I have been following this hearing from beginning and have read almost all of your posts. I commented a little, but I just feel that I could perhaps help a little bit more. English is not my language, so I apologise in advance if there is something unclear.
I am an anaesthesiologist and have been working as one for the last 11 years. Propofol is one of the medications that I can call an essential tool in my everyday practice. It is hypnotic and sedation agent used for induction and maintenance of anaesthesia, sedation during operations under regional anaesthesia, sedation on ITU. Used for induction, is given as a bolus. For a person whose weight is around 60 kg, young and pretty fit and well usually is given 120 – 150 mg, sometimes more or less. We are all different, so we follow the patient’s response and inject according to that. If the goal is anaesthesia, patients usually stop breathing. We take over the breathing and to maintain the airway and breathing we use Laryngeal mask, or we intubate (there are indications when we usually intubate or when we prefer Laryngeal mask, but I will not get into it as it is irrelevant). You can maintain airway and give artificial breathing even with only a mask connected to the anaesthetic machine or an AMBU bag for very short procedures (5-10 mins, e.g. manual non operative reposition of broken bones, electro conversion of hearth rhythm disturbances…
, To maintain anaesthesia we use either gas or Propofol infusion that is delivered by specially designed pump. It takes into account patients age and weight. To intubate, you usually need between 3 and 4 mcg/ml (plasma concentration) Propofol. After intubation you decrease Propofol to 2.5-3 mcg /ml, and often its concentration is even less than that because we use other medications that help maintain anaesthesia and analgesia (strong painkillers, muscle relaxants…
and we monitor the depth of anaesthesia with BIS (bispectral monitoring using electrodes that measure brain electrical activity).
If used for sedation plasma concentrations can be anywhere between 0.5 to 1.5 mcg /ml.
In order to use propofol even in the hospital, you need a monitored area, dvs operation theatre, procedure rooms, Intensive care unit, emergency room… Even in hospital you do not use propofol without proper monitoring. The minimum being pulse oxymetry, ECG, blood pressure, and you supply additional oxygen. You need resscucitation equipment at hand, to secure airway and breathing, you need medications to support the circulation, because propofol depresses not only breathing, but heart contractility as well and causes vasodilatation and drop in blood pressure. You need to have people who know how to use this equipment and the drugs. We monitor our patients continuously, no breaks, and leaving them for a second.
To use Propofol in someone’s home is a crime itself. Even if the patient did not die, to deliver such a powerful drug in such an unprofessional way is wrongdoing and crime. To make the patient believe it is safe is a crime as well. I mean, they can beg as much as you want YOU DO NOT GETTING IT FROM ME!!!! That is what would have been right.
To give it without proper equipment and resuscitation drugs is equal to driving a car on the open motorway in the opposite direction. The accident is going to happen for sure, we just do not know when and where exactly.
Murray said that MJ was breathing and he went to the toilet for 2 minutes, and when he got back he was dead. You do not die if you have not been breathing in 2 minutes. If you were getting oxygen your pulse oxymetry may not even change after 2 minutes. But even if you were not getting oxygen you do not die after 2 minutes. The only thing you have to do is open up the mouth, lift the jaw and if this does not help give rescue breaths with an AMBU bag (as I realise, there was an ambu bag and a mask in MJs room). You ventilate him until he starts breathing on his own. It is as simple as that if you know what you are doing. You do not need chest compressions with respiratory arrest, if the patient has pulse, and you do not lose your pulse after 2 minutes of not breathing.
Murray was either so stupid that he did not know how to use his AMBU or he panicked so lost precious time panicking. Or what is in my opinion more likely, he left the room much earlier, not checking on MJ, and when he found him he had been dead already.
Another thing, I am not toxicologist or pharmaceutical expert, but you do not get so high propofol concentrations in your blood after only 25mg.
Even if MJ injected himself, that should not help Murray. It is not about who injected, it is about unsafe and criminal medical practice that led to a person’s death. So self injection should not let Murray go free. He is still responsible in delivering the drug in an unsecure way.
Being anMJs fan for such a long time, I have been thinking so much about hm and the way he ended his life. He was an intelligent man. How did he let this happen? Did he really need to do This is it? Was he really so desperate to get some money? Or did he have another reason to do it?
He himself stated on so many occasions that he hated touring. He said that he would get sick, dehydrated, exhausted. I do not understand his thinking. Why was he so desperate that he let those people controlling his life?
He had 3 children, 3 wonderful reasons to live. How did he allow those horrible nights, oxygen cylinders, needles, infusions, drugs and those horrible sessions taking place under the same roof where his children slept?
I am asking this as a parent. I know most of you are very young and do not have your children. But being a parent changes the perspective of your life. I know that he was a great father, his wonderful kids are showing that to us. That is why I am puzzled about how on earth he allowed himself to end his life in such a horrible manner.
The doctor is responsible; there is no question at all about that. He should lose his licence to practice permanently and he should end up in jail.
But MJ has its own responsibility. Unfortunately he was punished for that in the most horrible way.
I love him so much, and will be his fan for the rest of my life. Still I had to say what I think. He, no matter how desperate he was, should not let this freak of a doctor and other leeches aroud him destroy his life.
