I was starting to feel, finally, that it was time to move on from the MJ/Prince-related topics, but with the toxicology reports from Prince’s autopsy finally in, and with the sense of closure that comes from having an official cause of death, I couldn’t help but feel compelled to comment on yet one more point of comparison between these two artists for which the media has seen fit to compare, whether fairly or not. I am talking, of course, about the matter of their deaths.
At least, with the toxicology reports in, we now have some answers as to what killed Prince-acute fentanyl toxicity. We also know that according to the coroner’s report, it was a self administered fatal dose. That puts to rest at least one question-we know now that all of the rumors of Prince having died of a drug related death are true, and we know the drug that was the culprit. Frankly, I never bought the story of the flu (yes, the flu can certainly be nasty, but let’s get real, the chances of it killing an otherwise healthy 57-year-old with access to the best in medical care just does not compute) but it still leaves a lot of puzzling and disturbing questions, of course, which I’m sure (just as we saw with Michael) will result in continued investigations, as well as endless conspiracy theories, tabloid stories, and future books to be written. The fact that Prince died alone, with no apparent witnesses, will no doubt only further serve to deepen the mystery of “what really happened.” And we still don’t know the full story of the circumstances that led him down this path. The only thing we can fully ascertain is that chronic pain-the debilitating chronic pain of a performer’s body that has come from years of wearing the body down through high intensity performances-and lack of adequate health care are the primary causes. (And yes, I am aware that this may sound contradictory to what I said earlier, but there is a vast difference between being able to afford adequate health care and actually having it). And by lack of adequate health care, I mean the lack of anyone with medical credentials who cares anything for this person’s well being other than as a never ending supply of cash. If looked at from that perspective, then yes, Michael and Prince at least died with that much in common. But I think we have to be very careful about lumping both of their deaths into the same tragic mold. Yes, we might say both came to very tragic ends, but the manner in which both died bear very striking differences that have to be considered. If we rely solely on media reports, however, we are never going to get that truth. You see, the media loves nothing better than stories of tragic, fallen superstars who ultimately do themselves in due to their own inability to cope. Just look at how the media continues to perpetuate the false story of Michael Jackson having died from a “prescription drug overdose” with every story written about him, despite having had full public access to the autopsy report for nearly seven years (and yes, even despite a fully televised trial leading to the conviction of his doctor Conrad Murray on the charge of manslaughter!).
Recent Typical Media Headline From ibtimes.com:
Like Michael Jackson, Prince Was Overprescribed Drugs By ‘Friendly’ Doctor: Report
The truth of Michael Jackson’s death has become, unfortunately, muddled by this inaccurate reporting. Remember Michael’s own words: “If a lie is repeated often enough, it becomes the truth.” The truth, as verified by his official autopsy report, is that Michael Jackson did not die from anything even remotely resembling a prescription drug overdose. His death was a result of acute propofol intoxication, administered by another’s hands (hence the reason why his death was officially ruled as a “homicide”). In this regard, we might argue that dying from propofol intoxication is still a drug-related death. But propofol is a surgical anesthetic; it is not a prescription drug. Part of the issue I have with this constant repetition of the erroneous “death from a prescription drug overdose” is that, first of all, it is patently false; secondly, it is lazy journalism, and third, it conjures for the uninformed reader a sense that Michael, like so many troubled celebrities before him, simply self administered his own end, whether willfully or accidentally, with a handful of sleeping pills. Or else they are left with the stereotypical image of another junkie shooting himself up with a fatal overdose.
