The murders of Arturo Gatti, possibly by his 23-year-old ex-stripper wife, and of Steve McNair by his 20-year-old lover, may reflect yet another sign that more Americans than we know —especially younger Americans — are losing their sense of self and, with it, their psychological and moral bearings.  

Certainly, crimes of passion are nothing new.  As has always been true, the killers of Gatti and McNair had to have had extreme life stories with major psychological fault lines reaching back, quite possibly, to childhood.  But in both cases, the victims were famous men who may well have offered the women in their lives temporary and fragile shelter from deep, unresolved questions about whether they could exist independently or would crumble into nothingness without their connections to fame and fortune. It is often those who feel dead themselves who take the lives of others.

Some may think it’s too big a leap to draw any connection between a lack of respect for life and the artificial, Internet-based, technology-fueled existences that too many of today’s teens and twenty-somethings have lived, but I’m not so sure.  I think that the kind of existential panic — the panic of having nothing real at one’s core — that can lead a young woman to murder her famous lover, rather than lose him, is a distant cousin of posting videos on YouTube of staged beatings and the deconstruction of real lives and relationships into profiles, IMs and tweets.

In a world that worships reality TV parents who turn their children into entertainment automatons and a psychologically disturbed pop star whose celebrity was initially forged through enslavement to his sadistic father, respect for one’s own life and that of others can start to erode.  Gaining fame and saving face on Facebook is what matters, and the loss of image can feel like the loss of everything.  I hope I’m wrong.  I hope that cases of extreme violence are now just the same as they always were — outlying cases that are no predictor of anything about the rest of us.  

But as a psychiatrist who has made it part of my life’s work to resist dismissing my instincts, I now sense something ominous about our culture reflected in the worst deeds of the most violent among us.  I fear we are at risk for losing respect for one another and for human life.  I fear our fragile God-given capacity for empathy is under siege. I fear that in obsessing over “Blanket” Jackson (and I feel a little disturbed by even writing his preposterous name), who was dangled over a railing by a father who may not have fathered him at all, we open the door to outlandish acts of dramatic violence that would make for decent psychological thrillers, but are now the stuff of what we call “real” life.

Q: What are the drugs that have been mentioned in connection with Jackson’s death and how do they work?
A: Propofol (Diprovan): A powerful intravenous sedative — not a DEA controlled substance — was found on the premises. It is used by anesthesiologists to put a patient to sleep before general anesthesia and surgery, or alone in a surgical suite for an elective procedure such as a colonoscopy or biopsy. Only small doses are necessary to be effective, and it can easily be misused by an untrained health professional leading to a respiratory arrest.

Narcotics: Demoral, Percocet, Vicodan — there are varied reports of prescriptions for these being found. All can lead a patient to stop breathing or sustain a cardiac arrhythmia and cardiac arrest if overdosed — especially if used in combination. These are controlled substances and prescriptions are subject to DEA review. Misuse can lead to loss of license or criminal prosecution.

Sedatives: A prescription for Xanax was reportedly found. This can also lead to supressed breathing.

Q: What are the questions about substandard care that surrounded Jackson’s death?
A: Excess prescriptions of narcotics and sedatives. When he stopped breathing, no opiate antagonist (narcan) was given to reverse the effects of narcotics. The doctor in residence did not coordinate the 911 call. CPR was done on the bed without a backboard, rather than on the floor where more force could be administered to the heart. No defibrillator was available, and no mouth-to-mouth breathing was reportedly given.

Q: Why is there a delay in getting the autopsy results?
A: The initial autopsy apparently showed no structural damage to the heart to explain his death. There is speculation that prescription drugs contributed to or caused Jackson’s sudden death, and initial toxicology reports may soon be ready. More extensive reports take longer because they look at blood and hair to quantify the exact amounts and combinations that could have led to his death. This will include a microscopic examination of the brain itself, which could show the effects of drugs and help determine the exact cause of death.

