Who is Responsible for Michael Jackson's Death?

Because Michael Jackson’s death has affected us all, I’m going to deviate from my usual posts to share my thoughts. Many individuals have asked me, in my role as a physician, to comment. His tragic death (and life) has brought up many important controversial issues.

First, let me be clear: I am not condoning any irresponsible or criminal behavior on the part of a physician. If these medications were not prescribed responsibly then, of course, this needs to be addressed, as it should be in any situation in which doctors are prescribing irresponsibly. When a person is addicted, they will use extreme means to obtain the addictive substance, and anyone with power or money will be more successful in obtaining these substances.

1. Michael Jackson was misunderstood by many. He viewed the world differently from others. We need to be very careful when judging another human being whom we do not understand. I would go so far as to say that we probably shouldn’t be judging him at all. But it is clear to me that he suffered from being misunderstood. It is also clear that he was dealing with both emotional and physical problems that were not treated by addressing the underlying causes. Conventional medicine is limited in diagnosing and treating underlying causes. This needs to be acknowledged. Addictions are also extraordinarily difficult to treat, and, when treated, relapses are the rule rather than the exception. Also, perhaps most important, the individual needs to want to heal (or be forced by those around him to seek treatment).

2. This leads me to the next point. Did Michael choose treatment for his addiction? Did those closest to him fail in getting him help? These are loaded questions. It is near impossible for someone who is addicted to “choose” treatment. It is equally difficult for others to enforce treatment, especially with someone so independently powerful and isolated.

3. So who, ultimately, is responsible? The doctors who filled his prescriptions? Michael, himself? Michael’s friends and relatives who were unable to recognize that he needed help, or recognized this need but were unable to intervene? What about those making career-related demands? How about society as a whole? What about all of the people who misunderstood him? And those who may have abused him emotionally or physically?

I feel that the issue of responsibility is too complex to blame any one person. If we look deeper, we will probably find many responsible. I was surprised by the extent of Deepak Chopra's anger. I have no reason to doubt his allegation that this is a common occurrence between celebrities and their doctors, and, as a physician who can’t remember the last time she wrote a prescription for a narcotic, I certainly understand his anger. I can’t help but notice, though, that his anger seems personally charged, and this makes me ask the question of whether or not he personally feels responsible for not being able to help Michael. I heard the same anger in the Jackson family attorney’s voice when he said that he had “warned” the family. I understand this all too well. Patients frequently expect me to take responsibility for their health. We each need to start taking responsibility for our own health and choices, rather than passing off this responsibility to others.

The chronic pain management situation has become almost schizophrenic. As physicians, we, in the past, have been so hesitant to prescribe narcotics that many patients who truly need them have been undertreated, and their chronic conditions have worsened. This has become so common that the State of California now requires all physicians to take a twelve-hour course about chronic pain management and end-of-life care. I hope that the outcome of this “investigation” of Michael Jackson’s death does not have the undesired effect of decreasing access of these medications to those who are in true need. I also hope that his death will bring more attention to finding viable solutions to addiction and chronic pain.

Lastly, I hope that Michael Jackson has finally found peace. We honor him, and we will miss him.

I would love to hear your thoughts about this.

Human Beings are Members of a Whole...

"Human beings are members of a whole,

In creation of one essence and soul.

If one member is afflicted with pain,

Other members uneasy will remain.

If you have no sympathy for human pain,

The name of human you cannot retain."

-Saadi

It Takes a Family

One Family...Five degrees in one week.

Supportive nurturing environments are feminine creations, and since our structured world does not value feminine creations as much as masculine ones it is no wonder that our country is suffering the consequences. We are reminded of the sad state of American families on a daily basis. More often than not, financially providing for the family as well as caregiving and nurturing falls upon women, and, frequently, this burden is unshared. It is no wonder that our families are crumbling.

This last weekend, I was reminded of this in an expected way.

Those who know me are aware that I would not have made it through my grueling residency training if it weren’t for two facts: 1. The location of my training hospital was the closest hospital to my family home. 2. The two other women who went through my program with me became my sisters. In other words, without the support of family-both genetic and environmental-I would not have survived.

Well, one of these two women flew across country for the Stanford graduation of one of her closest friend’s sons. Now, I’m a Berkeley gal. In fact, my family is a Berkeley family. Four of us have obtained six of our eleven degrees from UCB. The only time this Golden Bear has set foot on Stanford soil was for the Cal-Stanford Big Game—so this was no small compromise. But I would do just about anything for my dear friend, given that she saved my life over and over again.