To be sure, many celebrity deaths have occurred just that way, and it is no less tragic. But what I find most disturbing in the case of Michael Jackson is the media’s determination to write the narrative of Michael’s death in the manner that suits them, while blatantly ignoring all readily available evidence that either contradicts the narrative or makes it a lot more difficult to explain. It is certainly much more convenient-and less troublesome-to simply throw around the “death by prescription drug overdose” phrase than to do any actual research or to ask the tough questions. It irks me even more when such quotes are thrown into otherwise positive pieces about Michael’s art or humanitarianism. It bothers me because even when such pieces are sympathetic (as a lot of them are) it is still perpetuating false information. The danger in this is that, just as Michael prophesied, it is a falsification that is slowly becoming an accepted truth through sheer dent of repetition. When even well meaning writers and journalists are blindly repeating the “prescription drug overdose” lie (not because of malice but because they have simply been led to believe it is an accepted fact) we know it has become a problem-at the very least, it is a problem for those of us who care about truth and who care about justice. With another June 25th anniversary fast approaching, I am dreading what I know will be another onslaught of death anniversary “tribute” articles that will no doubt, once again, continue to perpetuate the “Jackson died from an overdose of prescription drugs” lie. Already, since Prince’s death in April, there has been no shortage of articles relating his death to Michael’s. I imagine that as June 25th approaches, we will be seeing a lot more of these memorial tributes that will no doubt laud their artistry on the one hand while, in the same breath, condemning them for what will be perceived as their shared inability to cope with the pressures of fame and addiction.
Allow me to back up a bit and talk about what prompted this post. On April 21, 2016, the day that Prince died, Nancy Grace hosted a call-in segment in which she was asked about the possibility of foul play in Prince’s death. Granted, it was the caller who invited the Michael Jackson comparison but it was Nancy Grace who chose to give the off-the-cuff and grossly misinformed answer that no, their deaths (like their lives) couldn’t be compared. Prince, she said, had died a “respectable death” and “wasn’t strung out on drugs; he didn’t need propofol to go to sleep.” She went on to speak of Prince as being “normal like us” (my reaction to that: since when?” and further insulted Michael’s work ethic by needlessly adding that “Prince went to work everyday” (never mind, I suppose, that Michael died while in the midst of a grueling rehearsal schedule). She also made a point of saying that Prince was someone who had remained “in control” of his life. Actually, I would agree with that statement but for reasons quite different than hers.
I know that I am probably going to get an onslaught of comments about how we shouldn’t get worked up over anything Nancy Grace says, and that her opinions are basically worthless. But all the same, the comments are troublesome because they serve as a microcosm for the media in general and for the prevailing attitudes and double standards in reporting on Michael Jackson’s life or death. It also troubles me because this was the same woman who covered the Murray trial extensively for HLN and who knows the in’s and out’s of all the ugly information that surfaced in that trial; the same woman who went on nightly tirades against Conrad Murray for leaving Michael to die, as she put it, “surrounded by his own urine.” Her rants then were all in favor of Murray’s conviction, and Michael was the victim whose life had been taken. Now, suddenly, three years later, she seems to have conveniently forgotten all of that, and it’s back to Michael’s death as an orchestrated will of his own inherently weak character.
Vitriolic (But Truthful!) Response to Nancy Grace’s Comments From a Prince Fan
Well, it wasn’t even within twenty-four hours of Nancy Grace’s tirade when the reports began to leak that Prince’s death was being investigated as a possible drug overdose (among many other crazy rumors that quickly spread throughout the media and tabloids). I bided my time, however, determined not to prematurely jump on that wagon until the official toxicology reports were in. Now that they are, I have to ask-is Nancy Grace eating another crow sandwich? And does it taste as nasty as the one she had to swallow on June 13th, 2005?
Don’t get me wrong, Prince’s death was a terrible tragedy. So was Michael’s. Any death, we might argue, is tragic unless, maybe, for the people who get to make it past ninety and who expire peacefully in bed surrounded by family. My real issue-and motivation for writing this piece-is that when it comes to the celebrity world and untimely deaths, it seems ludicrous to somehow hold up one celebrity’s manner of death as superior to another’s. And of all the “MJ vs. Prince” points of comparison-some fun, some intriguing, some ridiculous and some just inane-this comparison is probably one that has to rank among the most disturbing. It only goes to show that even when it comes to the manner in which a celebrity exits this life, Michael is still somehow held to an unfair double standard. Prince certainly didn’t die anymore or less of a “respectable” death than Michael Jackson, and depending on one’s view of these things, there were certainly many commanalities as well as important differences. In this post, I would like to look at some of those important differences, and why their deaths cannot be simply lumped into the same category. But I will also examine those important commonalities, as well, which I do think must serve as a vital warning of what is happening in the medical profession in regards to celebrity care.
