CELEBRITIES AND THEIR DOCTORS – FIRST DO NO HARM

Maxim W. Furek, MA, CADC, ICADC

CELEBRITIES AND THEIR DOCTORS - FIRST DO NO HARM

Celebrities and their doctors … drug dealers emanate from every stratum of society. They can be politicians, leaders of drug cartels, or respectable physicians. And while not every highly publicized celebrity death is a back-door drug deal, they often are the result of legitimate medical treatments. The phrase “first do no harm” represents the essence of the Hippocratic oath, translated as, “I will…abstain from whatever is deleterious and mischievous. I will give no deadly medicine to anyone if asked…”

Numerous examples can be cited of the relationship of celebrities and their doctors. Tom Petty, Prince and Elvis Presley died of legally prescribed narcotic painkillers, while the deaths of Michael Jackson and Anna Nicole Smith were suspect. The following cases represent the deadly patient-doctor relationship that are the sad domain of tabloid newspapers and Hollywood exposes.

Elvis Presley

Dr. George Nichopoulos, Elvis Presley’s personal physician, was in the ambulance with Elvis on August 16, 1977, the day Presley died.  Dr. Nick, in 1977 alone, prescribed 10,000 doses of amphetamines, barbiturates, narcotics, tranquilizers, sleeping pills, laxatives, and hormones to his patient.

Even though a jury trial exonerated Dr. Nick of criminal liability, he was still disciplined by the Tennessee State Board of Medical Examiners and temporarily lost his license. Laboratory studies of Presley’s autopsy found 11 drugs present at the time of his death, all “consistent with medical treatment.” The medical examiner ruled that Elvis died of cardiac arrhythmia and not drugs.

Following a twenty-year court battle, Dr. Nick’s license was revoked. The King and Dr. Nick: What Really Happened to Elvis and Me? was published in 2010, 15 years after Dr. Nick had been barred from practicing medicine and 33 years after Presley’s death. Dr. Nick said that Elvis was adept at “doctor shopping” and that he didn’t know about all of the other drugs that the star was taking. He emphasized, “I don’t regret any of the medications I gave him. They were necessities.” Dr. Nick said that he treated Elvis primarily for arthritis, an impacted colon, and insomnia, but was unaware of him taking any other prescribed medications.

Prince

Legendary musician Prince was 57 when he died of an accidental fentanyl overdose at his Paisley Park studio, on April 21, 2016. The artist suffered from chronic pain, and took excessive amounts of fentanyl, 50 times more powerful than heroin, to deal with it.

A detailed toxicology report  revealed “exceedingly high” amounts of fentanyl. The amount found in his body was absolutely deadly. Prince had 67.8 micrograms of fentanyl per liter of blood in his body; many deaths have occurred at just three micrograms per liter of blood. His liver contained 450 micrograms of fentanyl per kilogram, well over the level of what would be considered cause for “fatal toxicity,” which includes any amount of fentanyl over 69 micrograms per kilogram.

There were other drugs as well. Dr. Michael Schulenberg treated Prince, but prescribed oxycodone in the name of bodyguard Kirk Johnson, days before Prince died, knowing the drug would go to Prince.

The Minnesota Board of Medical Practice reprimanded Schulenberg and ordered him to pay a civil penalty of $4,648. Prince’s family members filed a wrongful death lawsuit against the Minnesota doctor, Walgreens, which filled prescriptions for Prince, and Trinity Medical Center that treated him for the opioid overdose. Schulenberg disputed that allegation, although he paid $30,000 to settle a federal civil violation alleging the drug was prescribed illegally.

Tom Petty

Musician Tom Petty died of an accidental drug overdose. The singer was prescribed pain medications, including Fentanyl, oxycodone and generic Xanax. He was also taking generic Restoril, a sleep aid, and generic Celexa, for depression. Petty lived and died in pain. He suffered from a broken hip and yet continued to honor 53 concert dates “keeping his commitment to his fans.” Petty had just completed a successful 40th Anniversary Tour.