Dr. Marc Siegel is an internist and associate professor of medicine at the NYU School of Medicine. He is a FOX News medical contributor and writes a health column for the LA Times, where he examines TV and movies for medical accuracy. Dr. Siegel is the author of “False Alarm: The Truth About the Epidemic of Fear“ and “Bird Flu: Everything You Need to Know About the Next Pandemic.” Read more at www.doctorsiegel.com

Dear Mr. Jackson:

The occasion of your child’s death is a moment when all parents, including me, offer you every wish for strength and God’s healing power in the face of your loss.  Any father or mother can sense the tragedy it is to lose a son or daughter, yet no one who has not suffered such a loss can truly know your pain.

I would write no more than this were it not for the fact that you have used the occasion of your son’s passing and the attendant publicity to also promote your own business ventures, including your new record label.  This makes me feel it important, as a psychiatrist with access to the media, to reach out to you, with other parents and their adult children “listening” in. 

The foundation of our nation assures each person in this great country of certain inalienable rights, including life, liberty and the pursuit of happiness.  Great leaders and courageous soldiers have safeguarded these rights for our citizens, and they would make a decent Bill of Rights for parents raising children, too.  Fathering a child, you see, means far more than participating in a child’s conception and witnessing his birth; it means doing everything possible to optimize that child’s life.  This requires many acts of love and self-sacrifice. It pays immeasurable dividends in the growing self-confidence and autonomy you witness developing in the child you care so much about.

Somehow, perhaps because of pain suffered in your own early life experience, you stole that God-given potential for healthy development from your son.  You have admitted lashing him with a belt or a switch when he failed to perform dance steps to your standards.  According to him, you called him ugly when acne affected him as a teenager.  You brutalized him by placing your own pathologic need for control and for “success” above his needs for security and comfort and self-esteem.  In a very real way, you buried enough of his love for himself that he was no longer comfortable with his race or age or sexuality or even his great fortune.  Trying to please a father who beats you with a belt for missing a dance step will do that to you.

Now, even when saying goodbye to your son, you think of yourself and your business.  You are deprived of a purer life and love.  This makes me feel badly for you, but feel worse for the son you injured so deeply. 

Some will see you only as a monster.  I know that monsters are made through cruelties suffered in life; they never spring fully-formed onto the planet.

In your quiet moments, I hope that you can dig up the roots of the emotional and physical violence you visited upon your child.  One of the wonderful things about still being on the planet is that you always have some chance to win back the potential for real humanity buried inside you.  

Here’s a hint:  Success or failure in becoming human isn’t measured in record sales or reflected in the lenses of television cameras.  You have to look much, much deeper.

There has been a firestorm of medical coverage, my own included, on Michael Jackson’s untimely death last week. There is much we still don’t know, including the final toxicology report which may help us to determine the combination of chemicals that appear to have led to his demise.

Here is what we do know:

1 – The initial autopsy appears to have shown no structural heart disease, in other words, no heart attack or heart failure. This increases the likelihood that prescription drugs were involved as a cause, leading to either a respiratory arrest (most likely), or an irregular heart rhythm which led to the heart stopping.

2 – The behavior of the medical team, especially Jackson’s personal physician, is very questionable, at least by my standards. I am a practicing internist, and I worked in the Bellevue Hospital Emergency Room for 8 years, and here are some of the points I and others have raised. Why wasn’t narcan, which rapidly reverses the effects of narcotics, administered? Why wasn’t he brought to the hospital if he wasn’t feeling well? Why did his personal physician allow or facilitate this concoction of pills that Jackson was supposedly taking. It isn’t simply a matter of writing or not writing a prescription; as a primary care doc I feel responsible for knowing and overseeing ALL medications my patients are taking. Why was CPR done on the bed instead of the floor, when the amount of force necessary to provide 30% cardiac output (the goal in CPR) requires full force that can be wasted on a bouncy mattress. Was Mouth to Mouth resuscitation used? Why didn’t the doctor direct the 911 call – why did he leave it to a security guard?

