Drugs That Killed Anna Were Prescribed to Howard Stearn. and Others

From TMZ

The Broward County Medical Examiner confirmed that none of the 11 drugs that were found in Anna Nicole Smith's hotel room were prescribed to Smith.

FOX News anchor Greta Van Susteren obtained documents from Dr. Joshua Perper's office which shows that of the 11 drugs, eight were prescribed to Howard K. Stern, two were prescribed to Alex Katz and one was prescribed to Anna's personal shrink, Dr. Khristine Eroshevich. We don't know who Katz is, but Perper acknowledged one thing that was clear -- Dr. Eroshevich wrote all 11 prescriptions.

Perhaps most interesting, the chloral hydrate that was the major cause of Anna's death (and was prescribed to Stern) was in a duffel bag in the hotel room. As Greta said, Anna was too weak to even get out of bed to go to the bathroom, so how did she get out of bed to rummage through the duffle bag and get the chloral hydrate? Van Susteren pressed Perper for an answer; the doctor said he asked Stern, Eroshevich and the bodyguard if they gave her the drugs and they all said the didn't.

Perper also acknowledged it was a bad idea for Anna to take sedatives in the morning, given she was already too weak to get out of bed. Perper said even if someone else gave her the drugs, "It's not wise for sure, but it's not homicide."

Alzheimer's and Dementia patients on antipyschotic drugs as sedatives are dying early because of the treatment

Via Reuters

Alzheimer's patients prescribed antipyschotic drugs as sedatives are dying early because of the treatment, British researchers said on Friday.

Although so-called neuroleptic drugs were originally developed for schizophrenia, they are frequently also used on an "off-label" basis to calm difficult or aggressive dementia patients.

A five-year investigation found that the drugs, when given to Alzheimer's sufferers, were linked to a significant increase in long-term mortality -- with patients on the medicines dying an average six months earlier than those given placebo.

Researchers led by Professor Clive Ballard of King's College London also found neuroleptics were associated with a significant deterioration in verbal fluency and cognitive function.

Ballard, who has criticized the use of such drugs in dementia patients in the past, said the latest study showed there was no benefit in giving neuroleptics to people with mild Alzheimer's.

For people with more severe behavioral problems, doctors had to balance potential benefits against the increased mortality, he added.

Up to 45 percent of people with Alzheimer's in nursing homes are prescribed neuroleptics as sedatives, according to the Alzheimer's Research Trust, which funded the study.

Ballard's colleague Professor Robin Jacoby of Oxford University said the causative link between neuroleptics and early death was unclear but past studies had implicated the drugs in adverse cerebrovascular events, such as mini-strokes

"We don't know what the mechanism is and we need to explore it further," Jacoby said.

The study involved 165 patients with Alzheimer's who were analyzed between 2001 and 2006. The findings will be submitted for publication in the New England Journal of Medicine.

Drugs used in the clinical trial included Johnson & Johnson's Risperdal and four older types of antipsychotics.

The Destructive Side Effects of Psychiatric Drugs

A Report from the Fox News show The Big Story about the destructive side effects of psychiatric drugs

Adventures in PsychoPharmacology

A bipolar student's long journey with wrong medications. Gogo Lidz was prescribed more than 15 different drugs in 5 years after being disagnosed with bipolar disorder. She was 16 when prescribed her first mood-altering drug. One patient's strong case for getting a second opinion. Do drugs like Adderall and Zyprexa do more harm than good?

Do you think you've been misdiagnosed or misprescribed? Are doctors too quick to prescribe meds to treat patients? Albow says, "Too many people blindly trust their psychiatrists. If you are not doing well, you need to move on."

Here is the Story on FOX

A Psychiatrist Speaks in Praise of Suicide Bombers

I recently came across this gem:

The Head of Psychiatry at Cairo's 'Ein Shams University, Prof. Adel Sadeq, on the Psychological Make-Up of a Suicide Bomber (Archival Material) Iqra TV (Saudi Arabia) - 04/25/2002 - 00:03:43

The Fallout from the Anna Nicole Smith Case Continues

More details have been coming out regarding the drug interactions that led to the death of Anna Nicole Smith. It seems that ordinary caffeine from soda pop could have played a factor. Lose sleep due to too much caffeine, then swig down the chloral hydrate to go to sleep.

One thing is for sure:

There were large quantities of heavy and dangerous drugs being used in a reckless manner without appropriate medical supervision. These drugs were prescribed by psychiatrist Khristine Eroshevich, and her 'patient' died. This surely cannot be an acceptable level of medical care and practice in any state or country.

As reported on Fox 411

Here's a theory about Anna Nicole Smith's various drug interactions: Apparently, the antibiotic she was taking has a deleterious effect when mixed with caffeine. Around Smith's bed, according to her autopsy report, were cans of soda.

The theory offered to me by an expert source is that the combination of Cipro and soda was keeping Smith awake and unable to sleep. The result was Smith accidentally overdosing on chloral hydrate, which she took in liquid form to sleep.

In other words: Dealing with severe insomnia, Smith was swigging the chloral hydrate and overdosed.

I asked Broward County toxicologist Howard Schueler about this Wednesday. He said caffeine was present in Smith's blood, but they don't know how much. Her Cipro level was not that high, as it turns out, but it's there. The main thing was the chloral hydrate. That level was over the top.

Schueler says the caffeine-Cipro theory could be contributory to Smith lapping up the sleep medication. On top of that, he adds, the other drugs in her system were just too much.

"It's the Ativan, the Valium, the Klonopin and the chloral hydrate together," he said.

So, what about the person who prescribed all this stuff, Khristine Eroshevich? Schueler explains that the medical examiner's office cannot rule on things like malpractice or negligence.

"We didn't think it was a homicide," he said.

In other words, Eroshevich did not prescribe this smorgasbord of sedatives and other medicines with the intent to kill. If she did anything wrong, it would have to be taken up in other quarters.

Cipro, by the way, also has a bad interaction with another of Anna Nicole's favorite drugs: methadone. But it's Schueler's feeling that Smith had not taken any methadone for about three days before she started on Cipro. Methadone, however, was found in Smith's bile.

All of this should have some effect on all of us. The next time someone says to you, "Don't take all those pills at the same, they will kill you," listen more carefully.

Sugar Pills are just as effective as Anti-Depressants according to Study

Actually, they are slightly better: From the Orlando Sentinel

Patients seeking treatment for bipolar-disorder depression are as likely to get relief from sugar pills as they are from widely used antidepressants, according to a study.

The findings, which appear in this week's New England Journal of Medicine, are sure to confound therapy, researchers say.

"Bipolar depression is notoriously difficult to treat," said David Miklowitz, professor of psychology and psychiatry at the University of Colorado-Boulder, and an investigator on the study.

This study, Miklowitz said, "helps us find what does and does not work."

In the largest study of its kind, researchers at the University of Colorado and sites across the country gave patients Paxil, Wellbutrin or a sugar pill.

During the study, all 366 participants took a mood stabilizer, which is commonly prescribed for those with bipolar disorder.

Neither the patients nor the researchers knew whether they were taking one of the two antidepressants or a placebo.

After 26 weeks, 24 percent of those taking antidepressants recovered from their depression and had no major symptoms for at least eight weeks.

Among those who took a sugar pill, 27 percent stayed well for eight weeks or more.

The study by Dr. Gary S. Sachs of Massachusetts General Hospital, is part of a seven-year, $26.8 million research project to examine the condition once known as manic-depressive illness.

During the study, funded by the National Institutes of Health, investigators at 22 sites across the country enrolled 4,361 participants. Researchers expect more results to be published soon.

About 10 million Americans suffer from bipolar disorder, characterized by extreme mood swings from elation and manic activity to incapacitating depression, according to the National Alliance on Mental Illness.

Mental health center to repay $556,687

A press release from the Massachusetts Attorney General

A not-for-profit, mental health and social services provider with several facilities located in suburbs north of Boston has paid $556,687 to the state Medicaid Program and the Massachusetts Department of Mental Health (DMH) to settle allegations they billed the program for services they allegedly never rendered. In addition to payment of the settlement, Tri-City Mental Health Center has entered into a compliance program under the terms of today's agreement with Attorney General Martha Coakley, United States Attorney Michael J. Sullivan and the Office of Inspector General, United States Department of Health and Human Services (OIG-HHS).

Tri-City Mental Health, as a state Medicaid provider and DMH contractor, is required by state and federal law and regulation to submit claims for payment based on necessary services which were actually provided to patients. In addition, they are required to maintain accurate documentation which substantiates the services rendered.

Employee complaints in 2003 lead Tri-City to internally investigate certain claims submitted to Medicaid and DMH by one of its service centers located in Malden. The internal investigation led to the termination of at least one manager at the Malden location and a full scale audit, which was conducted by outside auditors at the request of Tri-City’s Board of Directors. Tri-City notified the Attorney General, DMH and the U.S. Attorney in late 2004 under self-disclosure protocols established by the OIG-HHS.

The joint investigation by the Attorney General and U.S. Attorney, based in part on Tri-City’s own audit, found that from February 2002 through November 2003, there were claims submitted to the state Medicaid program for adult psychiatric day treatment services that were allegedly not supported by documentation or the services had not been provided at all. From September 2001 through October 2003 claims submitted by Tri-City under contracts with DMH for day rehabilitation and social club services allegedly could not be substantiated by documentation or the services were not in fact provided.