First of all, we have to keep in mind that we still do not have all of the facts yet about Prince’s death. Many media outlets have been falsely reporting that Prince’s official autopsy report has been released. It hasn’t. We still do not have a full autopsy report, nor the toxicology report. What has been released to the media is simply a coroner medical report press release, and that press release only states some very basic information. It does not go into the full clinical details of the autopsy procedure or its findings. So it is not a lot to go on, actually. But for the time being it is all we have. And based on that information, we at least know the official cause of death as well as the official coroner ruling-accidental (a key component I will be examining).
However, Michael Jackson’s full autopsy report has been public record for some time, as well as his full toxicology report, and those documents are a key component for looking at important differences in how he and Prince died, and why they died. While much of this information is going to be old news to MJ fans, it bears repeating here due to the media’s reluctance to discuss the real facts of Michael’s death. That reluctance has continued to perpetuate myths that are only growing-rather than diminishing-with every passing year, especially given the media’s refusal to treat with any degree of seriousness the official coroner ruling of “homicide” (let alone the fact that prosecutor David Walgreen had lobbied hard to get a charge of second degree murder against Conrad Murray, rather than manslaughter).
But let’s look at what we have, and what we do know.
Michael Jackson Coroner Medical Report:
Prince Coroner Medical Report:
As these two official documents show, their manner of deaths were completely different, and rendered under completely different circumstances. The only similarity is that both died from some form of chemical toxicity. But Prince’s death was ruled to be caused by a self-administered fatal dose of fentanyl, a powerful opioid whose potency is roughly equivalent to heroin, and in fact, is often mixed with heroin or sold as a heroin substitute. The coroner ruling of the death was accidental. If we rule out all of the various theories of suicide and murder (although I don’t think those can ever be ruled out completely) this means that Prince, acting of his own free will, chose to administer the drug that ended his life. He probably didn’t mean to die (though I have to admit, I do find many of the details around his death a bit odd, such as the all black clothing and being found in the elevator: that could have only been intentional or else one of the greatest coincidences among pop star deaths) but the end result was the same.
Now let’s look at what Michael Jackson’s coroner medical report reveals. The cause of death is listed as ” acute propofol intoxication.” Propofol, usually marketed under the brand name of Diprivan, is not an opioid but a surgical anesthetic. It can, of course, mimic some of the effects of an opioid, but its general purpose is to render unconsciousness, not euphoria. And unlike fentanyl, it is seldom used for recreational purposes (as Wikipedia reports, largely because of the monitoring that is required to use the drug safely). In the small percentage of cases where the drug has been known to be used recreationally, it has mostly been by-surprise, surprise!- those in the medical profession, whose work allows them easy access to the drug. Obviously, for the casual drug user, even if the effects of injecting propofol were worth the risks, the sheer unavailability of propofol outside of a hospital setting makes it an unlikely choice for simply “getting high.” It is not, in other words, to be confused with painkiller opioids or prescription meds that can be easily obtained with a prescription (legit or otherwise). This brings us to the second important difference between how Michael and Prince died.
Michael’s death was ruled as a “homicide,” meaning he did not die by his own hand-an important distinction. The medical report clearly spells out: “Intravenous injection by another.” And although Murray’s defense tried to make the argument that Michael had self injected (among many conflicting and confusing theories they desperately offered up at trial) the report clarified exactly why and how the ruling of “homicide,” rather than “accidental,” was justified. Indeed, it is naive to think that the medical and coroner professionals who were putting this report together would not have considered the possibility of a self administered injection. Thus, considerable space was dedicated in the report to explaining the reasons why the determination of of a homicide ruling was appropriate, and why the idea of a self administered injection was all but impossible:
It was this official ruling which paved the way for Michael’s death being investigated as a homicide, eventually resulting in the conviction of Conrad Murray.
