It was a relief when the jury found Conrad Murray guilty. Although the evidence against him was damning, many times over, California is notorious for flaky juries who have made some bizarre decisions, especially in celebrity cases.
Over the decades I have encountered some truly evil and amoral doctors, and some almost as comprehensively negligent as Dr Murray, but he may well be one of the most flagrantly delinquent and neglectful doctors yet to be convicted.
A tattered and tatty defence
He remained stony-faced throughout, even when being ostentatiously hand-cuffed in court and led away. His lawyers looked rather embarrassed, as well they should, for their oddly messy and unhelpful conduct of his case. Even though it's hard to imagine any form of defence which could have excused Murray's misconduct, their approach removed all possible doubt about it.
The closing argument for the defence was frankly offensive, aptly lampooned by the prosecutor as "Poor Conrad Murray", it ever more overtly blamed Michael Jackson for his own death, and petulantly grumbled as though Jackson had done this specifically in order to upset and embarrass his devoted doc.
So many nagging questions remain. Such a court case is aimed at deciding whether a particular person is sufficiently proved guilty of a particular charge, not to discover the truth, and surely not to explore the whole truth.
Why Did Murray act like this?
Why did Murray do what he did? Based on the evidence, this is a convincing scenario. He was a doctor who seems to have been competent enough within a limited field of cardiology, dealing with blocked blood vessels. But he seems to have also been content to function as a not particularly trained or skilful GP as well.
He appears to have been unduly desirous of praise and adulation, and cultivated floridly grateful patients. Maybe this is some or much of the reason for his choice to do some of his work with the poor and needy - though such work is commendable, it can also supply an emotionally needy doc with grateful and dependent patients.
It is not usual or wise practice for current, let alone past patients to have your home and cell numbers, and to feel free to call up for a chat; or to declare under oath that you are maybe their best friend. This is not to suggest that doctors should not be friendly, but that there are good reasons why the boundaries between a warm but professional relationship which is about your health, should not be blurred into a fuzzy, huggy non-clinical intimacy.
This may be why Murray so readily slid into a dangerously unprofessional master-servant and obediently pally relationship with Michael Jackson. He became an eager facilitator, more of a concierge than a clinician: servile, obedient, deferential, submissive, and meek.
This is a highly hazardous role for both doctor and patient. Professional expertise is worthless unless the doctor has the moral strength and understanding to address precisely what the patient needs, rather than what they may want. One must be prepared to be unpopular with some people, even to lose some patients, rather than persistently pandering to requests. You're a learned expert, not someone playing piano at a tea party, and taking requests.
Tender loving greed?
He also appears to have been seriously short of money, for a variety of reasons. Apparently maintaining multiple relationships and a lifestyle he could not afford, it may have seemed breathlessly perfect when he was offered a contract for potentially many months to provide medical backup for a huge celebrity. A steady income and comfortable lifestyle beckoned, perhaps a chance to pay off debts and build a nest-egg, and gain a reputation that might even be parleyed into work for other celebrities.
We don't know how Michael conveyed his requests for propofol and maybe other services. Did he threaten the dutiful Murray with dismissal unless his demands were met? Or was Murray so eager to please that even a hint became a command? Either way, Murray seems to have assumed that his fortunes depended on satisfying his boss's wishes. Jackson wanted not natural sleep (more easily achieved by stopping his large intake of Red Bull and perhaps other stimulants) but convenient, instant oblivion, on demand. Not for him the gradual sinking into sleep, but lights out on command. And except for the occasionally visiting nurse, who was ignored and used as a purveyor of nutritious snacks and smoothies, nobody contradicted his misinformed views or tried to persuade him otherwise.
So many questions remain unanswered, great and small. There was so much more, murky material which could have become revealed in cross-examination, Murray probably didn't dare testify on his own behalf.
Why did Murray make and keep that tragic and bizarre recording of Jackson's slurred and rambling speech, sitting at the bedside and pressing "Record"? Was this to be a trophy? Who else did he play it to, and why?
How did he know that Jackson liked to push the Propofol "milk" into his IV infusions? Had he allowed this macabre and dangerous practice? Had he even taught MJ this - or if not, who else?
It seems he didn't start Jackson's love of propofol - if not, who did? When Michael said "doctors" had told him it was safe to abuse Propofol so long as he was monitored - who told him this?
Who, if anyone, explained what competent monitoring would consist of?
What determined Michael Jackson's fate ?
Whatever the nature of his early childhood, by his enormous commercial success Jackson was empowered to set up a lifestyle of perpetual indulgence, like a rich and powerful eternally spoiled child. He chose, as most people in such situations tend to do, to surround himself with sycophants and enablers. The greatest health risk of the wealthy and powerful is that they can do this, and that they can avoid having anyone around who would say "No", or even "Why?"
He was vulnerable to exploiters, and to duff doctors. Propofol wasn't the first of his damaging fancies - there was the denied but utterly obvious and grotesque and repeated plastic surgeries which serially disfigured him. A handsome young black man was transformed into a distorted caricature of a white woman. Even in his last days he endured repeated injections of Botox and medicinal Polyfilla, accompanied by high doses of painkiller for easily avoidable pain.
Though most of us are forced to do so, Michael Jackson never learned to face the inevitability of limits. And that led him directly to the final limit of all.
(Professor MA Simpson, aka CyberShrink, November 2011)