In addition to payment of the settlement amount, and in exchange for the release of Tri-City and its Board of Directors from civil and administrative liability, Tri-City has entered into a Certificate of Compliance Agreement with OIG-HHS. This agreement requires Tri-City to establish policies, procedures and reporting obligations to address future conduct and prevent overpayments.

Tri-City Mental Health Center neither admits, nor denies the allegations as part of today's settlement and has cooperated fully with the investigation.

The case was handled jointly by Assistant Attorney General Ann Ackil from the Attorney General's Office and Assistant United States Attorney Patricia Connolly of the Office of United States Attorney for the District of Massachusetts. They were assisted by Steve Devlin, Deputy Chief of Investigations for the Attorney General's Medicaid Fraud Unit, Phil Coyne, Special Agent with OIG-HHS and by Peter Thomas, Director of Compliance and Audit at DMH.

Doctors Must Stop Pushing Pills

As seen in the Daily Campus from the University of Connecticut

Reality should not resemble the book "Running with Scissors," where a seemingly practiced psychiatrist offers his patients the latest sample of medicine that comes in the mail. The problem of crooked or uninformed doctors is nothing new. However, more and more people in the U.S. are being prescribed medications that are unnecessary and potentially dangerous to their condition, and, thankfully, people are starting to worry. This does not only happen with illness related drugs, as mental illness medications are being more often prescribed to cover up the symptoms of a disorder without helping cure it at all. At times, these medications do not affect the disorder at all. In contrast, some medications make the disorder worse or present the patient with side effects worse than the actual disorder.

More recently, several states have begun to notice how much antipsychotic medicine is costing people and affecting their health, perhaps unnecessarily. Eli Lilly, the manufacturer of the antipsychotic drug Zyprexa, is attempting to monitor doctors' prescriptions of the drug. The New York Times reports that, "at more than $300 for a monthly prescription, Zyprexa, which is used to treat schizophrenia and bipolar disorder, is the single biggest drug cost for state Medicaid budgets." Another worry for the drug is its side effects. Zyprexa has been known to put users at greater risk for heart attacks, strokes, diabetes, high blood pressure, dizziness, etc.

[...]

Over the past few years, there have been a growing number of patients that have died or experienced unfit side effects from badly prescribed medication. Not only have some side effects caused physical harm such as heart attack and death, but they have also created dangerous mental conditions. According to Sage Journals, a psychopharmacology journal, some patients with schizophrenia who take the anti-psychotic medication Clozapine will feel like they are entirely cured, while others may experience heightened hallucinations and psychotic episodes.

There isn't always a definite medication for a specific mental illness. Medications need to be prescribed with close psychological and bodily supervision. Too many people have had suicidal thoughts, or terrifying hallucinations, because of simply taking the wrong drug. Instead of prescribing medication for a certain disorder, doctors should obtain more specific symptoms and perhaps even wait to prescribe a specific medication until they learn more about the individual patient's condition. Additionally, doctors should obtain more evidence about a given drug and all of its side effects.

Not many people know that Prozac was originally approved to treat a heart condition. Psychiatrist Robert Post of the National Institute of Mental Health said that "research shows that antidepressants should be used the way digitalis is used for heart disease." Today, Prozac is a common anti-depressant, and isn't recommended for heart condition medication, but it may once again be suggested as a heart treatment. Because drugs may have multiple positive and negative effects, their uses must be monitored strictly.

In addition to failing to find the perfect mental illness medication for adults, doctors also struggle to find the perfect medication for children. Adults can better explain their symptoms and changes in their conditions, while children have a much harder time explaining and expressing their state and concerns. Because of this, doctors have to monitor children's prescriptions even more vigilantly than adults. In August, 2005, 12 children died from the ADHD medication known as Adderall. Studies found that five of the children had heart conditions. After that episode, heart condition was added to the label of Adderall. However, seven other children died on Adderall without explanation. This wasn't enough to take Adderall off the market because there was not enough conclusive evidence. However, since that case there have been more child deaths due to Adderall and other sedative medications. This is evidence that doctors need to look more closely into what they are prescribing.

Sadly, only some doctors take precautionary measures against careless prescribing. The majority of doctors need to prescribe medication more carefully and have more follow up appointments with their patients. This will cause the patient to spend less money on unnecessary drugs, it will help the patient's condition rather than simply masking it, and fewer people will suffer preventable side effects. In order to treat mental illness well, prescriptions must be supervised more closely.

Sex, drugs and pharmacology: Why 'hot women' are pushing pharmaceutical drugs

As seen on the Mind Hacks Weblog

The eDrugSearch blog has noted that Mia Heaston, the current Miss Illinois and one of the 2007 Miss USA hopefuls, is also a pharmaceutical industry representative.

If this link seems a bit too tenuous to be newsworthy, the blog also identifies two of last year's Miss USA contestants who were drug reps and identified no less than 16 professional cheerleaders who also work as reps for the pharmaceutical industry.

If you've ever met a drug rep, you'll know they tend to be charming, aesthetically pleasing young people with free gifts and selected scientific publications to hand, which of course, suggest that the company's medication is the best treatment for any number of mental illnesses or assorted disorders.

In a classic 1983 paper Webster and Driskell reported that attractive people are generally thought to be more intelligent and more competent, including when judged on their likely performance on tasks completely unrelated to good looks, such as 'ability to pilot a plane'.

The use and perceived credibility of information provided by drug reps to doctors has been found to correlate with prescribing.

In other words, even apart from the sex appeal, attractive drug reps are likely to make the marketing information seem more convincing, which in turn leads leads to more doctors using the drugs.

So it's no surprise that one of the biggest industries on the planet is selectively recruiting some of the most attractive people to promote both their product and their product-supporting research.

No Free Lunch has an extensive list of peer-reviewed research on drug marketing that is an essential antidote and will help you judge their information more effectively.

Link to eDrugSearch blog on Miss USA drug reps (via Furious Seasons).

Link to eDrugSearch blog on cheerleader drug reps.

Link to first page of classic Webster and Driskell paper.

Owings Mills Woman Sentenced for Medicaid Fraud

From the Maryland Attorney General's Office

Maryland Attorney General Douglas F. Gansler today announced that Susan Carol Mehlman, 54, of Owings Mills, MD, was convicted of Medicaid fraud in the Circuit Court for Baltimore City. Judge Martin P. Welch sentenced her to five years in prison with all but six months suspended and to be served in home detention. Mehlman, a licensed psychologist and Medicaid provider of mental health services, was also sentenced to two years of unsupervised probation upon her release from home detention. Mehlman has already paid $96,750 in restitution and penalties to the state Medicaid program.

While rendering therapy services to clients at A Caring Hand, an adult medical daycare center located in Anne Arundel County, Mehlman submitted claims to and received payment from Medicaid totaling more than $118,000 between February, 2004 and September, 2005. Mehlman repeatedly submitted claims for rendering as many as 13 units of service in a single day, although each unit of service is approximately 45-50 minutes, and the daycare center was only open from 9 a.m. to 3 p.m. She also billed and received payment for family therapy, although there was no evidence that such services were ever rendered.

Mehlman was suspended from the Medicaid program and as a provider of public mental health services in September, 2005. As an additional consequence of her conviction, Mehlman faces exclusion from the program as a Medicaid provider for a period of at least five years.

The case was prosecuted by the Medicaid Fraud Control Unit (MFCU) of the Maryland Attorney General’s Office. The MFCU conducted the investigation with assistance from the Mental Hygiene Administration (MHA). MHA has been working with the MFCU to root out fraud in its programs, and several cases of possible fraudulent behavior by MHA providers are currently under investigation by the Attorney General’s Office. In making today’s announcement, Attorney General Gansler thanked Assistant Attorney General Eileen McInerney for her work on the case.

Methadone clinic doctor sentenced in fraud

Seen in the Bangor Daily News

A psychiatrist who founded a methadone clinic in Westbrook was sentenced to six months in prison Monday for his convictions last year for prescription fraud.

Dr. Marc Shinderman was convicted of writing prescriptions for controlled substances using the name and drug registration number of another physician. Shinderman, who was not licensed to write the prescriptions in Maine, said he thought the arrangement was acceptable.

Shinderman also must serve another six months of home confinement during two years of probation. U.S. District Judge D. Brock Hornby also ordered him to pay $35,800 in restitution.

Shinderman was a co-founder of the Center for Addiction Problems in Chicago before he came to Maine, where he started CAP Quality Care in Westbrook in 2001. It was the second methadone clinic in the Portland area.

Shinderman has a 30-year history of working with methadone, which is dispensed to addicts to curb their craving for opiates such as heroin. But the charges against him were not related to methadone, but rather to other medications that he prescribed to patients.

More than 100 former patients, colleagues, employees and friends wrote letters to the court calling Shinderman a dedicated physician and groundbreaking researcher who bent the rules to prescribe necessary medication to patients in need.

But prosecutors in court documents described him as a reckless drug provider who used generous doses of methadone and prescription drugs to attract patients to his for-profit clinic.

Shinderman had faced up to 21 months in prison for his conviction on 58 counts, including 24 counts each of using another physician’s Drug Enforcement Agency registration number and aiding the acquisition of controlled substances by deception.

'Best Friend' Psychiatrist Lived Right Next Door. How Convenient.

As see on Fox 411

How close was Anna Nicole Smith to the psychiatrist who prescribed all those drugs for her? Very close, it seems. Maybe too close. In fact, they were next-door neighbors.