But what about the so-called “benzodiazepine effect?” Would that not justify the claims of a “prescription drug overdose” death? Not exactly. The report clearly states that the benzodiazepines detected were not direct causes of death, and are consistent with the reports of what Murray had given him that night. Even further revealing is the toxicology report. Of all the chemical substances that were tested for, only six came back positive (discounting Lidocaine, which is simply a drug used to prepare the area of injection for propofol, and is routine procedure for its administration, especially for patients with smaller veins who are exceptionally sensitive to pain-as Michael reportedly was). If we discount propofol-the known direct cause of death, the Lidocaine (standard procedure) and Ephedrine (generally only used as a mild stimulant-Michael had died as a direct result of cardiac and respiratory depression, so we can rule that out)) this leaves only the drugs we already know, via Murray’s statement, that were administered to Michael that night by his hand, and most of those, including midazolam, are also part of routine procedure in conjunction with the administering of propofol:
But what about those who will argue that Murray was merely abiding by Michael’s wishes? If I have heard that argument-“If it hadn’t been Murray, it would have been some other doctor”-once, I have heard it a million times. For Conrad Murray, it remains his personal mantra; indeed, his entire defense was built on it. He has already given a media interview to Inside Edition since Prince’s death, claiming that “Prince’s doctor will need to get a good attorney” (why the media even continues to give this man a platform is beyond me, but that is an old argument I have already beaten in many previous posts).
This is precisely why the Michael Jackson death case remains so muddled-and it is the loophole through which the media continues to justify its relentless insistence on lumping his death with other similar celebrity self-administered overdose deaths (Prince’s included). But even if we grant that Murray wasn’t the first doctor to introduce to Michael the idea of using propofol as a sleep aid, we still have to consider the peculiarities of this particular case. During the AEG trial, it was revealed that Murray had been administering this “treatment” to Michael on a nightly basis for over two months, an unprecedented experiment in the human body’s tolerance for this drug, and which had resulted according to expert witness testimony during the trial as a kind of slow, systematic poisoning. Whether it was intentional or not is beside the point. However one looks at it, the end result was the same-Michael had died as a direct result of his treatment at another’s hands. Any reasonable person would see this goes well beyond the more typical scenario of a doctor (or many doctors) whose biggest culpability is writing excessive prescriptions for their celebrity patients. We could argue, certainly, that those doctors are still culpable for those deaths, but it is a far more distant culpability than the direct actions of a physician who takes his patient’s life with his own hands, and as a direct result of his own actions. One can argue that the patient still makes a conscious choice when they decide to take the prescribed pills, especially in excessive dosage. In Michael’s unique case, the drugs were being directly administered by a doctor who certainly should have known better, and who had an obligation according to the Hippocratic oath to look out for the well being of his patient (regardless of how much money he was receiving, or what the patient may want).
But we also cannot afford to completely dismiss the similarities of their deaths. Both the untimely deaths of Michael and Prince are part of the new wave of musician deaths that have resulted-not from recreational drug overdoses as was common in years past-but as a result of prescription drugs and/or as a direct result of physician malpractice and greed. From an Inquisitor article on the rise of celebrity prescription overdoses (yes, again, another article that lumps the death of Michael Jackson in with all the other “celebrity prescription overdose deaths, but bear with me-this part of the article is worth quoting):
The Perfect Storm
A “perfect storm” is defined as a rare combination of events or circumstances that converge to create an unusually bad situation. In the case of these celebrities, in pretty much every single case, their perfect storm consisted of the same three attributes: access to doctors that would prescribe them anything; money to be able to afford it; yes-men surrounding them who didn’t have the courage to tell them they shouldn’t do it, and a lot of alone time, or a combination of the last two.
