Even with the verdict reconciled and hype already turning down regarding the death of Michael Jackson due to Dr. Conrad Murray’s trial, it is apparent that prescriptive drug abuse is quite prevalent in the world of medicine. In this insightful article, we have connected with Dr. Alex Lee whom practices in Las Vegas in the area of anesthesiology (the study and practice of physical insensibility in medicine), to give us the inside scoop on Dr. Conrad Murray’s pursuit of an “opportunity of a lifetime.”

Before we get into the meat of the situation, Dr. Lee, can you tell us a bit about your background and what you do?

I’m a 34 year old 4th generation Chinese American born in San Francisco and raised in San Leandro.  My great Grandfather immigrated to the United States in the 1890s.  I graduated from San Leandro High School in 1994, and from Cal Berkeley in 1997.  I taught Biology at John F. Kennedy High from 1997 to 2000, then did medical school at UC San Francisco.  My wife and I finished residency in Anesthesia at UC Davis in 2008.  I am currently the CEO of Zen Anesthesia LLC, which is a small, four physician group in Las Vegas.

Sunrise Hospital, Las Vegas NV

 

I am not surprised at the Murray conviction.  He practiced at Sunrise Hospital (Las Vegas, NV), which is one of the hospitals where I work frequently.  Although I never had the opportunity to meet him personally, I know many physicians and nurses who knew him personally.  His general reputation was that he was an extremely nice man, just not particularly smart or honest.  One physician told me, “It was his specialty to stent (open up) normal arteries (blood vessels)…But he was one hell of a nice, soft spoken guy”  A nurse told me that he told staff that he was going to put his practice on hold, “to pursue the opportunity of a lifetime.”  I did not verify this, but I was told he was the best man in Hakeem Olajuwon’s wedding

Regardless of his reputation, the case was quite straight forward.


Above is an video of an anesthetic induction.

Have you worked with the prescription that Dr. Conrad Murray signed off to Michael Jackson? If so, tell us a bit about the consequences.

First, some background.

Propofol is a very powerful, although short acting IV anesthetic that is used daily by Anesthesiologists and occasionally Intensive Care physicians around the world.  It’s primary action is to render a patient unconscious to facilitate surgery.  As a side effect, it decreases blood pressure, heart rate and causes breathing to slow or stop.  It has the side effect of causing a feeling of restfulness after the patient has awakened.  Patients often tell me that they feel as if they woke from a 2 hour nap even if they have only been unconscious for a few minutes.  Overdose leads to low blood pressure and cessation (a temporary or complete stopping) of breathing.  Blood pressure is managed by giving additional fluids or drugs. Addressing the respiratory issues requires various maneuvers including lifting the chin,  using a resuscitation (to revive, especially from apparent death or from unconsciousness) bag to force oxygen into the lungs or placing a breathing tube down the vocal cords.

Nobody should receive or administer general anesthesia outside of a hospital or surgery center.  I have never heard of an exception to this rule. Regardless of the unfortunate outcome, this would be reason enough to strip Dr. Murray of his license.

Dr. Murray was simply out of his field.  As I mentioned earlier, with few exceptions, only Intensive Care Unit (ICU) physicians and Anesthesiologists are comfortable with this powerful drug, or with airway management in general.  As I am not qualified to do cardiac procedures on patients, he was not qualified to perform anesthesia.

Finally, it would appear that Dr. Murray did not have proper equipment to monitor or resuscitate Michael Jackson.  Simple equipment such as a pulse oximeter (as cheap as $22 from Amazon.com) would warn a health care provider if a patient’s oxygen level dropped.  Airway equipment that could be used to more rapidly secure the patient’s away was also not present.

My speculation on the events of the day was that Michael Jackson’s physician simply wasn’t paying attention.  The propofol was dripping into him, and he already had a long list of powerful narcotics and sedatives in him.  There is synergistic effect between all these drugs, and Michael Jackson simply stopped breathing.  This would be easily addressed by someone who was watching him closely and was experienced with airway issues, but Dr. Murray’s inattention, lack of monitoring equipment and lack of experience in airway situations probably sealed Micheal’s fate.

By Derick Lee | Jackfroot.com | derick@jackfroot.com
With Dr. Alex Lee | Zen Anesthesia LLC | alexlee.md@gmail.com
Respects to Dr. Currie Lee | Oakland Raiders Team Anesthesiologist

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