Real estate records for both Anna Nicole and Dr. Khristine Eroshevich reveal that the patient and her doctor actually lived next door to each other in million-dollar homes in Studio City, Calif. Even Tony Soprano doesn’t have that close a relationship with Dr. Melfi!

Public records indicate that Eroshevich and her husband, Wes Irwin, live at 3656 Avenida Del Sol in Studio City. Their house is listed as a four-bath, four-bedroom set-up purchased in 2002 for $925,000. Eroshevich bought the house with a mortgage of $693,750. In 2006, according to public records, the total value was $980,335. And yes, the house has a pool.

Oddly, right next door at 3646 Avenida Del Sol is a home owned by Smith and Howard K. Stern. The home was purchased in 2004 for $1,335,000, with a $934,500 mortgage from a private firm in Burbank, Calif., called J&R Lending.

The deal wasn’t finalized until almost a year later and the home was registered to a company called Hot Smoochie Lips, Inc. Stern and Smith were the only officers of that company. A woman who answered the phone at J&R said the loan had been subsequently sold, but refused to give any more information.

(Someone should tell Stern’s parents he owns real estate. Stern testified under oath to that clueless probate judge in Florida, Larry Seidlin, that he was living off his parents and had no money.)

But the bigger question now is: What was the real relationship between Eroshevich and Stern/Smith? The autopsy results listed nine drugs in Smith’s system, nearly all of them ordered by Eroshevich. The doctor also said in a TV interview with “The Insider” that she administered all the drugs personally. She herself cited chloral hydrate as one of them.

Smith's medical examiner said in his press conference that it was an accidental overdose of chloral hydrate and other drugs that caused Smith’s death.

Girl forced into pysch ward for saying police spied on her - but police records reveal they did.

As reported in Mother Jones

Police Surveillance is the Quickest Way to Take the Fun Out of Puppet Making

My friend was one of the Billionaires for Bush. She worked tirelessly and hardly slept, organizing new ways of getting other students to care about the election looming. Humor is our best strategy, she thought.

So in the spring of 2004 she spent a few evenings in the backyard of an off-campus co-op, twisting chicken wire into a globe, plastering it with paper mache, and painting on green land and blue sea. Bigger than she was, it took the help of a few friends to carry to a rally in front of the university president's office, where she and some Billionaires, dressed ridiculously in furs and cocktail dresses and tuxedos, ferociously smashed it to bits. But chicken wire is hard to smash. The wire cage eventually wound up in the backyard, recycled into an an overflow compost container.

Was she being watched? What if she had a hunch and entertained the thought—well, that would make her crazy. Who would perceive her as dangerous? Who would have the time to watch? Who would even care? If she'd wondered out loud to her doctor—well, that falls under a few diagnoses in the DSM-IV. She would have been sent to the loony bin. And she was. She spent a few weeks in the psych ward and was forced by school officials to take the rest of the semester off. I saw her once, in a group, during visiting hours, and couldn't think of a damn thing to say.

But she would have been right. Today the New York City Police records covering those months were exposed. Jim Dwyer writes in the New York Times, "From Albuquerque to Montreal, San Francisco to Miami, undercover New York police officers attended meetings of political groups, posing as sympathizers or fellow activists, the records show. They made friends, shared meals, swapped e-mail messages and then filed daily reports with the department’s Intelligence Division." They sent daily notes back to New York on forms called DD5s, describing the activists, their meetings, and their plans. My friend's name must be in those piles of paper.

Another Billionaire, Marco Ceglie, told the Times, “It was a running joke that some of the new faces were 25- to 32-year-old males asking, ‘First name, last name?’ …. Some people didn’t care; it bothered me and a couple of other leaders, but we didn’t want to make a big stink because we didn’t want to look paranoid."

Investigating Psychiatrist Khristine Eroshevich - a look at her role in the death of Anna Nicole Smith

Presenting an overview of the various news stories tied in with Anna Nichol Smith's own personal Dr. FeelGood psychiatrist Khristine Eroshevich, and the possible role her prescriptions played in the death of her patient. Material stated here goes to the stories as found on this site with links to the original news story as found on the web.

This entry updated and expanded Tuesday, March 27th, 2007.

It is our opinion the the shrink should be investigated merely for making such a deadly cocktail available, and for not taking proper responsibility for their use. Especially if, as Eroshevich claims, she was a "best friend" to Anna Nicole Smith. Otherwise, it is giving something deadly to someone who is not competent to administer their use. Similar to giving a small child a loaded gun.

Given the potential of criminal negligence (after all, somebody died), the prosecution of Dr. Khristine Eroshevich may be likely in the near future. It is difficult to imagine much that would mitigate completely against prosecution under these circumstances.

• Wednesday, March 07, 2007
  How Anna Nicole Smith's Shrink Got Her Pink Slip
  
• Friday, March 16, 2007
  More on the Psychiatric Drugs Prescribed for Anna Nicole Smith by Her Psychiatrist 'Friend' Includes detailed information on the list of drugs Smith was prescribed, including link to the original fax.
  
• Sunday, March 18, 2007
  Psychiatrist is haunted by celebrity death
  
• Monday, March 19, 2007
  The Betrayal of Marilyn Monroe by Her Psychiatrist
  
• Tuesday, March 20, 2007
  Anna Nicole Smith's Shrink Ignored Drug Expert's Warning
  
• Wednesday, March 21, 2007
  Anna Nicole's Drugs: More, More, More from her 'Best Friend' Shrink
  
• Friday, March 23, 2007
  Sleep drug killed Anna Nicole Smith, 2 mags say
  
• Sunday, March 25, 2007
  Anna Nicole Smith's overdose from same drug as Marilyn Monroe (and new reports) have observers arguing whether murder or suicide
  
• Monday, March 26, 2007
  Coroner's Report says Anna Nicole Smith died of an accidental overdose of psychiatric drugs
  
• Tuesday, March 27, 2007
  'Best Friend' Psychiatrist Lived Right Next Door. How Convenient.
  

Of addition interest are the comments regarding Dr. Eroshevich on this Medical Rating Site

The Smoking Gun has the autopsy, along with the full Medical Examiner report, and scene reports from the Hard Rock Cafe and Casino as well as from the Memorial Regional Hospital

Coroner's Report says Anna Nicole Smith died of an accidental overdose of psychiatric drugs

And now for the official report: As reported on CBS News

Former Playboy Playmate Anna Nicole Smith died of an accidental overdose of a sleeping medication and other drugs after she was found unresponsive at a hotel, authorities said Monday.

Broward County Medical Examiner Joshua Perper said Smith died of "combined drug intoxication" with the sleeping medication chloral hydrate as the major factor. Smith was taking a lengthy list of other medications, including methadone for pain, he said.

Chloral hydrate is a sedative used to treat insomnia and alcohol withdrawal, relieve anxiety and ease post-surgery pain. Perper said Smith had been on several antidepressant and antianxiety drugs prior to her death.

"We found nothing to indicate any foul play," said Chief Charlie Tiger of the Seminole police department. Perper said the detailed autopsy also showed no evidence of disease.

So the only thing implicated were the dozen psychiatric drugs prescribed for Anna Nicole Smith by her "best friend" psychiatrist Khristine Eroshevich, along with the other quackery that was going on.

There are these details

In the days prior to her death, Smith had taken several antidepressants and antianxiety drugs medications, including methadone, human-growth hormones for longevity, weight loss and immunoglobulin drugs, Perper said. Her friends and psychiatrist said Smith had suffered from a 105-degree fever two days before her death. He said Smith was on anti-flu medication for a fever caused by a bacterial infection from the drugs she was taking.

TMZ notes

Along with the list of nine drugs found in her system, Anna Nicole Smith's autopsy report also bizarrely reveals that her "anus is unremarkable."

In the eight page report obtained by TMZ, Dr. Perper describes, in detail, the condition of Anna's body.

The report lists every mark on Anna's body, even tattoos. Smith's body art included the words "Daniel" and "Papas," a pair of red lips, a Playboy bunny, a combination of a Christ head, a bible, a naked women's torso and a smiling Marilyn Monroe among others.

On a positive note, Anna's fingernails and toenails were both listed as "clean."

TMZ also provided this link to the actual autopsy report. (Note: PDF File)

The autopsy report is also available via the Smoking Gun Website

Anna Nicole Smith's overdose from same drug as Marilyn Monroe (and new reports) have observers arguing whether murder or suicide

From Hollywood Today. What was the role of her psychiatrist 'best friend" Khristine Eroshevich in all of this? Inquiring minds want to know! With friends like these ...

The Anna Nicole Smith circus tent is on fire as reports of toxic levels of sleeping medication chloral hydrate in her body, the same drug found in her hero Marilyn Monroe, have sparked rage and outrage in a furious debate over whether her death was murder, suicide or overdose.

Criminal culpability may be one step closer when the official toxicology finally report comes out Monday, partially stalled until now to allow for police investigation, according to Broward County medical examiner Dr. Joshua Perper.

“The finger is pointed at her entourage… They all stood by and watched her die slowly,” said Nancy Grace on her Headline News show, tinged with her trademark anger over developments. “She was not in any shape to inject herself or take her own nighttime medication.”

The choral hydrate, along with a raging infection will be the cause of death according to the Star and the National Enquirer, not our usual source for any news whatsoever. Nonetheless they appear to have used their hefty checkbooks to pay for a leak of Anna Nicole’s toxicology report. The National Enquirer made its name with the death of Elvis Presley by bribing a relative to photograph the King in his coffin.

