VIP syndrome: why do the doctors to the stars attain fatal mistakes?

Medical professionals who treat celebrities such as Prince and Michael Jackson are as susceptible to star power as the rest of us, and research results can be deadly

Anthony Mobasser, a Beverly Hills dentist, virtually swooned when he responded to a medical emergency and detected the patient was the screen legend Elizabeth Taylor.

It was an amazing experience. You have to act cool but youre sweating inside. I only feigned that she was any other patient and I calmed down.

That was in 1980. Since then Mobasser has treated many Hollywood starrings and still, to this day, can feel a frisson.

When were treating celebrities we have to go beyond our consolation zone. Celebrities demand much more than the average person and rightly so because they are in front of cameras and on the red carpet. But you have to know your restrictions. If you mess up, you have a problem.

In extreme cases, a dead celebrity problem. Elvis Presley, Michael Jackson and Joan Rivers are among the circumstances in which fame appeared to pressure, amaze or distract physicians into bad medication. The phenomenon has a name: VIP syndrome.

It is not new. Walter Weintraub, a doctor who coined the expression in 1964 , noted venerable examples. The well-known cases of such historical figures as King George III of England and King Ludwig II of Bavaria clearly demonstrate that the treatment of an influential human can be extremely hazardous for both patient and doctor.

With researchers probing the possible role of Los Angeles and Minneapolis-based physicians in Princes opioid overdose, the observation remains valid. Doctors who bend the rules to provide special care to special patients can end up killing them.

There are physicians who give things that build no sense, for example growth hormones to build person seem younger, said David Agus, a cancer expert who treated Steve Jobs. It builds the field look bad.

Before his death in 2011 the Apple co-founder bombarded Agus with quack redress. Agus, a professor of medication and engineering at the University of Southern California, said he repudiated them.

The challenge is to stand up to people. My medical practice is about tough love. Its very data driven. Steve fired me a hundred times and hed call me back an hour later.

Cancer specialist David Agus said some of Steve Jobss doctors strayed from solid medical science. Photograph: Bloomberg/ Bloomberg via Getty Images

In addition to requesting unwise therapy, some celebrities have been known to pressure doctors to forgo invasive tests, or to not share information with colleagues to protect their privacy.

Theres no question that people who are rich and powerful are treated differently than those who are not, said John Connolly, chairwoman and CEO of Castle Connolly , which ranks physicians. Physician can be star-struck and swayed by powerful patients in directions that may not be the best.

It can be hard telling no to a high-profile patient who in addition to lucrative business can bestow prestige and glamour. The Hollywood Reporter uses Castle Connolly data to published an annual list of Hollywoods top doctors in which starrings single out dentists, oncologists, pediatricians, obstetricians and other experts for kudo.

One article features Charlie Sheen posing alongside orthopedic surgeon, Bal Rajagopalan( aka Dr Raj ), who boasts about a miraculous stem cell cocktail which supplies tools to regenerate bone cartilage and turn back time.

Unexpected celebrity demises have illuminated the darker side of medical relationships.

The midwest medical examiner quoth Princes cause of death as self-administered fentanyl, a powerful opioid. Researchers are probing the musicians suspected prescription drug addiction.

Michael Todd Schulenberg, a doctor in Minnesota, prescribed medication. Days before Prince died Howard Kornfeld, a California addiction specialist, sent his son Andrew, to fulfill Prince. Kornfeld has defended his therapy of Prince on social media.

Physicians were reportedly star-struck by Joan Rivers, even photographing her on the operating table. Photo: Karen Robinson for the Observer

Fame appeared to be a factor in Joan Rivers demise in August 2014 during a routine procedure. Doctors were reportedly so star-struck and nervous they transgressed protocols. One took a photograph of the comedian on the operating table before she went into cardiac arrest. The clinic and doctors accepted persons responsible for her death in a malpractice lawsuit.

Michael Jacksons doctor, Conrad Murray, facilitated the singers request for propofol, a powerful surgical anaesthetic, to help him sleep. A jury convicted Murrayof involuntary manslaughter on the grounds the medication played a key role in Jacksons death in 2009.

Doctors largely escaped public blame in the case of Jobs. The Apple chief refused to let them remove a pancreatic tumor and instead tried to treat it with a vegan diet, herbal remedies and acupuncture. When he subsequently agreed to surgery the tumor had spread uncontrollably.

For many high-profile patients who get a disease its the first time theyre not in control and its hard for them to get used to that, said Agus, who started treating Jobs after the cancer had advanced.

A lot of the time you have a high-profile person and they want, say, a herb from China, and theyll search out someone who can provide that. Steve would send me literally dozens of things, asking about special mushrooms, or a treatment in Germany.

Agus, an author and health guru who treats Silicon Valley billionaires, said some of Jobss physicians strayed from solid medical science. He had some well known physicians telling him to do things that built no sense based on the data.

Rick Friedman, an ear expert prominent in the Hollywood Reporters listing of top LA doctors, said famous clients could warp medical decision. Physicians are very human. Ive no doubt that some who are now star-struck can have clouded judgment.

As the brother of a film studio executive, Friedman said he felt largely inoculated from celebrity worship but still felt a tingle with certain patients, such as a pop superstar who had lost hearing in one ear. I try to keep my composure. I tell them I respect their work and get on with my job. I remember quoting the Hippocratic oath at my graduation. I take it very seriously.

Mobasser, the dentist, recalled his exhilaration when Mel Tillis, the country and western star, summoned him at 2am to repair a broken front tooth on the eve of an important Tv appearance. Of course you get intimidated. But I got it done. You rely on your training and get fantastic outcomes. He mentioned me on Johnny Carson and wanted to give me a pony as a present.

Mobasser said he had turned away some famous patients. Many times Ive said no to a celebrity if I think theyre coming for the medications. You have to do your duty. Unfortunately I do know colleagues who say yes. That is when morality comes into play when you want to keep a celebrity just for the sake of having that patient. Ive find colleagues who do it and in the long run they have regrets.

Elvis Presley is examined by an army doctor during his pre-induction physical in 1958. Photo: Don Cravens/ Time& Life Pictures/ Getty Image

Elvis Presleys death in 1977 from heart problems linked to prescription drugs is perhaps the most famous instance of VIP syndrome.

Criticism rained on his physician, George Constantine Nichopoulos, also known as Dr Nick, who succumbed earlier this year. He blamed Presleys addiction on the singers west coast doctor, Leon Cole, who died a few months before Presley.

He publicly blamed my papa for everything, claiming he was the bad guy, and that he, Dr Nick, was always “ve had to” clean up the mess and maintain Elvis healthy, told David Cole, Leons son. Most people didnt buy that hooey, but Dr Nick outlived my dad by quite a few years, so his version is the one enshrined in volumes.

Cole said he knew from his late mom that his father routinely furnished morphine and quaaludes to Presley. Dr Nick was supplying too, on a more daily basis, but my daddy made a good fall guy, especially after he died and couldnt fight back.

Leon Coles own death bolstered the contention that treating an influential man can be hazardous for both patient and physician. He took velocity to run a near-2 4 schedule, said his son. He had become so blas about doling out drugs to celebrities, he believed himself immune to the effects, but the amphetamines wore out his heart.

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