3 – The latest news involves a drug known as propofol or Diprivan. There are reports that Jackson may have been demanding, and possibly receiving this intravenous drug, which could certainly have led him to stop breathing. This is a drug that anesthesiologists ONLY use to induce anesthesia either as a stand alone treatment in elective procedures such as colonoscopies, endoscopies, small plastic surgeries, etc., or as a pre-anesthetic to put patients to sleep followed by general anesthesia and intubation. As a stand alone for colonoscopy, it is generally accompanied by a mask, though it is given intravenously. The dose must be very carefully regulated by an anesthesiologist, and in the doses used, generally only lasts for a half hour or hour. It is never used outside of a hospital or surgical suite.

4 – We have an epidemic of pill popping in our society. Narcotics are vastly overused, in combination with sedatives. These are dangerous combinations, especially when you consider that people become tolerant, requiring more and more to achieve the effect they want, and can easily slip into a toxic, life-threatening range.

Dr. Marc Siegel is an internist and associate professor of medicine at the NYU School of Medicine. He is a FOX News medical contributor and writes a health column for the LA Times, where he examines TV and movies for medical accuracy. Dr. Siegel is the author of “False Alarm: The Truth About the Epidemic of Fear“ and “Bird Flu: Everything You Need to Know About the Next Pandemic.” Read more at www.doctorsiegel.com

Michael Jackson’s sudden death by cardiac arrest is less shocking than the slow, but steady demise of his soul, which turned him into a music machine fueled by addictions to drugs, money, possessions, fame and plastic surgery.  As my friend and fellow journalist Josh Resnek has remarked, Jackson’s body died at 50; the rest of him died much younger.

Jackson’s life story is a cautionary tale about what happens when a child is deprived of his core self.  That deprivation likely stemmed from what Jackson himself described as the physical and psychological brutality of his father Joe, who reportedly whipped him and verbally abused him and monetized his talents from age 10 through endless rehearsals and performances of The Jackson 5.  Now Joe is planning a big, public funeral for his twice-dead son, keeping him on the stage even after he is gone from this earth.

Jackson’s first, long, tortuous death was a gradual stopping of his metaphorical heart—the heart of a boy harnessed to a father’s tyrannical plans to enslave him.  It left him uncertain whether anything at all was authentic about him, whether there was anything whatsoever he could embrace as the truth. 

He was forever ambivalent about his race, bleaching or otherwise altering his skin tone to appear Caucasian. 

He was forever ambivalent about his facial structure, undergoing plastic surgeries until his nose seemed in danger of falling off his face, his chin became a caricature of the kind with a cleft he must have admired on other people’s faces, and his jaw line became a haunting skeletal representation of just how dead he really was inside.

He seemed forever ambivalent about his gender, because he could not claim even that as his own, morphing from tough guy to girl in appearance and garb. 

He seemed ambivalent about his age, living in an amusement park he built, with zoo animals on display.  Could he have actually missed the fact that he was a caged animal himself, thrilling crowds with his exotic movements and appearance? 

He may have been ambivalent or twisted about what pleased him sexually, given his habit of inviting young boys into his bed and his history of having paid out $20 million to settle a child sexual molestation suit.

He staged sham marriages and “fathered” children who appeared wearing carnival masks in public—all part of the show.  He dangled his baby boy over a railing for his fans, in what may have been the starkest representation of how he felt his own life had ended shortly after birth. 

The distance between a man’s mind and his core self — his soul — is the breeding place for anxiety and depression.  And Jackson apparently tried to contain those unwieldy emotions in the predictable ways — drugging himself by acquiring possessions and trying to shut up the long-dying person inside him with opiates and tranquilizers.  Then the truth asserted itself in the final way it sometimes does.  It stopped his heart suddenly, when, for all intents and purposes, it had not been beating (not for real) for decades.