Specifically the papers say on Feb. 5 Anna received an unsterilized injection before boarding a plane from the Bahamas to Florida and later developed a painful abscess, not uncommon with junkies and others who take injections with less care and precaution than medically advised. She also reported a bad flu and experienced vomiting, severe diarrhea and couldn’t urinate.

On the day before she died, Wednesday Feb. 7, she reportedly took the choral hydrate at toxic levels with the infection still going — and supposedly never regained consciousness. At 1:33 pm the next day, Thursday Feb. 8, she was reported “unresponsive,” leaving huge questions about the activity of Howard K. Stern as well as her nurse and bodyguard during that time.

More ominous is that the drug was allegedly delivered by injection into her right buttocks, a task likely done by one of the entourage. “Somebody has to help you do that,” according to Dr. William Moroni, a medical examiner in Michigan. “You can’t get the angle. The hand is reversed, thumb position is wrong and you can’t see. You need help.”

James Neaviitt, attorney for Stern, not to be confused with radio personality Howard Stern, said “Speculation running rampant and we will have to wait and see. Dr. Joshua Perper said there were no injection marks on her body last month. On Monday we will find out.”

“Somebody is going to end up paying for this,” said family law attorney Rene Rockwell. “She had a nurse there, she had a bodyguard, she had a boyfriend/lawyer.”

“I think that Howard and the doctors Anna was seeing were keeping her in a stupor” said Dr. Carole Lieberman. “When you consider she had a history of substance abuse and had such psychological problems, the (prescriptions) were particularly dangerous,” the psychiatrist said on Showbiz Tonight.

She noted that many of the laundry list of drugs that were prescribed for Smith in the day’s after her son’s death, including anti-anxiety Lorazepam were in liquid form, fairly unusual. “Since this is a medication that is tasteless and colorless, Whether this was put in her food, in her drink, without her knowledge (is a question).”

Son Daniel allegedly went to a private investigator prior to her death to say he was worried about Stern who was acting like “some Svengali” and administering “mind-bending drug” to her, the PI said on Showbiz.

The fact that Stern is also a figure in the inquest into the overdose death of Smith’s son Daniel and had a role in supplying drugs to both of the departed, has Smith’s mother Vergie Arthur crying murder, most foul. Some of our readers agree and vehemently say so in comments to previous articles. Yet the suicide possibility looms larger, if Perper confirms the choral hydrate presence on Monday.

Since chloral hydrate was the drug found in Monroe’s bloodstream (a form on Nembutal was found in Marilyn’s liver, too) there is a chance Smith was doing yet another imitation of her idol’s habits and affectations. The usually-liquid substance is a fairly uncommon and old-fashioned sleep drug, given more popular new alternatives like Ambien and Lunesta.

This, along with testimony in Florida court last month that she had a “death wish,” sparked a debate on the possibility of suicide, or assisted suicide. David Caplan at Star said that on Oct. 18 after her son’s death, she set emails to several friends saying “I want to die, I wish I could be in a better place.”

Author Susan Lipkins argues that the recent news reports surrounding her death reveal suicidal thoughts. “She had a suicidal plan to the extent she knew what she wanted to cover the coffin with.” I wonder if she came to Florida with knowledge of that. I don’t think she knew about her infection, I’m not sure this was part of a plan for herself.”

As for how Star/Enquirer got the toxicology report, it was only a matter of time till someone succumbed to the tens or hundreds of thousands likely offered for a quick photocopy of the long-delayed report. The leaker “could be prosecuted for leaking out of the medical examiner’s office,” said one attorney. However, the report might also be in the hands of investigating officers in multiple jurisdictions, so they would know what to look for. Furthermore, the two papers are headquartered in Hollywood, FL where Anna was found dead.

Meanwhile, two purloined diaries sold for over $500,000 on eBay, with sex outselling Jesus by a small margin. The 1992 diary, which has the words “I follow my own star” on the cover, Smith confesses: “I hate for men to want sex all the time. I hate sex.” This diary sold for about $285,000. In the second diary Smith writes about the illness of her billionaire husband Howard Marshall, who died in 1995 at age 90, with a religious awakening and featuring lots of references to Jesus. This sold for about $230,000.

Dr. Perper promised a surprise when he announces his autopsy results on Monday and the twist may be that the infection or a blood disease stopped her heart, and not the drug. But whatever the specific cause, her weakened state of health was all part of her spiraling drug use as was the actions and inactions of those around her in the time leading up to her death. So the autopsy is likely to raise as many tough questions as it answers. Especially for Howard K. Stern.

US paedophile sting traps evil psychiatrist

From the Irish Examiner

A Saudi Arabian psychiatrist who travelled to the US in the hope of molesting a three-year-old girl has been sentenced to seven years in prison.

Nabil Al Rowais, 37, from Riyadh, had arranged the trip during nine months of graphic email correspondence with a man he thought was the girl’s father, according to court records.

However, the “father” was an undercover agent posing as a fellow paedophile who was abusing his own daughter.

Al Rowais flew to San Francisco in April 2006 and took a limousine to a nearby hotel. He carried an overnight bag containing a video camera and girls’ underwear, US Attorney McGregor Scott said after yesterday’s sentencing.

“He went to room 328 and he knocked on the door, fully expecting to encounter a father and his two and a half-year-old – now three-year-old – daughter,” Scott said.

Instead, the man was arrested. The girl does not exist.

His emails indicated that Al Rowais had previously molested two and 10-year-old girls in Saudi Arabia, Scott said. The man’s conduct, Scott said, “absolutely shocks the conscience”.

Al Rowais pleaded guilty in January to travelling to the US intending to have sex with a minor.

His plea agreement called for him to serve nine years in prison, but US District Court Judge Lawrence Karlton imposed the seven-year sentence.

According to prosecutors, Karlton’s rationale was that Al Rowais could be in danger in prison because of the nature of the crime, his Middle Eastern ethnicity and his slight physical stature.

When asked about the lighter sentence, Scott said only that it was the judge’s discretion.

Al Rowais is likely to be deported after completing his prison sentence, Scott said.

See also this news story from the Vallejo Times, where the man was arrested

A federal judge Friday sentenced a Saudi psychiatrist to seven years in prison for flying more than 8,000 miles to have sex with a 2 1/2 year old girl in a Vallejo motel.

U.S. District Judge Lawrence K. Karlton of Sacramento set the sentence despite a defense plea citing overwhelmingly "hard time" for his Arab Muslim client in a post-9/11 world.

Dr. Nabil Al Rowais, 38, of Ryadh, Saudi Arabia, pleaded guilty in January to traveling into the United States to engage in illicit sexual conduct.

"All crimes involving the exploitation of children are disturbing," said U.S. Attorney McGregor Scott, in a released statement. "From time to time certain cases involving exploiting children, however, truly shock the conscience."

California Justice Department officials spent a year luring Al Rowais, who went by the screen name "Openminded-guy39," to a rendezvous at a Vallejo motel room. It was unclear why Vallejo was chosen as the meeting point.

During the lengthy sting, an undercover agent pretended to be a father, propositioning his 21 2-year-old daughter for sex.

Al Rowais' attorney Quin Denvir asked Judge Karlton to reduce his client's sentence, citing a psychiatrist's report he suffered from post-traumatic stress disorder from sexual molestations as a child.

Denvir also asked the judge to consider the "hard time" Al Rowais faced due to the nature of the offense, his size (5-feet-6-inches, 120 pounds), and his ethnic background and religion.

Al Rowais wrote the judge from jail that after he's released, he will hold weekly clinics to help adults with child abuse pasts.

"Fortunately, in my case there was no real victim and hence no harm done to anyone," he wrote. "What happened was a strange out of character behavior which stemed [sic] from a fantasy. What happened was a mistake I will be always regretful for. It left me with pain I struggle with every day."

His Canadian fiance and her 12-year-old daughter, who considered Al Rowais her father, also submitted letters of support.

The government argued that his 74 pages of explicit chats over a nine-month period showed "a robust and unhealthy desire to act upon what the defendant characterized as merely 'fantasies.'"

The Al Rowais case fell into investigators' laps in July 2005, according to court documents.

In 2004, investigators arrested Larry Jeffs on child pornography charges, after he was alleged to have molested his two-month-old daughter and shared web cam photos of the live criminal act with several individuals.

In 2005, one of Jeffs' online friends, who authorities also were investigating, told Al Rowais to contact Jeffs because "they both liked them really young."

Unbeknownst to Al Rowais, when he contacted Jeffs' e-mail account, he actually made contact with an undercover agent. The agent posed as the father of a 2 1/2-year-old girl, and soon, Al Rowais wrote that was "a lovely age and that it was good that his daughter could grow up knowing how to please daddy" and "i could pay u for sharing."

Al Rowais also chatted that he had previous sexual contact with a 10-year-old while she slept, and a 2-year-old, who was awake. He called them his "girlfriends."

From there, Al Rowais sent sexually explicit photos of prepubescent girls to the undercover agent for nine months.

A meeting was arranged at Vallejo Motel 6, 458 Fairgrounds Drive.

Al Rowais flew to San Francisco and took a limousine to the Vallejo motel room, where authorities were lying in wait. After knocking on the motel room door, agents arrested him and in his overnight bag found a video camera and two pairs of girls underwear, among other items.

He has been held in Sacramento County Jail since his arrest.

