When Michael Jackson, a pop icon and musical genius, was found dead at his home in Los Angeles in 2009, the world was left stunned. How could this man, someone who seemed invincible; a man who managed to connect with millions of people across the globe with his dance moves, his timeless music, and his thoughtful lyrics, die so tragically and under mysterious circumstances, at the ripe old age of 50?
The public demanded answers.
At the forefront of the investigation was his personal physician, a Cardiologist named Conrad Murray, and his choice to use Propofol, a potent sedative and hypnotic agent, to help Michael Jackson sleep at night. But what many people even within the medical field fail to understand, is that Propofol does not make you go “to sleep”. It induces general anesthesia; a state where no matter how hard you try to awaken the person, you would not be able to do so by simply nudging them or shaking them. Dr. Murray failed to understand this because the use of Propofol was out of the scope of his practice. Additionally, Mr. Jackson’s home was certainly not the place to administer it.
Propofol is widely used in outpatient surgical centers and hospitals around the world by Anesthesiologists and mid-level practitioners trained in Anesthesia on a daily basis. It is used only in those environments because the person administering Propofol must be trained in airway management due to the drug’s ability to impair respiratory drive.
According to the medication insert of Propofol from AstraZeneca,
“As with any other general anesthetic agent, propofol should be administered only where appropriately trained staff and facilities for monitoring are available, as well as proper airway management, a supply of supplemental oxygen, artificial ventilation and cardiovascular resuscitation.”
In other words, placed in the wrong hands, this medication can be deadly.
The trial of Dr. Conrad Murray received extensive coverage by the international media for Michael Jackson’s death, and as a result, many patients are asking questions about Propofol and how it is used for their surgeries. Some of them call it, “Jackson Juice,” an increasingly common, yet unnerving nickname for it.
I use Propofol daily in my clinical practice as an Anesthesiologist. Understandably, individuals concerned about its use for surgery ask me about it, and I don’t shy away from explaining how I use it for cases ranging from moderate sedation to general anesthesia. Many people feel anxiety and uncertainty about how anesthesia will make them feel, primarily because of fear of the unknown. They often ask, “How will I wake up?” “Will I know when its done?” “Does it hurt?” Others simply say, “Give me the good stuff, doc.”
In fact, I savor the opportunity to explain my use of it within the context of their anesthetic and how it will be utilized as part of my plan. This is more important today with increased patient awareness of complex medical information found readily via the Internet.
Interestingly, what I have found brings solace to my patients is the fact that someone trained to use Propofol and manage its effects on the body will be with them throughout the entirety of the procedure, managing their anesthetic and adjusting the vital signs as necessary. For some reason, a lot of people have in their minds that the Anesthesiologist simply turns on a switch, leaves the room, and then leaves the patient unattended. This is utterly a false, dangerous, and misinformed notion.
A concerted effort must be in place to educate the public about Anesthesiologists and their role in surgical procedures. This responsibility lies primarily at the hands of the practitioners. With increased awareness and honest dialogue, we can eradicate the divide that often fosters distrust between physicians and their patients.
It does not take long to establish good rapport between physician and patient. So long as an open dialogue exists between both parties and trust lies at the forefront of the relationship, patients will be more satisfied with their care.
This vital understanding will be key in preventing future catastrophes such as in the case of the “King of Pop”, Mr. Michael Jackson.