Failure of the medical system?

I hesitated a bit to blog on this for a variety of reasons, the major ones being a) the death of Michael Jackson has been a wee bit over-publicized and b) I don't like gossip and accusations. However, the more I thought about it, the more I realized that what I had to say was less about the King of Pop and more about people with eating disorders in general.

To be honest, I don't know whether Michael Jackson had an eating disorder, or body dysmorphia, or addiction problems. Perhaps the final autopsy will have some of those answers, and perhaps we may never fully know what happened. But a recent editorial (working on the assumption that all three were true) said that the medical system had failed Michael Jackson.

Most people with eating disorders don't have the kind of fame and money that MJ had, but perhaps family and friends and medical professionals still fell sway to the same assumptions that MJ's doctors might have. MJ was dancing and rehearsing and performing- he couldn't be that bad. I had straight As and a research position and scholarships- I couldn't be that bad. This is, maybe, fame and fortune of a type. People held my academic and musical accomplishments in awe. Though I would be the first to dispute the accuracy of that, I will also admit that these achievements gave a lot of people plenty of reasons to overlook the oh-so-minor detail that I wasn't eating.

Writes Mark Rubi in his editorial:

Time and again, these pillars of American society reacted to a starving patient with prescription drugs.

I'm not anti-prescription drugs- just look in my medical cabinet and you'll see quite an array. And any toxicologist will tell you that the dose tends to kill you, much less than the drug itself. That being said, maybe what MJ needed was someone to say screw the fame, you need to eat. The medication he may have been most in need of was food. But people may have been afraid to say something because of the fame, afraid of what that might mean. Maybe some of my professors and supervisors were afraid of what my wasted frame might mean. Maybe they just didn't know. Or maybe they thought I could see the problem and would ultimately do something about it.

And that is the biggest failure of the medical system when it comes to eating disorders: that we expect people to want to get better and to do everything possible to recover. But in the acute stages of anorexia especially, the sufferer is almost unable to perceive his/her condition accurately. Either I truly didn't think I had a problem or I didn't think starving myself was problematic, or it wasn't that serious. I wasn't, like, emaciated or anything (except, oops, I was). If a high school valedictorian got cancer, we wouldn't wait for her to will herself well. But most medical professionals were quite content to do that when I developed anorexia.

Did the medical system fail MJ? Perhaps. But sadly, perhaps no worse than many other people with eating disorders have been failed.

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Kristina said...

While I see your point in regards to eating disorders in general, I don't agree that THIS particular case is a failure of the medical system. Jackson hired a cadre of physicians who were functioning outside said 'system' and pandering to his requests. Yes, that is sad, but it's also sad that he couldn't or wouldn't surround himself with people who were honest, who would have said to him "screw the fame".

Gwen said...
This comment has been removed by the author.
Gwen said...

I couldn't agree more. I know Kristina (the first commenter) doesn't believe this is a failure of the medical system. I don't agree. Ill people need and are entitled to compassionate care. If they are unable to ask for it because of the nature of their illness, then they need to be forced into treatment. Yes, MJ hired the physicians and they pandered, but at the end of the day those physicians were part of the existing medical system that was supposed to help him, and they failed to do that. Hence, it was absolutely a failure of the medical system. He obviously had some sort of body dysmorphic disorder, at the very least. Nobody undergoes that kind of plastic surgery on a perfectly normal face without having some serious issues. I'd like to know why the plastic surgeons who took his money while destroying his facial structure haven't been held accountable. They too were part of the medical system that failed this mentally ill man. It's so sad. And it angers me.

MissBlueBird88 said...

I very much agree.

Carrie Arnold said...


Perhaps these doctors did operate essentially autonomously- and maybe this is also a failure of the medical system.

And friends and family can be honest and if the medical profession doesn't step in and order treatment or hospitalization, or accepts "emaciated" as the status quo, then this is still a problem. It's sad all the way around, really.

Tiptoe said...

I see both points of view on this. After reading a piece by Deepak Chopra, you really learn of the unfortunate doctors that will not say no to these celebrities, how they get caught up in the fame of having an A-list star, how essentially money buys everything, etc.

I've read that there were several tried interventions with MJ, but none successful.

In any case, it's just sad all around.

Anonymous said...

I agree with whole system problem thing. I went to see a Dr. the other day for something. I got there thought everything was fine, then she say's I need a re-exam. After the re-exam she say's my insurance is up for the year, so I used up my "last" insurance vist for something that does me no good. What a joke. On the other hand it made me so mad that total gave in to ED last night and am close to canceling apointments with the dietician and the thearapist (ED like's it when I'm alone), I can't tell them I'm restricting again. Three month's of therapy gone in a moment.
Sorry Just needed to vent.

Anonymous said...

First I have to admit that I have paid very, very little attention to Michael Jackson while he was alive. I was just never a fan of his music and am not that interested in celebrities other than professional athletes. So, I would have no clue as to whether he had an eating disorder or was unhealthfully thin- the last time I saw even a picture of him was probably 10 or 20 years ago, and he looked unremarkable.
But as for doctors- I am becoming increasingly disappointed and disillusioned with the medical profession in general. And I can certainly point to Jackson as an example of the utter failure of some doctors to heed the simple mandate of "First do no harm". I cannot imagine how any doctor would have agreed to perform the plastic surgeries and whatever other horrible treatments were done on him to make him go from a decent looking young man to what I can only describe as a ghoul. I don't care how much money he had or was willing to pay- why couldn't any doctor say, no, I won't mutilate you like that? And seeing that outward sign of what, IMHO, is clearly malpractice, I have absolutely no trouble believing that his other doctors were complicit in any number of other self-desctructive behaviors and provided him the means to carry them out. So, yes, I believe the medical system failed Jackson, and fails so many of us. I also have no trouble whatsovever believing that more than one doctor or other medical professional could look at Carrie, and for whatever reason, fail to come forward and offer help.

This failure of the medical system is something I think about a lot lately, having recently been diagnosed with a condition that may or may not have serious effects in the future, and wondering whether I ought to move to a different country in order to trust that I am being given effective, but not unnecessary, treatments and straightforward answers, and treated based on my needs and not money.


Sarah said...

Carrie, this is just a post idea. I heard recently that it takes a long type to replenish glycogen stores after AN, when I complained that I feel faint and almost hypoglycemic if I don't eat for a few hours whereas my friends/family can go for hours without eating and be fine. But I am 3 years into recovery! This seems like a loooong time for my glycogen stores to be replenishing!

So, I did a quick PubMed search to try to see if this was true, but don't really have the time to or enormous drive investigate this issue as deeply as it appears I would need to. If you are looking for things to do as you are at home, I'd appreciate a post on this--it seems like an area you would probably enjoy researching. Totally your call though--only post on this if it interests you.

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I'm a science writer, a jewelry design artist, a bookworm, a complete geek, and mom to a wonderful kitty. I am also recovering from a decade-plus battle with anorexia nervosa. I believe that complete recovery is possible, and that the first step along that path is full nutrition.

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nour·ish: (v); to sustain with food or nutriment; supply with what is necessary for life, health, and growth; to cherish, foster, keep alive; to strengthen, build up, or promote


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