4-Year-Old's Fatal Overdose Raises Questions About Psychiatric Prescriptions For Kids

As seen in the International Herald Tribune, and on CBS News HealthWatch

In the final months of Rebecca Riley's life, a school nurse said the little girl was so weak she was like a "floppy doll."

The preschool principal had to help Rebecca off the bus because the 4-year-old was shaking so badly, and a pharmacist complained that Rebecca's mother kept coming up with excuses for why her daughter needed more and more medication.

None of their concerns was enough to save Rebecca.

Rebecca — who had been diagnosed with attention deficit hyperactivity and bipolar disorder — died Dec. 13 of an overdose of prescribed drugs. Her parents have been arrested on murder charges, accused of intentionally overmedicating their daughter to keep her quiet and out of their hair.

Interviews and a review of court documents by The Associated Press make it clear that many of those who were supposed to protect Rebecca — teachers, social workers, other professionals — suspected something was wrong but never went quite far enough.

But the tragic case is more than a story about one child. It raises troubling, larger questions about the state of child psychiatry, namely: Can children as young as Rebecca be accurately diagnosed with mental illnesses? Are rambunctious youngsters being medicated for their parents' convenience? And should children so young be prescribed powerful psychotropic drugs meant for adults?

Dispensing drugs to children diagnosed with mood or behavior problems is "the easiest thing to do, but it's not always the best thing to do," said Dr. Jon McClellan, medical director of the Child Study and Treatment Center in Lakewood, Wash. "At some level, I would hope that you'd also be teaching kids ways to control their behavior."

According to the medical examiner, Rebecca died of a combination of Clonidine, a blood pressure medication Rebecca had been prescribed for ADHD; Depakote, an anti-seizure and mood-stabilizing drug prescribed for the little girl's bipolar disorder; a cough suppressant and an antihistamine. The amount of Clonidine alone in Rebecca's system was enough to be fatal, the medical examiner said.

The two brand-name prescription drugs are approved by the Food and Drug Administration for use in adults only, though doctors can legally prescribe them to youngsters, and do so frequently.

Rebecca's parents, Michael and Carolyn Riley, say they were only following doctor's orders. Rebecca, they told police, had been diagnosed when she was just 2½, and Rebecca's psychiatrist prescribed the same potent drugs that had been prescribed for her older brother and sister when she diagnosed them with the same illnesses several years earlier.

But Rebecca's teachers, the school nurse and her therapist all told police they never saw behavior in Rebecca that fit her diagnoses, such as aggression, sharp mood swings or hyperactivity.

Prosecutors say the Rileys intentionally tried to quiet their daughter with high doses of Clonidine. Relatives told police the Rileys called Clonidine the "happy medicine" and the "sleep medicine."

Through their attorneys, Michael Riley, 34, and Carolyn Riley, 32, have accused Rebecca's psychiatrist, Dr. Kayoko Kifuji, of over-prescribing medication.

Kifuji did not return calls for comment and declined to be interviewed. But Kifuji has vehemently denied any role in Rebecca's death. She has agreed to a suspension of her license while the state's medical board investigates.

Kifuji told police Rebecca had been her patient since August 2004, when she was 2. She said she based her diagnoses of ADHD and bipolar disorder on the family's mental health history, as described by Carolyn Riley, and Rebecca's behavior, as described by Carolyn and briefly observed by her during office visits.

Kifuji told police she became alarmed in October 2005 when Carolyn Riley told her she had increased Rebecca's nighttime dose of Clonidine from 2 to 2½ tablets, and warned Carolyn the increased dose could kill Rebecca.

But Carolyn told investigators Kifuji told her she could give Rebecca and her sister extra Clonidine at night to help them sleep.

Tufts-New England Medical Center, where Kifuji worked, issued a statement supporting Kifuji, saying her care of Rebecca "was appropriate and within responsible professional standards."

In the months leading up to Rebecca's death, others noticed there was something wrong.

Teachers and staff members at the Johnson Early Childhood Center in Weymouth, about 20 miles south of Boston, say they called Rebecca's mother repeatedly to tell her that Rebecca was "out of it," but her mother said the girl was tired because she wasn't sleeping well.

A neighbor who lived next door to the family in the last month of Rebecca's life said Rebecca and her siblings seemed listless.

"They looked like little robots. They looked very lethargic," Phyllis Lipton said. "I said, `Wow, they don't look right,' but who knew?"

Pharmacists at Walgreens in Weymouth called Kifuji twice to complain that Carolyn Riley was asking for more Clonidine, even though her prescription was not due to be refilled yet, according to state police.

Once, Riley said she had lost a bottle of pills; another time, she said water had gotten into her prescription bottle and ruined the pills, according to police.

Kifuji authorized refills, but after the second incident, she began prescribing Clonidine in 10-day refills instead of 30-day supplies, investigators said.

On Aug. 16, a prescription for 35 Clonidine tablets — a 10-day supply — was filled at Walgreens, even though the Rileys had obtained a 10-day refill only the day before, investigators said.

Walgreens spokeswoman Tiffani Bruce said: "The scrip was filled as written, as it was prescribed by the doctor, and all the appropriate information on the medications was given to the family."

After Rebecca's death, police found only seven Clonidine tablets in the family's medicine tray; the pharmacist said there should have been 75. All together, prosecutors say, Carolyn Riley got 200 more pills in one year than she should have.

The Rileys' lawyers call them unsophisticated people who did not question their children's doctors.

Both were unemployed; they collected welfare and disability benefits and lived in subsidized housing. Michael Riley, who is also awaiting trial on charges of molesting a stepdaughter in 2005, claimed to suffer from bipolar disorder and a rage disorder; his wife told police she suffered from depression and anxiety.

"They are not the sort of people who go on the Internet and look on WebMD. These are the sort of people who, when they go to a doctor, the doctor is God and they do what the doctor says," said John Darrell, Michael's lawyer.

Carolyn's lawyer, Michael Bourbeau, said because the Rileys' three children were all taking Clonidine, Rebecca's prescription may have come up short at times when her siblings were given some of her pills. Also, some of the pills may have been lost when they were split in half, he said.

In July, after a therapist filed a complaint with the state Department of Social Services, social workers met with the family's doctors and other medical professionals and were assured that the medications Rebecca was taking were within medical guidelines.

"There were lots of medical eyes on this case and none of them seemed to say there was an issue of over-medication in this case," said Social Services Commissioner Harry Spence, who has come under fire for the agency's handling of the case.

Still, there were lingering concerns. When social workers tried to make a home visit in November, Carolyn "resisted and evaded," Spence said. Weeks later, workers resolved to make a surprise check, but Rebecca died the very next day, before they could visit.

Rebecca was found dead on the floor of her parents' bedroom wearing only a pink pull-up diaper and gold-stud earrings, on top of a pile of clothes, magazines and a stuffed brown bear.

Rebecca's uncle, James McGonnell, and his girlfriend, Kelly Williams, who lived with the Rileys, told police that the Rileys would put their kids to bed as early as 5 p.m. Rebecca, they said, often slept through the day and got up only to eat.

When Michael Riley decided the kids were "acting up," he told Carolyn to give them pills, McGonnell and Williams told police.

According to McGonnell and Williams, Rebecca spent the last days of her life wandering around the house, sick and disoriented. But the Rileys told police they were not alarmed. "It was just a cold," Carolyn repeatedly said during police interviews.

The medical examiner said Rebecca died a slow and painful death. She said the overdose of Clonidine caused her organs to shut down, filling her lungs with fluid and causing congestive heart failure.

Williams told police that the night before she died, Rebecca was pale and seemed "out of it." At one point, the little girl knocked weakly on her parents' bedroom door and softly called for her mother, but Michael Riley opened the door a crack and yelled at her to go back to her room, Williams said.

Later that night, McGonnell told police, he heard someone struggling to breathe and found Rebecca gurgling as if something was stuck in her throat. McGonnell told police he wiped vomit from his niece's face, then kicked in the door to her parents' room and yelled at the Rileys to take Rebecca to the emergency room.

Instead, Carolyn Riley said, she gave her daughter a half-tablet of Clonidine.

Carolyn's mother, Valerie Berio, said that when she visited the kids the night of Dec. 11, Rebecca seemed congested but not seriously ill. In a photograph Berio said she took that night, about 18 hours before the girl's body was found, Rebecca is smiling slightly as her mother holds a new green velvet dress in front of her.

Berio said that shows that her daughter and son-in-law could not have known how sick Rebecca was.

Rebecca's death has inflamed a long-running debate in psychiatry. Some psychiatrists believe bipolar disorder, which was traditionally diagnosed in adolescence or early adulthood, has become a trendy diagnosis in young children.

"As a clinician, I can tell you it's just very difficult to say whether someone is just throwing tantrums or has bipolar disorder," said Dr. Oscar B. Bukstein, a child psychiatrist and associate professor at the University of Pittsburgh.

A study of mentally ill children discharged from community hospitals, published in January in the Archives of General Psychiatry, found the proportion of children diagnosed with bipolar disorders jumped from less 2.9 percent in 1990 to 15.1 percent in 2000.

A report released by the Centers for Disease Control and Prevention in 2002 estimated that about 7 percent of elementary school-age children — or approximately 1.6 million youngsters ages 6 to 11 — have been diagnosed with ADHD.

The annual number of U.S. children prescribed anti-psychotic drugs jumped fivefold between 1995 and 2002, to an estimated 2.5 million, according to a study published last year by researchers at Vanderbilt Children's Hospital in Nashville, Tenn.

[...]

