them. Both the quality of the police investigation and the thoroughness of the autopsy will be painstakingly scrutinized and often unfairly criticized by the public media.
The investigational fog started to dissipate with the August 2009 unsealing of a batch of documents in Houston, specifically police affidavits that had been submitted in order to permit review of medical records and facilitate search and seizure of evidence from different medical offices. The investigation of treating physicians and their medical records was prompted by the fact that Dr.
Sathyavagiswaran, the Los Angeles County Chief Medical Examiner and Coroner, informed the police that Michael Jackson had lethal levels of a short acting anesthetic (propofol) in his blood. The affidavits made it clear that the goal was to secure evidence from Jackson’s other doctors that might substantiate whether Dr. Conrad Murray, Michael Jackson’s personal physician, had committed manslaughter. Under California law, manslaughter may be considered voluntary or involuntary. In the Jackson case, if any charges are filed, involuntary manslaughter appears to be more likely.
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Prior to becoming Michael’s personal physician, Dr. Murray was a cardiologist with 20 years of experience with offices in Houston and Las Vegas. In several interviews he indicated that he had been Jackson’s doctor for 6 weeks prior to his death and that he had on occasion administered a medication by the name of propofol (Diprivan) diluted with lidocaine to Michael for insomnia. Propofol is a short acting anesthetic that is used for induction of general anesthesia. It causes loss of consciousness very rapidly and it is eliminated from the body in several minutes. Because of the strength of the drug and its fast-acting nature, it is necessary to monitor the patient’s heart rate and breathing closely after its administration.
As propofol can suppress breathing to the point where a patient’s heart stops, it is almost exclusively used under the guidance of an anesthesiologist or other medical professional where resuscitation equipment is available. It is not a sleeping pill nor is it routinely used by cardiologists in the rental homes of celebrities.
Because the medication has to be given intravenously and since it is not usually available in general pharmacies or on the street, addiction to propofol is rather rare amongst the general population. Some physicians have abused it, however, for its ability to block out the world temporarily, allowing them to escape their daily stressors or the demons dwelling in their minds. The problem is that because of the short acting nature of the drug, addicts have to take the drug repeatedly at frequent intervals.
Furthermore, the drug is very dangerous because the window of safety between the therapeutic level and the toxic level is very narrow and abusers of this prescription drug may cease to breath. Michael Jackson was afflicted with severe insomnia and he turned to propofol to find a few moments of relief from life – these moments became an eternity.
Dr. Murray related that Michael was very familiar with propofol, which he called his “milk” (the propofol solution has a milky appearance). Jackson had told Murray that he had been prescribed propofol by a number of doctors in the past, including two German physicians during a recent European trip. While serving as Jackson’s personal physician, Murray also observed multiple injection marks on the hands and feet of Jackson. When he asked about them, he was told by Jackson that he had been given a “cocktail.” If the accusations being leveled at Dr. Murray are substantiated in a court of law, then he was serving as Michael’s bartender.
The most potentially damning evidence against Dr. Murray is the timeline of medications that he gave Jackson over the days leading up to the icon’s death. By his own admission, on June 22, in order to help Michael sleep, he gave him 25 mg of propofol instead of the usual 50 mg (he was beginning to think the singer was addicted to this drug!) along with lorazepam (Ativan) and midazolam (Versed). On June 23 he gave Jackson only lorazepam and midazolam without propofol and Jackson went successfully to sleep. According to Murray’s account, Jackson was again having trouble sleeping the night of June 24. Murray resisted the use of propofol, but this time Jackson wore him down. Starting in the early morning of June 25, he gave Jackson enough drugs to put a class of teenage boys on a field trip to the Playboy Mansion to sleep:
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– At 1:30 AM. he injected Jackson with 10 mg of lorazepam
– At 2:00 AM Jackson was still awake and was injected with 2 m
g of lorazepam
– At 3:00 AM Jackson was still awake and was given 2 mg of midazolam intravenously, again with no effect, and
– At 7:30 AM Jackson was still awake and Dr. Murray injected him with another 2 mg of midazolam. He also began monitor the singer’s blood oxygenation at that time, though it is unclear if Jackson was having trouble breathing Within a few hours of receiving this last sedative, Michael began to “beg” Murray repeatedly to give him “his milk.”
Sometime in the late morning on June 25, the physician finally gave in and allegedly injected his patient with 25 mg of propofol diluted with lidocaine. Jackson finally fell asleep. Murray stated that he monitored Jackson for about 10 minutes and then went to the bathroom for no more than 2 minutes. When he returned he found Jackson comatose and not breathing. Dr. Murray said that he immediately started resuscitation and after a few minutes called for assistance from a security person and Prince, Jackson’s eldest son. He continued his efforts until the paramedics arrived and the rest is history. The period during which resuscitation was given by Dr. Murray is apparently in doubt, however, because the police found that Dr.
Murray was on the telephone from 11:18 AM to 12:05 PM. It is tough to chat when you are performing CPR. Dr. Murray traveled with the patient to the hospital and told Dr. Cooper, the Emergency Room physician, that he gave Jackson only 2 mg of lorazepam during the night and an antidote; he apparently did not mention any other drugs, including propofol.
On Friday August 28, 2009, the Los Angeles County Coroner’s office officially ruled Michael Jackson’s death a homicide, stating that it was primarily caused by acute propofol intoxication. The Coroner’s report also listed benzodiazepines (sedatives including lorazepam and midazolam) as contributing to the singer’s death. “The drugs propofol and lorazepam (Ativan) were found to be the primary drugs responsible for Mr. Jackson’s death,” the news release read; other drugs detected included midazolam (Versed), diazepam (Valium), and lidocaine. The manner of death was determined to be homicide since the cause of death, an overdose, was said to have been caused by “injection by another.” Dr. Conrad Murray would have to be the “another.”