Brilliant, Free Marketing (and a little revenge)

This man is a genius! AND! Look at the free marketing while also taking on a huge airline! Anyone who has traveled extensively for business would love to do this to an airline who overbooked a flight (never could figure that one out), lost luggage, or had a body cavity search because you DON'T fit the terrorist (dare I say it?) PROFILE?

Several years ago I flew to Brownsville, Texas to provide a day long program at a hospital there. I had a layover in Dallas. I arrived in Brownsville while my luggage traveled to Oakland. My lecture material was in my checked luggage along with my suit and tie. I was assured the luggage would arrive at my hotel by 11:00pm.

It didn't. When my wake up call arrived at 5:00am, my luggage had not arrived from it's junket to the west coast. The hospital educator arrived at 6:30am to escort me to the hospital. When I met her in my polo shirt, jeans (yes, they were clean, but I had worn them the day before), and tennis shoes, she surmised something wasn't quite right. We stopped at a Kroger and picked up a razor, shave cream, and some deodorant (cheap hotel).

I did the presentation with 2 white boards and red, black, and green dry markers. It went OK. When I arrived at my hotel at 4:30pm, my luggage had JUST arrived! The airline said they would cover up to loss of $250.00. My speakers fee was significantly above that mark (not too significantly above). The airline informed me they wouldn't cover that loss if the client decided not to pay the full fee, even though it was their mistake that could have cost me a significant amount of money.

I wish You-Tube would have been around at the time. It would have been fun to extract some justice (and maybe even $$) as a result of the free marketing.

Michael Jackson, Addiction, the Media, and the Medical Profession

I've been following the Michael Jackson saga since the first news alert of his "possible" death. The first thing that went through my mind was he died from an accidental overdose. Little did I realize it would take us to the "propofol" thing. And while his death is tragic, so are the deaths of all addicts. They are tragic because many, many, MANY of them don't have to happen.

So why DO they continue to happen? And why do they appear to be increasing? Because our culture continues to follow the same failed ways of "dealing" with this "issue".

First of all, it's NOT an issue...it's a disease. Until we treat it that way, this kind of crap will keep happening more and more. "Dealing" with a disease in a punitive way...i.e., with the police department and jail instead of with interventions and treatment leads to continued progression of the disease and ultimately death.

"BUT TREATMENT DOESN'T WORK!"

Of course it does, when it's started as early as possible, is evidence based, and is ongoing. Currently, that doesn't happen in too many cases.

Why not? Because we approach this disease with what I call the "3 Ms" of addiction: Myth, Misbelief, and Misinformation. One of the predominant myths is known as "hitting rock bottom".

"Treatment doesn't work until the addict HITS ROCK BOTTOM!"

What is rock bottom? I'm sure there are numerous definitions. I think the most accepted one is this...the addict has to lose most (if not all) of the things that are important to them....job, marriage, family, money, car, etc. before they will be willing to enter treatment. But without an intervention of some kind...the bottom for all too many addicts is death.

Mr. Jackson is just one example of what happens when treatment is withheld until the addict "hits bottom".

Goodness, he even had a physician with him at the time of his death! It will be interesting to see what happened leading up to his death that day (if we ever really find out). But there are some clear things that DID happen.

First, Michael Jackson was surrounded by sycophants (self-seeking, servile flatterers; fawning parasites...according to dictionary.com). Some of these people were health care providers, some even (gasp) physicians! As you can see, doctors, nurses, pharmacists, etc. are not immune from all of this. There are star struck individuals in all walks of life, just as there are unethical people in all areas of business and government. When someone told Mr. Jackson no...he found someone who would say yes. My guess is the physician with Mr. Jackson at the time of his death thought he was skilled enough to prevent what happened. Guess what...MD doesn't automatically endow the person with the ability to manage an airway or prevent them from making a mistake in administering a medication they have no business administering. Combine that with administering this medication in a place where it should never be administered and you have the very situation on June 25th in his rented home.

Second, let's compare how we (meaning society and the medical community) approach other chronic, progressive, potentially fatal diseases.

Diabetes. We teach about the disease, that if there is a family history, the risk increases. We teach early signs and symptoms. We suggest early EARLY treatment, aggressive treatment, and evidence based treatment.

Cardiovascular disease. Early recognition of signs and symptoms. Immediate intervention at the first sign of possible heart attack or stroke. Get to the ER now! Education about prevention (family history, diet, exercise, check ups, etc.).

Cancer. Education about the disease, causes, risk factors...like family history (where have we heard that before?), early signs and symptoms, and early, aggressive treatment.

Addiction. How do we handle it? Don't talk about it. Ignore family history...hell, don't even THINK about talking about it! Ignore the early signs and symptoms (it's a phase, it's part of "growing up", they're in the "wrong crowd", they made "bad decisions" or "mistakes"), cover up the consequences for their "bad decisions" (called co-dependent behavior), and WAIT UNTIL THEY HIT BOTTOM. Does anyone see how completely crazy this is? Does anyone see how it makes absolutely no sense from a medical stand point? And yet we keep doing the same stupid stuff over and over hoping the outcome will be different. Didn't Einstein say that was INSANITY!?

If you don't see the idiocy, you're part of the problem. If you do see the idiocy and do nothing, you're part of the problem.

Several family members and friends have said over and over, "We tried to save Michael but we just couldn't. We did everything we could and it just wasn't enough."

BALONEY! Did they hire an interventionist? Did they require him to enter treatment and refuse to provide him with drugs? Did they hire recovering addicts to keep the sycophants away? Did they fire the doctors who were unethically and unprofessionally supplying him with addictive drugs?

Let's stop the insanity and actually start doing what needs to happen. Education, early recognition, intervention, aggressive treatment, and long term follow up...just like we do for other chronic, progressive, potentially fatal disease.

I hope Michael Jackson's death won't be in vain.

American Association of Nurse Anesthetists Warned of Propofol Dangers 3 Days Before Jackson's Death

Thank you to a good friend and colleague for writing this for publication on my blog.

PARKRIDGE, IL. The American Association of Nurse Anesthetists published a statement on June 22 warning of potentially fatal results when the anesthetic agent propofol (Diprivan) is abused, just 3 days before Michael Jackson died of a possible overdose of the drug. The association also warned that propofol has properties which make it a potential drug of abuse and addiction, Indeed reports of propofol abuse and fatal, accidental self administered overdose have been reported since 1992 and are on the increase. The majority of incidents of abuse are among health care providers since propofol is an intravenous medication which is use only inside hospitals, outpatient surgery centers and clinics. "Our concern has been growing over the ease of access to propofol within hospitals compared to other drugs of abuse like morphine. Most disturbing is a 30-50% incidence of fatal outcomes when this dangerous drug is abused. Propofol stops breathing, followed in 4-5 minutes with cardiac arrest due to lack of oxygen" says Greg Stocks CRNA, a peer assistance advisor at the association.

Propofol has no approved clinical use outside of health care institutions and is not available by prescription. It is never indicated for treatment of insomnia. Despite the potential for propofol abuse, it is not a drug controlled or restricted by the DEA and is treated no differently than antibiotics. Some hospitals and anesthesia departments have taken their own steps in securing and accounting for their supplies of propofol after it became clear to them that a high incidence of fatal overdose results from abuse.

See the AANA propofol Position Statement at www.aana.com