Sleep drug killed Anna Nicole Smith, 2 mags say

As seen in the NY Daily News, from the National Enquirer and the Star. While these are not the best sources, the details of the report will be easy enough to verify in a few days. Of course, the main culprit is one of the drugs provided by her 'best friend' psychiatrist Khristine Eroshevich. With friends like these ...

Anna Nicole Smith died of a lethal level of a potent sleep medication, but she had a raging blood infection that could have killed her had she not overdosed, an exclusive report has revealed.

Smith took the speedy sleep-inducer chloral hydrate, which is sometimes used in "date rape" drugs, the night of Feb. 7 and never woke up, according to a joint investigation by sister publications the National Enquirer and the Star.

In its most stunning disclosure, the report says Smith's life might have been saved had she simply gone to a hospital rather than treating her severe fever, nausea and other infection symptoms on her own.

Smith's lawyer pal Howard K. Stern, a bodyguard and a nurse were with her in the days and hours leading up to her death.

The magazines' report comes days before Broward County Medical Examiner Dr. Joshua Perper is set to reveal his official findings about what killed the 39-year-old ex-model, who died Feb. 8 at a Florida hotel.

Smith's infection, which drove her temperature to a staggering 105 degrees, was caused by an injection in her left buttock with a needle that apparently was not properly sterilized, according to the report, posted on the Enquirer and Star Web sites.

Tests did not reveal what substance had been injected into Smith three days before she died, but a painful abscess developed, the report said.

Psychiatrist Charged with Defrauding Benefits Services, Private Employers to the tune of $1,000,000

A Press Release from the office of the Attorney General for the State of Florida.

Attorney General Bill McCollum today announced the arrest of a Miami-Dade psychiatrist on charges that she defrauded the Florida Medicaid program and several other benefits services out of more than $1 million. Investigators with the Attorney General’s Medicaid Fraud Control Unit believe Moraima Trujillo was involved in a scheme that defrauded the Florida Medicaid program, the Medicare program, the Veteran’s Administration and several private employers during a year-long period.

“Organized efforts to defraud assistance-oriented programs directly affect the individuals who legitimately rely on those programs,” said Attorney General McCollum. “We must not allow greed and criminal activity to victimize Floridians who may genuinely need the assistance.”

Investigators acted upon information received from the State of Florida Agency for Health Care Administration. A review of documents from Trujillo’s facility revealed that between January and December 2004, Trujillo billed the Medicaid and Medicare programs for the treatment of Medicaid and Medicare recipients at the same time she was supposedly performing similar functions for the Veteran’s Administration and several other employers. Throughout the year 2004, there were 207 days on which Trujillo submitted time reports to several employers and billings to the Medicaid and Medicare programs claiming to have worked between 20 and 40 hours on each day.

Today’s arrest was made by authorities with the Medicaid Fraud Control Unit. The investigation was a cooperative effort between the Medicaid Fraud Control Unit, the State Attorney’s Office for the 11th Judicial Circuit, the U.S. Department of Health and Human Services and the U.S. Department of Veterans Affairs, Office of Inspector General.

Trujillo is currently being held at the Miami-Dade County jail. She is charged with one count each of grand theft and organized scheme to defraud, both first-degree felonies. If convicted of both charges, she faces up to 60 years in prison and a $20,000 fine. The Medicaid Fraud Control Unit also seized funds from several bank accounts controlled by Trujillo pursuant to the Florida Contraband Forfeiture Act. Trujillo will be prosecuted by the State Attorney’s Office for the 11th Judicial Circuit.

A copy of Trujillo’s arrest affidavit is available here.

Dr. Feel Good

A poem found on the Advocate Web website. AdvocateWeb is a nonprofit organization providing information and resources to promote awareness and understanding of the issues involved in the exploitation of persons by trusted helping professionals. They are attempting to be a helpful resource for victim/survivors, their family and friends, the general public, and for victim advocates and professionals.

Dr. Feel Good
Toni

His guise was to heal,
But that was not the deal.
I put my well being into his hands,
and naively followed his commands.

I did not see he was there to seduce;
Feelings of shameful stupidity it would produce.
He caught me in a weakened state,
at his will would lie my fate.

Self respect is not all he would take.
I could not find it in my of him to forsake.
My awful secret I would conceal.
Who would believe me if I were to reveal?

Like a thief he took my dignity,
along with my trusting ability,
taking full advantage of my vulnerability.
He took it all the while
he kept a cunning smile.

What he took can not be replaced.
From my memory it can never be erased.
I could find no hiding place.
To his “charm” I fell victim.
My welfare did not matter to him.

His intentions I refused to believe.
The damage he could inflict I could not conceive.
By this ugly truth I am consumed.
And he? He remains immune.

But why me did he pick.
This man who supposed to heal the sick?
Was it the color of my hair?
Or was I just... THERE?

Drugs is what he would supply
in order to get me to comply.
Give in I would not do.
So I became a waste of time in his view,
but he was in too deep.
Of all of this he did not want me to make a peep.
Enough drugs and maybe she'll never wake from sleep.

Ethics is only part of what he lacks.
He provided a monkey for my back.
Like a child to a father, I trusted him.
That trust soon began to dim.

What he did is equivalent to child abuse,
it was the child in me he did use.
One day I may get bold
and of this story I will have told.

No one could get him to admit
to the moral crimes he did commit.
It is him and public opinion I fear.
I would be viewed as the guilty and my name left to clear.

He'd come out smelling like a rose all along
knowing it is he who is in the wrong.
I could testify,
and him try to defy.

But can he really be caught?
And unbiased justice truly be sought?
If so, could there be a happy ever after
come the end of this chapter?

Anna Nicole's Drugs: More, More, More from her 'Best Friend' Shrink

More news on the drug cocktail mix that Anna Nichol Smith was taking (all courtesy of her 'best friend' psychiatrist pal), which leaves me wondering how she lived as long as she did.

Now Anna Nicole's drug list looks like this:

• Ativan
  
• Chloral hydrate
  
• Cipro
  
• Dalmane
  
• Dilaudid
  
• Methadone
  
• Morphine
  
• Prexige (A British drug)
  
• Paxil
  
• Robaxin
  
• Topamax
  
• Valium

For being her 'best friend', it seems that Psychiatrist Khristine Eroshevich actually did much more harm than good.

With friends like these ....

FOX 411 has this report on the additional drugs that were in the mix. (scroll to the bottom in their column)

What else was Anna Nicole Smith taking last winter, and who gave it to her?

Some of that was answered by our pal, Dr. Khristine Eroshevich, on TV Monday night. This column had already reported that Dr. Eroshevich had ordered methadone, Dilaudid, Ativan, Dalmane and a British drug called Prexige, all muscle relaxers and painkillers, for Smith.

But the doctor volunteered some more info on TV. She added to the mix Paxil, Robaxin, Topamax, morphine, Cipro, Valium and chloral hydrate.

How she got it to the Bahamas and why she thought Anna Nicole needed all this remains Dr. Eroshevich's call. But she did say in her "exclusive" interview with "Entertainment Tonight" that she administered it all herself.

And what of these added drugs? Chloral hydrate, for example, is used by veterinarians to calm their patients. One description says: "An overdose is marked by confusion, convulsions, nausea and vomiting, severe drowsiness, slow and irregular breathing, cardiac arrhythmia and weakness. It may also cause liver damage. It is moderately addictive." Topamax is anti-convulsant. Valium and Paxil we know about.

Smith's toxicology report is taking a long time, and maybe now we know why. It should be interesting to see how much if any of this stuff turns up in her blood. No wonder she seemed so stoned during her "Entertainment Tonight" interviews right before her death. It's amazing that she was awake long enough to sign the releases.

Are America’s Doctors Accepting “Drug” Money? AMA Report Details Results of Study

As seen on the Blogger News Network, part of our continuing interest in the financial practices of the Pharmaceutical Companies. See also this report in the Tuscaloosa News There is nothing illegal about doctors’ accepting money for marketing talks, and professional organizations have largely ignored the issue. But research shows that doctors who have close relationships with drug makers tend to prescribe more, newer and pricier drugs — whether or not they are in the best interests of patients.

There’s a report coming out Wednesday detailing one reason the average American is spending more and more on prescription drugs.

The Journal of the American Medical Association (JAMA) is issuing the report, which in part, stresses that even if disclosure’s required under law, the average consumer will have a tough time digging it out.

Minnesota and Vermont are the first two states to enact laws designed to illuminate whether or not your family doctor or your high priced team of specialists accept drug money or shall it be said, payments and, or gifts from drug companies.

Getting information from these two states required a lawsuit in Vermont and photocopying individual disclosure forms in Minnesota.

Dr. Allan Collins may be the most influential kidney specialist in the country. He is president of the National Kidney Foundation and director of a government-financed research center on kidney disease.

In 2004, the year he was chosen as president-elect of the kidney foundation, the pharmaceutical company Amgen, which makes the most expensive drugs used in the treatment of kidney disease, underwrote more than $1.9 million worth of research and education programs led by Collins, according to records examined by The New York Times.

In 2005, Amgen paid Collins at least $25,800, mostly in consulting and speaking fees, the records show.

The payments to Collins and the research center appear in an unusual set of records. They come from Minnesota, the first of a handful of states to pass a law requiring drug makers to disclose payments to doctors. The Minnesota records are a window on the widespread financial ties between pharmaceutical companies and the doctors who prescribe and recommend their products.