CNBC reported on a survey that was released by the Kaiser Family Foundation that found “44 percent of Americans said they personally know someone who has been addicted to prescription painkillers.” Most Americans believe the government is not doing enough to provide health care resources for the people who are addicted to prescription painkillers (66 percent), or heroin (62 percent).
Read more at http://www.inquisitr.com/3061420/celebrities-prescription-drugs-and-the-rise-in-overdose-deaths/#7eGJGcOk43614srE.99
What we do know of Prince’s situation is that he had actively sought help for his addiction, but that “help” arrived too late. His body was discovered by the son of the addiction specialist who had arrived into town that very morning to begin rehabilitation therapy. The media was also quick to pounce on another morbid fact after the medical report was released: The paparazzi shots taken of Prince as he left a local Walgreen’s pharmacy on Wednesday evening, April 20th, 2016, evidently show him wearing the same black clothes he would later be found in, and most likely carrying the bag containing the fatal contents.
While this post may have been inspired, to some extent, as a defense reaction to Nancy Grace’s comments and my continued irritation with the media’s continual insistence on ignoring the facts of Michael Jackson’s death, it is definitely not my intent to pass judgement on Prince for the way he died. Rather, I think we do owe it to ourselves to examine their commonalities. However we may add or subtract the details, the fact remains that we have lost two amazing music legends way too soon, and it is a crime against humanity if we don’t at least pause for a moment to ask ourselves why we lost both Michael Jackson and Prince before either could make it past their fifth decade. Both deaths occurred without reliable witnesses, compounding the mystery and speculation. The only ironic difference we might note is that if Prince hadn’t been left alone-if someone had been on the premises to witness the onset of a medical emergency-he would probably be alive today. On the other hand, if Michael had been alone (without Conrad Murray present) he would probably still be alive. Personally, I have my own theories about the circumstances of Michael’s death, as I related in this post last year, and conversely, I have found some of the circumstances surrounding Prince’s death to be disturbing and puzzling as well, but since the official accounts are all that we can go on without entering the realm of conspiracy theories, that is where I will leave it for now. Ultimately, the thing they shared most was pain-not necessarily emotional, though we can’t ignore that aspect of it-but the sheer physical pain of a dancer’s body that has worn itself down through years of demands. By far, one of the best (certainly one of the most profound and sympathetic) pieces to come out since Prince’s death was an article from Lorraine Berry titled “Prince Did Not Die From Pain Pills-He Died From Chronic Pain.” I would highly urge everyone to click on the link and read the article in its entirety. I can only quote a small excerpt here, but it is an excerpt that certainly highlights what I have said here:
Prince was not addicted to pain medication. Prince had a medical condition — chronic pain — which is criminally under-treated. It is also a medical problem that is more likely to be reacted to with stigma and condescension, even challenges about the patient’s moral character, or, if male, masculinity. Pain is still the condition that we treat by telling its sufferers to just “suck it up,” or “maintain a stiff upper lip,” or to stop acting like a “wuss.” And yet, when someone dies from complications of the disease — for that is what chronic pain is — we react with shock and pity and anger that the person died from a drug overdose. Some outlets make money off our confusion about overdose and medications and our fascination with drugs.
In another interesting excerpt, Berry notes the racial discrepancies in the medical profession for dealing with pain and very real medical issues:
Into the mix must surely be added the element of race. Prince was a black man. Strong racial disparities in how doctors and other medical staff respond to pain in the emergency room has been documented. For example, a recent study published in one of the most prestigious pediatrics journals studied the treatment of appendicitis, a condition that is often initially suspected after a “chandelier test.” In medical slang, if a doctor places her hand on the pain point in the lower abdomen affected by the pain of an inflamed appendix, the patient will try to jump up into the metaphoric chandelier on the ceiling above their head.
And yet, even here, black kids cannot get a break.
“Our findings suggest that there are racial disparities in opioid administration to children with appendicitis,” wrote one of the lead researchers, Dr. Monika Goyal.