His level of pain was described as “unbearable.” The cause of death was “multisystem organ failure due to resuscitated cardiopulmonary arrest due to mixed drug toxicity” and the manner of death was “accident,” the medical examiner’s news release said. Petty also suffered from coronary artery atherosclerosis, emphysema, and knee problems. He died on October 2, 2017 at the age of 66.

In all of the references used to research this article, and unlike the other celebrities, there have been no mentions of Petty’s physician or medical staff.

Anna Nicole Smith

Anna Nicole Smith, 39, died in a Florida hotel room. Her personal psychiatrist, Dr. Khristine Eroshevotz, was also there on that tragic day when the TV reality star overdosed.

Because traditional sleep medications such as Ambien were ineffective, Eroshevich had prescribed Smith the sedative chloral hydrate. The combination of chloral hydrate and four prescription benzodiazepines, usually prescribed for anxiety, depression and insomnia, were found in her bloodstream: Klonopin (Clonazepam), Ativan (Lorazepam), Serax (Oxazepam), and Valium (Diazepam). In addition, Smith had taken Benadryl (Diphenhydramine) and Topamax (Toprimate), an anticonvulsant GABA agonist.

All of those drugs likely contributed to the tranquilizer effects of the chloral hydrate-benzodiazepine combination, causing Smith’s death on February 8, 2007.

According to the medical examiner, Eroshevich had written eleven prescriptions, later called “pharmaceutical suicide” by a pharmacist who refused to fill one of Eroshevotz’s prescription orders. Smith’s former boyfriend Howard K. Stern and physicians Eroshevotz and Sandeep Kapoor were charged with “illegal conspiracy to prescribe, administer and dispense controlled substances to an addict.”

Eroshevich’s license was suspended for 90 days and she was placed on five years of probation by the state licensing agency for wrongly prescribing opiates and other misconduct. As part of her Medical Board discipline, she had to undergo a psychiatric evaluation and take an ethics course. A jury acquitted Stern and Eroshevich on most of the 11 charges involving drug prescriptions given to the former Playboy Playmate.

Michael Jackson

The death of Michael Jackson, 50, was ruled a “homicide” by the Los Angeles County coroner. Jackson died of an overdose of propofol, a powerful sedative used to induce sleep. Jackson’s personal physician, Dr. Conrad Murray, a Houston cardiologist, administered the propofol prior to the singer’s death on June 25, 2009. Murray had been treating Jackson for insomnia for six weeks and gave Jackson 50 mg of propofol diluted with the anesthetic lidocaine every night.

Propofol (Diprivan) is an extremely dangerous drug used as a general anesthetic and administered intravenously in operating rooms. It works as a depressant on the CNS, but once the infusion is stopped, the patient wakes up almost immediately.

Murray was not the only physician to treat the troubled rock star. Another five doctors and a nurse practitioner are believed to have also attended to Jackson’s medical needs. “Detectives … believe that the miscellaneous prescriptions, from multiple doctors … could have contributed to his death,” the official affidavit stated. It added that “it cannot be determined whether the cause of death is due to the actions of a single night and/or a single doctor, or the grossly negligent treatment of several doctors over an extended period of time.”

After a sensational trial, Murray was convicted of involuntary manslaughter. He was sentenced to four years in jail, but only served two. Evidence presented to the jury painted Murray as an individual more concerned about himself, and his image, than as Michael Jackson’s caregiver. Even as Jackson stopped breathing and suffered cardiac arrest, Murray chatted on his phone and sent and received e-mail and text messages. Murray also lied to paramedics and emergency doctors and delayed calling for help.

We have heard these tragic stories for far too long of celebrities and their doctors. Like a series of old television reruns, this saga continues through each decade, as we witness the deaths of our beloved celebrities, some with physicians at their side, silently passing away. Perhaps we need to be reminded of the Hippocratic oath, and that our primary concern is of the patient’s safety and well-being. First do no harm.

Maxim W. Furek has a rich background that includes aspects of psychology, addictions, mental health and music journalism. His book The Death Proclamation of Generation X: A Self-Fulfilling Prophesy of Goth, Grunge and Heroin explores the dark marriage between grunge music and the beginning of the opioid crisis. jungle@epix.net