Patient advocacy groups and many doctors themselves have long complained that drug companies exert undue influence on doctors, but the extent of such payments has been hard to quantify.

The Minnesota records begin in 1997. From then through 2005, drug makers paid more than 5,500 doctors, nurses and other health care workers in the state at least $57 million. Another $40 million went to clinics, research centers and other organizations. More than 20 percent of the state’s licensed physicians received money. The median payment per consultant was $1,000; more than 100 people received more than $100,000.

Doctors receive money typically in return for delivering lectures about drugs to other doctors. Some of the doctors receiving the most money sit on committees that prepare guidelines instructing doctors nationwide about when to use medicines. Collins, who received more money than anyone else in the state, is among a limited number whose payments financed research. In dozens of interviews, most doctors said that these payments had no effect on their care of patients.

Collins said his sole focus was the health and well-being of patients. “Just because I might do consulting work doesn’t mean I don’t press the agenda of the public health,” he said.

Ken Johnson, senior vice president of Pharmaceutical Research and Manufacturers of America, said interactions between drug companies and doctors were beneficial. “In the end, patients are well-served when technically trained pharmaceutical research company representatives work with health care professionals to make sure medicines are used properly,” he said.

There is nothing illegal about doctors’ accepting money for marketing talks, and professional organizations have largely ignored the issue.

But research shows that doctors who have close relationships with drug makers tend to prescribe more, newer and pricier drugs — whether or not they are in the best interests of patients.

“When honest human beings have a vested stake in seeing the world in a particular way, they’re incapable of objectivity and independence,” said Max H. Bazerman, a professor at Harvard Business School. “A doctor who represents a pharmaceutical company will tend to see the data in a slightly more positive light and as a result will over prescribe that company’s drugs.”

In an e-mail message, Collins said he personally received in 2004 less than $10,000 from Amgen for educational presentations. “The contract amount of $1.9 million from Amgen was paid to the Minneapolis Medical Research Foundation (MMRF) for the research contract, on which I am the designated senior researcher,” Collins wrote.

He wrote that he did not work for or serve on the board of directors of the foundation. Collins discloses on his Web site and research papers that he is a consultant to Amgen, among other companies.

Dan Whelan, an Amgen spokesman, said the company paid the Minneapolis Medical Research Foundation “to conduct sophisticated research and data analyses that have enhanced the understanding of health care delivery” for kidney patients.

But Dr. Daniel Coyne, a kidney specialist at Washington University said he was troubled by the payments.

“Amgen’s funding for Dr. Collins’s MMRF is another huge financial connection to individuals at the National Kidney Foundation,” Coyne said. “The foundation’s recent pro-industry anemia guidelines — and the revisions due next month — have to be viewed with great skepticism.”

Coyne recently wrote an editorial in an influential journal decrying guidelines written last year by the kidney foundation that encourage doctors to use more of Amgen’s drugs to treat anemia in kidney patients despite studies showing that increased use led to more deaths.

Ellie Schlam, a spokeswoman for the National Kidney Foundation, said the foundation sought out the world’s foremost experts. “These are the same people that are wanted by government and industry,” she said. “We really work hard to separate the financing from the content.”

Drug makers listed Collins and the research group as the recipient of payments totaling more than $2 million between 1997 and 2005. Most doctors on the list are far less prominent than Collins.

Ten doctors and one dentist in Minnesota received more than $500,000. Because the records are incomplete, these sums likely underestimate the providers’ earnings. Device makers and Wall Street firms tracking medical research were not required to report, although consulting arrangements between such companies and doctors are common.

More than 250 Minnesota psychiatrists together earned $6.7 million in drug company money — more than any other specialty. Seven of the last eight presidents of the Minnesota Psychiatric Society have served as consultants to drug makers, according to media reports.

After psychiatrists, doctors who specialized in internal medicine garnered the most money, followed by cardiologists, endocrinologists and neurologists.

Doctors in Minnesota said they generally did not tell their patients about these arrangements. Indeed, few patients are aware of the financial connections between those prescribing drugs and the companies making them.

A New York Times/CBS News poll last month found that 85 percent of respondents thought it “not acceptable” for doctors to be paid by drug companies to comment on prescription drugs. Eighty-five percent also said such payments would influence the decisions that doctors made about patient care.

In addition to Minnesota, legislators in Vermont, Maine, West Virginia, California and the District of Columbia have passed laws requiring some level of disclosure of drug company marketing efforts. In Vermont, the state has collected three years of data on payments to doctors, but drug makers are allowed to keep the records private by declaring them trade secrets.

In the 2005 fiscal year, the most recent year for which figures are available, drug makers declared 73 percent of payments to doctors in Vermont as trade secrets. The Journal of the American Medical Association today is publishing data summarizing physician payments from drug makers in Minnesota and Vermont.

The study concludes that many payments exceeding $100 were made but that the records were difficult to decipher and all but impossible for individuals in either state to interpret.

Dr. David Blumenthal, director of the Institute for Health Policy at Massachusetts General Hospital, said, “We have given physicians a lot of freedom and self-governance because of their professional reputation and a sense that they know how to help their patients.”

Doctors said their lectures about drugs to other doctors in return for the payments were gentle marketing pitches that adhered strictly to messages approved by drug makers and federal drug regulators.

Drug companies “want somebody who can manipulate in a very subtle way,” said Dr. Frederick R. Taylor, a headache specialist in Minneapolis who earned more than $710,000 between 1997 and 2005, much of that from GlaxoSmithKline, the maker of the migraine drug Imitrex.

Dr. George Realmuto, a psychiatrist from the University of Minnesota, said most of the marketing associated with his lectures was packaged around his talks.

"It’s at a wonderful restaurant, the atmosphere is very conducive to a positive attitude toward the drug, and everyone is having a good time,” said Realmuto, who compared the experience to that of buying a car in a glitzy showroom.

He earned at least $20,000 between 2002 and 2004 from drug makers.

Doctors said that lectures were highly educational, and that drug makers hired them for their medical expertise and speaking skills. But former drug company sales representatives said they hired doctors as speakers mostly in hope of influencing that doctor’s prescribing habits.

“The vast majority of the time that we did any sort of paid relationship with a physician, they increased the use of our drug,” said Kathleen Slattery-Moschkau, a former sales representative for Bristol-Myers Squibb and Johnson & Johnson who left the industry in 2002. “I hate to say it out loud, but it all comes down to ways to manipulate the doctors.”

Jamie Reidy, a drug sales representative for Pfizer Inc. and Eli Lilly & Company who was fired in 2005 after writing a humorous book about his experiences, said drug makers seduced doctors with escalating financial inducements that often start with paid trips to learn about a drug.

“If a doctor says that he got flown to Maui, stayed at the Four Seasons — and it didn’t influence him a bit? Please,” Reidy said.

The lectures earn doctors more than cash.

“You’re making him money in several ways,” said Gene Carbona, who left Merck as a regional sales manager in 2001. “You’re paying him for the talk. You’re increasing his referral base so he’s getting more patients. And you’re helping to develop his name. The hope in all this is that a silent quid quo pro is created. I’ve done so much for you, the only thing I need from you is that you write more of my products.”

For many doctors, marketing lectures are also a welcome diversion.

“It beats talking to little old ladies about their bowels,” said Dr. Eric Storvick of Mankato, Minn., who made more than $174,000 between 1998 and 2005 from drug makers.

The number of drug marketing presentations delivered by doctors across the United States rose nearly threefold between 1998 and 2006, according to Verispan, a company that tracks drug marketing efforts.

In some cases, consulting doctors are so well recognized that they offer drug makers far more than the chance to influence their own prescriptions. For drug makers, among the most prized consultants are those who write guidelines instructing their peers about how to use drugs.

This list of top doctors in Minnesota includes Dr. Richard Grimm of the Berman Center for Outcomes and Clinical Research in Minneapolis, who has twice served on government-sponsored hypertension panels that create guidelines about when to prescribe blood pressure pills. Last year, he served on a National Kidney Foundation panel that wrote guidelines about when kidney patients should be given cholesterol pills.

Between 1997 and 2005, Grimm earned more than $798,000 from drug companies, according to records. In 2003 alone, Pfizer paid Grimm more than $231,000. Pfizer markets Lipitor, a cholesterol drug that last year had $12.9 billion in sales, more than any other drug in the world. It also markets Norvasc, a hypertension drug that last year had $4.9 billion in sales.

Guidelines that suggest greater use of these drugs would be a huge boon to Pfizer.

“Drug companies are like lions,” Grimm said of his sponsored talks. “For lions, it’s their nature to kill zebras and eat them. For drug companies, it’s their nature to make money. They’re not really trying to improve anybody’s health except if it makes them money.

“On your side, you’re making a bit of money, but you’re also trying to educate the doctors. And in my view, the doctors need a lot of educating.”

Grimm said that he contributed more than $50,000 between 1997 and 2005 to the Minneapolis Medical Research Foundation, and that his lectures were not biased.

Dr. Donald Hunninghake served on a government-sponsored advisory panel that wrote guidelines for when people should get cholesterol-lowering pills. The panel’s 2004 recommendations that far more people get the drugs became controversial when it was revealed that eight of nine members had financial ties to drug makers.

The full extent of those ties has never been revealed.

In 1998 alone, Pfizer paid Hunninghake $147,000, and he earned at least $420,800 from drug makers between 1997 and 2003. He left the University of Minnesota in 2004 to become a full-time industry consultant. He is now retired.