“Our findings suggest that although clinicians may recognize pain equally across racial groups, they may be reacting to the pain differently by treating black patients with nonopioid analgesia, such as ibuprofen and acetaminophen, while treating white patients with opioid analgesia for similar pain.”
Similar studies have documented that African Americans’ chest pain is less likely to be diagnosed correctly as a heart attack. Other studies have attempted to measure whether African Americans have a “lower pain threshold.” Similar studies about why women’s pain is not taken seriously in emergency rooms have also been produced.
However, while treating Prince’s death with unusual insight and compassion, even Berry is guilty of trying to hold his death as somehow “above” Michael Jackson’s when she casually lumps Michael’s death in with Amy Winehouse, Whitney Houston, Phillip Seymour-Hoffman, etc as typical celebrity “drug deaths” from heroin and other illegal substances. Ironically, she chastises the media for “pushing Prince toward that precipice over which we have pushed Amy Winehouse, Whitney Houston Phillip Seymour-Hoffman, Michael Jackson, and every other artist who has died from drugs in the past century” while she, herself, contributes to the continued confusion and media misrepresentation of Michael Jackson’s death. In some ways, as much as I loved the rest of her article, it is merely another variation of a trope we have seen far too often, and far too disturbingly, in the last two months-the need to build Prince up by tearing Michael down. But when this even comes down to the manner of their deaths, I say something has to give.
First, we need to look at the facts. Second, we need to get past this societal tendency to judge-not only in judging other peoples’ pain, but in judging their tolerance for pain as well as the methods they may choose to cope. When I look at the deaths of both Michael and Prince, and the means by which both were taken out, one fact stands abundantly clear above all others-both died as a result of craving oblivion. That is what both fentanyl and propofol provide. I have long wondered (and granted this is just a personal theory of mine) if part of Michael’s attraction to propofol over other means of sleep aids may have been desire for the complete, dreamless state it provides (even dreams are a state of consciousness, and can be terrifying; propofol simply brings on a state of temporary non-existence). And we cannot begin to understand why either of them died until we are prepared to understand the root causes of their need to obliterate pain and to have oblivion from the demands of consciousness. In that regard, I think we have a long, long way to go-and until we get there, maybe it is best to refrain from our shallow judgments. How do we begin to judge what is a “respectable” death, especially in the celebrity world? I’m reminded of the comments which that old geezer Gene Simmons recently took heat for, when he likewise tried to claim that “David Bowie’s death was a tragedy; Prince’s death was just pathetic.” Aside from the fact that he was speaking out prematurely (Prince’s autopsy results weren’t even in at the time) there are simply too many fallacies in a statement like that. How do we know that even David Bowie’s liver cancer wasn’t a direct or indirect result of his lifestyle and his partying days? The answer is simply that we don’t. Every death, ultimately, has its cause-even a so-called “respectable” death like cancer. In the end, it all comes down to a common factor-the lungs stop breathing, and the heart stops beating. That is all. Death shows no favoritism, either in who it claims or how, or why. True, some deaths are perhaps more avoidable than others, and that is the gauge by which we tend to judge them, especially for celebrities whose entire lives have already been an open book for our greedy consumption. In the case of Michael and Prince, we owe it to both of them to continue putting the pressure on unethical doctors who take advantage of the vulnerabilities of celebrity patients. Their deaths and the circumstances that led to them are indeed very different in many critical ways-certainly we can’t afford to overlook the crucial difference between a homicide case and a self-administered accidental overdose. But it is equally irresponsible to ignore their tragic similarities.
Perhaps, ultimately, we owe it to both of them to stop comparing their deaths, especially simply for the sake of exploitative sensationalism , or simply to add yet one more final, macabre chapter to the “Who Is Better” rivalry.
If we have to talk about why they died, we had better be prepared to look equally hard and critically at our own failings, and journalists, especially, must be held accountable for inaccurate reporting that tries to cast every premature celebrity death in the same mold. If not, then we are better served by investing our energy and focus to where it matters most-cherishing their lives and celebrating the legacy they left.