I thought I was the one making sacrifices. I couldn’t have been more wrong. First of all, although I came uninvited, I have never felt more welcome. I was accepted, without hesitation, into her extended family of friends. Okay, in all fairness, their acceptance was as much a reflection of my friend’s extraordinary nature as her friends’ extraordinary generosity. But that was just the beginning.

For the first time, in a very long time, I participated in preparing the meal with a group of women. When was the last time that you, as I woman, had the help of three other women in preparing a meal? We forget that this used to be the norm until fairly recently. The biggest surprise, though, was the graduation ceremony that followed afterward. This wasn’t her “nephew’s” actual graduation ceremony but a separate ceremony for the students who were of Native American descent. Although her nephew is only one-quarter Native American, the percentage was irrelevant. My girlfriend explained to me that when her friend had gone through the same ceremony several years earlier after earning her Ph.D., there had been very few Native American graduates. This time there was standing room only, and the ceremony took several hours.

Each graduate approached the stage with his or her support system, which included family members, extended family and significant friends. Most groups filled the stage. A Native blanket was placed over each graduate's shoulders. Then, graduates, along with their family members and friends, were invited to speak. It was the most wonderful graduation ceremony I had ever experienced. This is a significant statement, coming from a woman with an extremely tight-knit family that valued education highly, a woman who has experienced more graduation ceremonies than she can count.

One after the other, the graduates explained how difficult their University experiences had been and how they could not have made it through without the support of their families and the Stanford Native American community. Many of the graduates were the first in their families to obtain university degrees. Some were the first in their towns. Almost all were the first to obtain degrees from Stanford. Then their families and friends spoke; many of them cried. I have never seen so many men cry in such a short period of time—not even at a funeral. Many expressed their admiration and pride. All expressed their love. Some reminded the graduates to give back. All impressed the importance of community and working for the greater whole.

It was extremely inspirational and sobering at the same time. I kept thinking: this is the way graduation ceremonies should be. It takes an entire family, extended family, friends and community for each of us to accomplish not just our educational goals, but to accomplish anything of significance in our lives.

It did my feminine heart good to be surrounded by family the entire weekend. I had to remind myself that I wasn’t related to a single person that I encountered, yet I was accepted as a family member. This is the heart of the feminine. This is what we are missing. This is what we need to reclaim.

Are you still trying to do it all alone? Who is your family? What family will you create?

As for me, I so missed my own family after being surrounded by so much caring and love from people unrelated to me that, when I left my friend, I drove straight to my brother’s home to spend the day with my nieces and nephew.

It’s not popular to create community, to work together, to practice interdependence--but create family we must! Our future and our world depend on this.

Congratulations Graduates!

Fear Factor

We are fearful, even terrified, of anything new or different, of change.

I was reminded, tonight, that this fear begins at an incredibly early age. Sometime between our toddler years and kindergarten it hits us--the notion that the world is not a safe place.

Our French friends were visiting for the first time in over twenty years. My four-year old nephew, usually the (only) life of the party suddenly became shy and refused to go anywhere near one of our friends. She had made an attempt to play a game with him, a French version of peek-a-boo, and it scared the beejeezus out of him. I suggested that perhaps he was frightened by her accent, explaining that she sounded different, because she lived in France. He latched onto that explanation, but stuck to his position, which was several rooms away from hers. I traumatized him further by incorrectly assuming that the kitchen coast was clear. Big mistake! She was there. (Bad Auntie! Will he ever forgive me? Even worse, have I scarred him for life?)

Later, I explained that our French friends had grandchildren his age that played in big sand dunes at their beach home in Arcachon, just like he had played in sand dunes with his cousin in Death Valley. I then, out of guilt mostly, stayed glued to his side in the kitchen while he ate his rice and beans. I promised him that I would never ever leave his side again. It took half the night and a serious one-on-one talk with Mommy before he relinquished his fear and not only spoke to our friends but embraced them into our family.

Looking back I am amazed that he was able to do this, and in less than a couple of hours—a rather remarkable feat, considering that, as adults, it may take us years, if not lifetimes, to relinquish similar fears. Neither my mother’s words nor my inner strength was powerful enough to extinguish similar fears that I have held. Not only that, my nephew had no reason to trust me after I steered him wrong (Yes, I still feel horrible about it.). And yet, trust us he did.

So what happens to us? Do we lose our trust? Do we lose our resilience? When does the world become so large, so unsafe, that we lose our sense of control and personal power?

I don’t have answers for you today, just questions:

1. What is your greatest fear?

2. What area(s) of your life feel(s) the most out of your control?

3. Are there people in your life that scare you? Why?

4. When was the last time that you experienced something different or new? Perhaps a different food or activity, met new people, traveled to a new place, learned something new…
What was that experience like for you?

