Doctor let pop icon's life slip away
A few years ago, I got to watch a fresh crop of medical school graduates from the University
of Iowa take the Hippocratic Oath.
It was surprisingly moving hearing that old but updated pledge to avoid both "overtreatment
and therapeutic nihilism" mouthed by a group of optimistic new doctors.
It was a reminder of the immense power doctors have: the power to heal and the power
to harm.
Even if you followed the trial of Conrad Murray, the doctor hired by pop icon Michael Jackson
to cater to his pharmaceutical wishes, it still was shocking Monday to hear the obvious
conclusion -- that Murray had committed felony involuntary manslaughter.
It was shocking that an unscrupulous, money-hungry medical professional would surrender
the profession's rules and protocols to give a patient who could afford to hire him privately
whatever he wanted -- even if it defied medical wisdom.
It was shocking that someone with Jackson's fame and following could be left so vulnerable
putting his life in trusted medical hands.
It's a story full of paradoxes. Few of us could afford to hire a private-duty doctor and pay him
$150,000 per month to stay over at least six nights a week and give us powerful sleeping drugs.
Jackson, for his vast fame and fortune, in the end had no one looking out for him, to assess
the bizarre set up and intervene. You've heard those clichés about "lonely at the top,"
but it might be true that those of us with less means who are more dependent on interactions
with our communities have more protection.
Murray had given Jackson propofol, the powerful IV sedative used for anesthesia during surgery,
every night for two months before his death. He told investigators that Jackson routinely
pleaded for more.
That, in conjunction with two other drugs in his system, were what the coroner said killed
the singer in June 2009.
Jurors didn't buy Murray's claim that Jackson had administered the fatal dose to himself
when Murray was out of the room. In any case, doctors testified such a drug never should
be administered outside a hospital. Murray also used it without the proper heart- and
respiratory-monitoring equipment and kept no records. Worst of all, he waited more than
20 minutes to call an ambulance after Jackson had stopped breathing. And then he didn't
tell the paramedics about the propofol. Evidently, he spent some of Jackson's final moments
trying to stuff away drug evidence.
In fact, in the final hours of Jackson's life, when he should have been closely monitoring
his patient, Murray was talking to four current or past girlfriends on the phone. At one level,
it's so hard to identify with the self-absorbed cast of characters and their entitled lifestyles
that the whole trial could leave you cold. But at the same time, it shows how any of us under stress
can be vulnerable to unscrupulous practitioners. Especially as the boundaries of science
have been pushed into new territories for life-creating and extending, or ending,
medical ethics are more important than ever.
"There is art to medicine as well as science, and that warmth, sympathy and understanding may
outweigh the surgeon's knife or the chemist's drug," said the modern-day Hippocratic Oath.
A good doctor, like the old Marcus Welby of TV fame, would have helped a patient like Jackson
find peace of mind in other ways. Although Welby has been replaced in modern television culture
by the arrogant and obnoxious but brilliant Gregory House, the goal is still to cure patients
by getting to the root causes of their symptoms.
Instead, we have "doctor shopping," where patients go from one doctor to another until they
find one to prescribe drugs to feed their addictions. Now, we have a cardiologist who couldn't
or wouldn't say no to overdosing a patient, not because he wanted him dead but out of basic
indifference.
The judge jailed Murray until sentencing Nov. 29, calling him a risk to public safety.
The case is a reminder of how much we still and always will depend on a social contract,
that network of ethical relationships, laws and understandings essential to protect a society
and its members. Murray held Jackson's life in his hands. He let it go.
One can only hope any other doctor similarly tempted down that road of ego trip and
financial bonanza will think long and hard next time.