A.J. Court Session 51: Michael Jackson went into a coma every night for two months
Today, a video of the interrogation of Dr. Emery Brown was shown in court.
Dr. Brown is an anesthesiologist specialist. She works at MIT and Harvard universities. She had been a student of Dr. Charles Ciselr, who previously gave an astonishing testimony in court. (News) Mr. Brown is a member of many medical specialist communities. She has at least 140 articles in her field.
Dr. Brown received an hourly fee of one thousand dollars to review the case and asked the lawyers to donate it to the General Hospital. The total amount is 75,000 dollars. Dr. Brown has been interrogated before, but she has never testified in court.
Dr. Brown listed different types of anesthesia: general and regional. She considered Michael’s anesthesia via propofol as general anesthesia. General anesthesia includes four states: unconsciousness, no pain sensation, no movement, and amnesia. Before surgery begins, heart rate, blood pressure, breathing, and body temperature are monitored. She described general anesthesia as a type of coma.
“Anesthesia is a reversible coma.”
She explained that a patient in a coma cannot receive and respond to external stimuli. The patient is given medication to put them into a coma for surgery, then the medication is stopped so the patient can come out of the coma. She said there is a collective tendency to compare general anesthesia to sleep, but anesthesia is not sleep. People who are asleep cannot tolerate surgery.
Propofol is one of the drugs used by Dr. Brown. She has used propofol for almost all her patients. Propofol is the most common anesthesia drug in the world.
She has studied propofol for seven years and says no one else has examined this drug as much as she has. She has published an article about her method of using propofol.
Brown reviewed the forensic medical report of Michael Jackson. According to the report, the amount of propofol in Michael’s body was so high that it would have been enough to perform surgery. Michael Kascaf, the Jacksons’ lawyer, asked Brown whether she confirms this statement. She said the amount of propofol mentioned in the report was the same amount used in major abdominal surgeries.
Dr. Brown is not specialized in sleep science. She said her professor, Dr. Charles Ciselr, is known worldwide for his knowledge of sleep. Dr. Brown researched the effects of propofol on human sleep. One of her articles examines the relationship between general anesthesia, sleep, and coma, and she said no one else has done such research.
Kascaf: “Does the brain go to sleep under the influence of propofol?”
Brown: “It’s not sleep.”
Kascaf: “What about doctors who use this drug to make people sleep?”
Brown: “They’re making a serious mistake.”
She explained that sleep has two natural parts: REM and non-REM. When we sleep, we enter non-REM sleep stages one, two, three, and four, and then REM sleep. REM sleep is the time of rapid eye movement and dreaming. Learning and memory happen during REM sleep. In this stage, the conscious mind is active, the body is paralyzed, and the heart rate is irregular. Non-REM sleep is the opposite: slow heart rate and regular breathing.
Brown said that during anesthesia, these natural stages do not occur. Instead, the patient is deliberately put into a coma and kept in that state until the surgery ends. There is no method in the world that can create REM or non-REM sleep using anesthesia. Under anesthesia, the brain cannot move between sleep stages or go from non-REM to REM.
Brown said that to fall asleep, we need to shut down the brain. The control center sends commands to the entire body to shut down. The full sleep cycle takes 7 to 8 hours.
Dr. Brown said that propofol in minor surgeries also creates pain-relieving anesthesia for the patient and keeps muscles relaxed during the procedure. But for major surgeries, in addition to propofol, the patient must be given painkillers and anesthetics so that muscles do not react during surgery.
Brown said that after patients wake up from propofol anesthesia, they feel refreshed and energized because propofol causes the release of dopamine hormone in the brain. This gives the patient the impression that they were asleep.
Brown then talked about Michael’s use of propofol to sleep: “If he used propofol, then he would have been deprived of sleep.”
She read the text of Dr. Murray’s confession, in which he said that before Michael’s death he had injected propofol into him for sixty nights. In his interrogation with police, Murray said that on the day of Michael’s death he injected him with a small amount of propofol. Dr. Brown said this statement contradicts the forensic medical report, and that Murray did not tell the truth.
Dr. Ciselr had said in his testimony that Michael spent sixty days without real sleep and in those conditions he wouldn’t survive more than eighty days.
Brown then said one reason she agreed to work on the case was to clarify for the public the effect of anesthesia drugs on the brain. She said she had been asked to explain the mechanism of propofol in a way that ordinary people could understand.
Katherine Kahan from A.J.: “Is it possible for someone to be in a coma for years and still remain alive?”
Dr. Brown: “Yes, there are many such cases.”
Kahan: “And these people don’t die from lack of sleep?”
Brown said that a coma caused by anesthesia is different from a coma caused by brain injury. The case Kahan is discussing is a coma caused by brain damage. A person may remain in a coma caused by drug injection for several days, and this is currently being researched by scientists.
After that, Dr. Peter Fornowsis took the stand to testify. Fornowsis has a doctorate in economics. He has worked at the Federal Reserve, the U.S. central bank, as well as the Los Angeles Commission and several private banks. He has participated as a witness in at least one thousand legal cases across the United States.
Fornowsis previously worked with Brian Panish as well. He has testified between 20 and 30 times for Panish and has been hired by Panish’s law firm between 50 and 100 times. He has also worked in cases against Panish’s company.
Before Fornowsis, Panish asked whether he knows anyone who would have more qualifications to testify in his field. The answer was no.
Fornowsis testified that A.J. had invested almost 34 million dollars in the Dangerous Is It tour, and if they didn’t believe in a return on investment, they wouldn’t have done it.
Fornowsis said most people have the ability to create income. Some of them don’t use this ability.
Katherine Jackson’s lawyers asked Fornowsis to convert the future income figures estimated by Arthur Erskine into present value using a discount rate. He has been doing present value calculations for 50 years and had estimated present value for 40 years for presentation in court cases.
Dr. Fornowsis used a discount rate of 7 to 15% in his estimates. Panish said one of A.J.’s experts considered this rate to be 18%.
He calculated the present value of the Dangerous Is It tour revenue using a $108 ticket and discount rates of 7, 10, 15, and 18%, resulting in 919,366,479; 856,002,240; 768,026,177; and 723,523,742 respectively. As can be seen, a higher discount rate means a lower present value.
Source: eMJey.com / AP & CNN