5. What was the last thing you did that pushed you beyond your usual comfort zone? How did you feel afterwards?

6. What do you wish you could do or experience that you haven’t yet, because it scares you?

7. If you could change anything about you or your life, what would it be?

8. When did you feel the safest and most powerful in your life? Where were you? Who were you with? What were you doing?

9. Including yourself, who is/are the most powerful person(s) in your life?

10. From where does your strength come?

The first step is to ask the questions. The second is to avoid censoring your responses. Sometimes merely bringing these questions into your conscious awareness is enough to begin the process of change.

As for me--I’m going to hang out with these questions for a bit and with my nephew a whole lot more…I have a lot to learn from him!

Got Kefi?

Nia Vardalos’ new film My Life in Ruins is all about getting her kefi back (See article #1 and article #2).

Kefi is the Greek word meaning the passion for and joy of life! And the Greeks seem to have this in spades. No matter how bleak, how bad their lives get, they have the ability (like energizer bunnies) to bounce back up, snap their fingers and jump into that next circle dance. They are paradoxical. I had never before seen a group of people who could hold grief and tragedy in one hand and kefi in the other. Unfortunately, this isn’t the case for most Americans. Not only have many of lost our kefi long ago, it’s been so long that we don’t realize that it’s missing.

There is a lot we can learn from the Greeks. No matter how bad things get, they are able to bounce back. They are downright resilient. Most of my Greek friends will credit this lesson to nearly 400 years of Turkish occupation. I understand this well, because my great-grandmother was forced to rebuild and re-create everything over and over again after constant theft and destruction in her small Middle-Eastern village. When we must constantly re-build and recreate we not only learn to detach from things, but we also experience our incredible capacity to create anew. We are forced to live in the moment. We are forced to let go of everything that is non-essential. Instead, we focus on what is important.

This is exactly what so many people around the world have been called to do this past year. With financial and environmental crises and job losses, we are all being forced to let go of all that is non-essential. In the process, many people are discovering a sparkling jewel—their kefi!

Fortunately, it isn’t essential to experience tremendous loss to recognize what is important. Have you lost your kefi? Do you want it back? There are as many ways as there are people to find it again.

I will use the Greeks to illustrate. Here are some examples:

1. Greeks live in the present moment! I know, easier said than done…and I know that I’ve said it before, but it’s the most important step.

2. You can’t have kefi if you’re lost in victimization and entitlement. That’s not to say that neither exists in modern day Greece; it certainly does. The point is, though, that we will never be able to experience the power and the joy of creating if we remain victims and expect the world to treat us fairly. I am still surprised by how easily the Greeks accept the natural cycle of life and death. Malpractice is just recently on the rise in Greece.

3. They let go. What will be will be. When I was an extra on the set of Mamma Mia, we had to be down at the port at some ungodly hour—I think it was 3:30am one day. That morning the weather was so stormy that my umbrella turned inside out within five minutes. I was complaining the whole duration of the hour-long bus ride to the camp. Most of my Greek compatriots were catching up on sleep. I just knew, I was saying to anyone who would listen, that we’d go through the entire day, waiting in the rain, without shooting. Why didn’t they just let us go home? And, sure enough, we did wait the entire day without a single shoot—while wearing damp costumes to boot (Yes, they stored the costumes in an open-walled building!). What did the Greeks do? I didn’t hear them complain once, other than a wishful sigh that they had some tsipouro (similar to ouzo, the preferred drink of Northern Greece on a rainy day!). But we didn’t have tsipouro, so what did the Greeks do? Dance and sing, of course!! (The tsipouro we had later that night. Don’t ever drink tsipouro after 6pm—another story…)

4. They get up and move their bodies; they usually dance (and, yes, sometimes other things).

5. They sing.

6. They gather in groups with friends and family, constantly. A typical social network and support system includes almost the entire population of Greece.

7. They work hard, play hard, and nap hard.

8. No matter what, they always have time for a (Greek) coffee or an ouzo.

9. They cherish their friends and family. Nia Vardalos’ kefi returned when she adopted her precious little girl—or, perhaps, it was the other way around!

10. They enjoy life!

I don’t know about you, but I’m off to Greece!

But if you can’t go to Greece, then how will you get your kefi back? …you can always see My Life in Ruins on Friday, June 5th! Opa!

See my post on My Life in Ruins.

See my interview with Andi about the shoot on her Blog: Misadventures with Andi.

My Life in Ruins is Coming on June 5th

See my post about the shoot at the Delphi location of the new

Nia Vardalos film, My Life in Ruins, coming on June 5th.

My post.

My interview about the Delphi shoot with Andi here.

See the trailer here.

See my favorite interview with Alexis Georgoulis here.