Propofol expert and anesthesiologist Dr. Paul White gave exhaustive testimony in a defense attempt to counter Dr. Steven Shafer's compelling propofol testimony for the prosecution. White refuted Dr. Shafer's theory of the IV setup and series of events leading to Jackson's death by stating it requires "an incredible coincidence of circumstances" involing a "befuddling" IV drip configuration that Murray likely would not have used as well as "irrational" assumption about how Murray injected sedatives along with the propofol administration. Dr. White used an inordinate amount of time to demonstrate what he thought the IV setup most likely looked like and contrasted it with Dr. Shafer's demonstration as well as commented on various charts of bioavailability of lorazepam when ingested orally, and the effects of the other drugs in question. He disputed virtually every point of Dr. Shafer's testimony save what could be the most important: if Murray had been present when Jackson went into distress, he could have intervened, most likely saving his life.
Dr. White testified he thought Jackson most likely ingested several tablets of lorazepam in the early morning hours without Murray's knowledge. White hypothesized the lorazepam on top of the propofol administration Murray had given him had a fatal effect when Jackson awoke and injected himself with another dose of propofol.
The cross examination of White will commence on Monday, October 31, 2011. Today, Judge Pastor apologized to the jury for the extended length of the trial and thanked them for their service prior to recessing. Dr. White is the last scheduled witness for the defense. If the prosecution decides not to recall Dr. Steven Shafer as a rebuttal witness to Dr. White's testimony, the trial could go to the jury mid-week next week.
Nephrologist and Addiction Practitioner Dr. Robert Waldman testified about dermatologist Arnold Klein's medical records in Michael Jackson's treatment. Waldman read and commented on an exhaustive day by day accounting of Klein's near daily administrations of doses of Botox, midazolam, Demerol, and Restylane. Defense attorney, Ed Chernoff, displayed Klein's records of "Omar Arnold," one of Jackson's many aliases, spanning from March 2009 to June 2009. During that time, it seems Klein frequently had Jackson in his office for what he labeled treatments for excessive perspiration. (Restylane is a wrinkle filler, midazolam is a benzodiazepine often used to treat anxiety, and Demerol is a powerful and addictive painkiller.) In March 2009, Klein often started with 100-200mg of Demerol for Jackson's visits, but by May 2009, he was routinely administering 300mg of Demerol in addition to midazolam and Botox. The Botox was injected into Jackson's groin and armpits. Waldman said the treatments Jackson received were not painful procedures and he did not think Demerol, especially in those amounts, was a necessary accompanyment. Indeed, the Demerol was not the standard of care and the treatments themselves were unnecessary. Click to see a screenshot of the medical record and to read more about Waldman's heated testimony.
Five of Murray's cardiac patients testified about what a caring, careful doctor he was during their care. Murray cried in court as Ruby Moseley testified about his lack of greed in opening up a clinic in a poor neighborhood in Houston in honor of his father. Even Randy Jackson seemed affected by her testimony and was heard remarking, "She's sweet," as she left the stand. Gerry Causey, a 68-year-old former patient testified 'Murray was the best doctor.' "He's the best doctor I've ever been to, and I just don't think he did what he's being accused of." Causey further testified that Murray refused even to charge him his insurance deductible. Causey hugged Dr. Murray and kissed him on the head after his testimony. Murray's defense is expected to call Dr. Paul White to the stand tomorrow in an attempted rebuttal of Dr. Steven Shafer's propofol testimony.
Nurse Cherilynn Lee described meeting Michael Jackson to treat his children and his subsequent search for a sleep remedy. She testified that he requested she procure and administer propofol on several occasions but that she refused, instead recommending holistic and natural remedies to his desperate insomnia. Her testimony was very emotional and at one point she broke down on the stand in tears. Partway through her testimony she asked to be excused to rest and Judge Pastor granted her request.
Lawyer for the defense, Ed Chernoff continued the cross examination of propofol expert, Dr. Steven Shafer. The defense tried the tack to try to get Shafer to answer questions leaning towards Jackson's self administration. At one point Dr. Shafer allowed that yes, under an unlikely scenario, Jackson could have awakened from the last propofol dose and pushed the syringe to release another fatal dose into the tubing, BUT even under this scenario, Murray is culpable for leaving his patient unattended.
Shafer gave a lot more detailed propofol testimony focusing on explaining how propofol is metabolized by the body, the 1st pass mechanism, and its bioavailability. They went over how the digestive system is laid out. How drugs are distributed if they are injected into the blood stream versus ingested in the mouth (as Murray claims MJ did). He went over the fact that so little propofol remains in the bloodstream after being processed by the liver that it is virtually useless and non-sedating. He cited a study in which 3 subjects were injected with propofol and 3 ingested it. None of the people who ingested experienced any lowering of blood pressure or breathing rate. He then went over what seemed like 6 scenarios with Murray giving various amounts of lorazepam to Michael at different times of the night and morning to try to explain the abnormally high levels found in his femoral blood sample at autopsy. None even came close to what was found which only leaves the conclusion that Murray lied through his teeth about the amounts given and the times he administered. Even a massive dose of 100 mg pushed through a syringe wouldn't have resulted in the levels found.
One is left to conclude after the testimony the other day that Murray was gone MUCH longer than 2 minutes and after today's testimony that he gave numerous unmeasured doses of lorazepam through the night and a massive amount of propofol without monitoring in the morning so he wouldn't be bothered by Michael's complaints and so he could speak on the phone with his various women. Read more and watch videos from today after the jump.
Sleep expert, Dr. Nadar Kamangar, testified today about the nature and relevancy of Dr. Murray's treatments for Michael's insomnia. Dr. Kamangar questioned not only the efficacy of said treatments, but whether or not the condition they were meant to treat--insomnia--even truly applied to Michael Jackson. Dr. Kamangar stated he was unable to determine the true nature of Michael's sleep disturbances due to shoddy record keeping by Conrad Murray. Murray's defense team asserts he was using propofol to treat Michael for insomnia brought on by a number of causes, but exacerbated by various drug regimens prescribed by other physicians, especially Jackson's dermatologist, Dr. Arnold Klein. According to Klein's records, he administered 6500 mg of Demerol to Michael between April and June of 2009, a massive amount. Murray's lawyers assert this prolonged use of Demerol made Michael's insomnia more difficult to treat by requiring much larger doses of benzodiazepines and propofol than would otherwise be used on another patient. Dr. Kamangar and other expert prosecution witnesses dispute this position by saying propofol is not even a recognized or effective treatment for insomnia under any circumstances.
Jurors heard the iPhone recording Murray made of Michael allegedly under the influence of unknown substances. This is the same recording from which attorneys played a snippet in the opening week of the trial. In the recording, Michael speaks in a slow manner and slurs his words. He speaks extensively about wanting to put on the greatest show the world has ever seen--bigger and better than Elvis or the Beatles and wanting to donate the money to build the Michael Jackson Children's Hospital. He wanted the hospital to have a movie theater and a game room to treat as many as a million sick children; to lift them out of the depression of having their childhoods taken from them, much as his was. "I hurt. You know, I hurt," Michael says in the recording, in reference to his stolen childhood.
He goes on to say, "Children are depressed. The... in those hospitals, no game room, no movie theater. They're sick because they're depressed. Their mind is depressing them. I want to give them that. I care about them, them angels. God wants me to do it. God wants me to do it. I'm going to do it, Conrad."
Another voice (Murray's), answers, "I know you would."