“Most of my talks did not relate to drugs but the guidelines for treatment,” Hunninghake said. He said his consulting practice included a variety of activities, including lectures.

A 2002 survey found that more than 80 percent of the doctors on panels that write clinical practice guidelines had financial ties to drug makers.

“It is critical that the experts who write clinical guidelines be prohibited from having any conflicts of interest,” said Dr. Marcia Angell, a former editor of The New England Journal of Medicine, “Since they have no data themselves but are just making judgments based on their expertise, they absolutely must be impartial or it undermines the whole enterprise.”

According to JAMA, access to payment data required extensive negotiation with the Office of the Vermont Attorney General and manual photocopying of individual disclosure forms at Minnesota’s State Board of Pharmacy.

In Vermont, 61% of payments were not released to the public because pharmaceutical companies designated them as trade secrets and 75% of publicly disclosed payments were missing information necessary to identify the recipient.

“The Vermont and Minnesota laws requiring disclosure of payments do not provide easy access to payment information for the public and are of limited quality once accessed, JAMA concluded. However, substantial numbers of payments of $100 or more were made to physicians by pharmaceutical companies. “

Vermont disclosures are required for payments of $25 or more, but with exclusions including prescription samples and money for research and education-related travel, which likely total huge sums of money.

Also, Vermont law allows companies to designate payments as trade secrets and to withhold them from public disclosure. The watchdog group Public Citizen, whose researchers co-authored the study, have filed suit seeking information on “trade secret” payments.

In Vermont, 12,227 payments totaling $2.18 million were publicly disclosed. But that amount represents less than half of all reported payments because disclosure data on $3.41 million was withheld on trade secret grounds, the researchers said.

Anna Nicole Smith's Shrink Ignored Drug Expert's Warning

Fox411 has more news on Psychiatrist Khristine Eroshevich. Even though she is trying to ride this horse for all it is worth, it is quickly becoming evident that Eroshevich could face some liability for her actions, and apparent lack of professional ethics. Here is the report:

Dr. Khristine Eroshevich is digging a deeper hole for herself on TV.

Last night on CBS Paramount TV's syndicated show "The Insider," Eroshevich turned up to defend herself against our revelation from last Friday that she had been giving Anna Nicole Smith a potentially lethal cocktail of heavy drugs including methadone, Soma, Prexige, Ativan and Dilaudid.

But Eroshevich failed to say that it was she who had written and sent the fax from the Bahamas asking for all the drugs. She and "The Insider" simply said who had received it: Anna Nicole's regular doctor, Dr. Sandeep Kapoor, of Los Angeles.

And then, "The Insider" neglected another important fact: Dr. Kapoor refused to fill the order.

In fact, this column has learned even more: Eroshevich was put in touch by phone with an addiction and pharmacology expert at a prestigious local university. Smith's local pharmacist, who also refused to fill the prescriptions, put them in touch. The expert told Eroshevich that the medicines and doses she was asking for were inappropriate and dangerous.

"He told her she was in way over her head and that Anna Nicole should be hospitalized," a source who knew about the conversation told me last night.

Eroshevich was referred to treatment centers where Smith's problems — chronic pain and grief over her son's death — could be addressed professionally.

But Eroshevich would have none of it. Even though the expert warned her that the drugs she was ordering were "horrible combinations" and that one dose was enough to kill someone, Eroshevich ignored him.

Luckily, sources say, Kapoor was reassured when he first heard from Eroshevich, Smith and Howard K. Stern, that she was not breastfeeding her newborn baby girl.

Nevertheless, Kapoor was apparently horrified when Eroshevich told him, "I need something to knock her out." And the notion that the baby might be a priority didn't seem to matter.

"She told Kapoor that she hadn't bonded with the baby, and that she had people there to look after her," a source said.

All of this happened on or around Sept. 15, 2006, approximately five months before Smith died. Because "The Insider" and "Entertainment Tonight" have paid Eroshevich for interviews, they are not asking her anything definitive or questioning what went on in the Bahamas at that time or from then on.

Smith became Kapoor's patient in 2004 after he inherited the practice of a physician who retired. He had continued the treatment prescribed by the prior doctor: a low dose of methadone for chronic pain.

"Hundreds of thousands of pregnant women are on methadone. It doesn't affect the placenta," a source said.

Many respected medical journals describe the safety of taking methadone during pregnancy. But the other drugs Eroshevich ordered surprised Kapoor, friends say, especially since he had never heard her name until that day in September.

"Stern told him Eroshevich was a longtime friend," a source said. "He said that they hadn't given Anna anything for pain after her C-section. And Eroshevich said she would be with Anna Nicole 24/7 and that she would administer the drugs herself."

Kapoor responded that he would not send them, and that he was particularly concerned about the dose of Dalmane, which was 12 times the limit.

"Eroshevich told him Anna Nicole was really tolerant of Dalmane," a source said.

But after the phone call and fax from Eroshevich, he heard from Smith only one or two more times. The last time was in November. Smith died three months later.

Psychologist pleads guilty to sexual contact.

From the Ashbury Park Press

A fired psychologist at Greystone Park Psychiatric Hospital admitted sexually touching one of her male patients. Lisa Anne O'Neill-Ryan, 45, pleaded guilty to criminal sexual contact Thursday. O'Neill-Ryan, of Phillipsburg, admitted she touched the then-31-year-old patient during treatment between Nov. 1, 2004, and Jan. 31.

She was charged in 2005 with three counts of sexual assault, three counts of official misconduct and one count of criminal sexual contact. O'Neill-Ryan will face probation and community service when she's sentenced.

Fake Psychiatrist Lied on His Resume.

From the report

A doctor invented a string of qualifications as he tried to fulfill his ambition of working as a psychiatrist, a disciplinary hearing has been told.

Dr Kelvin Chatoor claimed that he had passed a Bachelor of Science degree with first class honours and that he was the top student in a class of 2,700 pupils.

But the General Medical Council heard that Chatoor, whose ambition was to become a psychiatrist, had dropped out of the course before completing it.

Dr Chatoor also told bosses at the former Queen's Park Hospital in Blackburn that he was a junior doctor in Trinidad, West Indies, when he had only held the lesser role of medical trainee.

He was employed as a clinical fellow in general medicine - equivalent to senior house officer - in August 2000 and left in July the next year.

Dr Chatoor also "escalated" his experience in psychiatry, even claiming he held a post graduate qualification from the Fellowship of the Royal College of Australia and New Zealand, the hearing was told.

Dr Chatoor, 40, of Cheadle, Stockport, faces a catalogue of charges that he embellished his CV to get jobs throughout the UK between May 2000 to April 2005, including NHS trusts in Herefordshire, Kent, Plymouth and Berkshire.

He has admitted his actions were misleading and "not of the standard expected of a medical practitioner" but denied that they posed a risk of compromising patient safety and or that he had been dishonest.

Andrew Hurst, for the GMC, told the hearing that Chatoor's lies made a mockery of a system that depends on honesty.

"This case concerns the systematic and repeated actions by Dr Chatoor as to his qualifications and work experience in his effort to secure the clinical posts that he desired without having the clinical experience he claimed he did.

"Dr Chatoor repeatedly re-worded his experience either by falsely claiming a post he hadn't done or by re-writing history by turning the posts he had held into different specialties in order to advance his CV.

"Dr Chatoor told, we say, escalating lies on his CV as to his psychiatry experience and qualifications.

"Along the way Dr Chatoor claimed a degree he had not achieved or even sat for.

'He also falsely claimed membership of the Royal Australian and New Zealand College of Psychiatrists."

Dr Chatoor was employed by Blackburn, Hyndburn and Ribble Valley Healthcare NHS Trust, which disbanded in 2003 and was replaced by East Lancashire Hospitals NHS Trust.

A spokesman said: "We can confirm that the doctor in question worked for the trust between August 2000 and July 2001."

The hearing continues.

The Betrayal of Marilyn Monroe by Her Psychiatrist

With all the speculation about the role of Anna Nicole Smith's self proclaimed "best friend" psychiatrist Khristine Eroshevich, we now have this eerie report about the possible role of the psychiatrist Ralph Greenson in the death of Marilyn Monroe. Of course, it is all possible that, as conventional wisdom has it, that 'Marilyn just took one pill and one drink too many … as simple as that'

But for four decades there have been rumors that Marilyn Monroe's death was not a simple suicide. Now a Los Angeles-based Australian writer and director, Philippe Mora, has uncovered an FBI document that throws up a chilling new scenario.

As reported by the Sydney Morning Herald in two reports:

• FBI file links Kennedy to Monroe's death
  
• How Bobby betrayed Marilyn

While there is enough dirt to go around, our attention is on the role of the psychiatrist in the alleged plot. And it points up some of the irresponsible actions of her psychiatrist, even if the alleged plot is pure speculation.

The two reports are a bit long so here are some 'highlights':

The detailed three-page report implicates the Hollywood actor Peter Lawford, Monroe's psychiatrist, staff and her publicist in the plot.

The allegations suggest the 36-year-old actress, who had a history of staging attention-seeking suicide attempts, was deliberately given the means to fake another suicide on August 4, 1962. But this time, it is suggested, she was allowed to die as she sought help.

[...]

"Lawford is reported as having made 'special arrangements' with Marilyn's psychiatrist, Dr Ralph Greenson, from Beverley Hills. The psychiatrist was treating Marilyn for emotional problems and getting her off the use of barbiturates. On her last visit to him he prescribed Seconal tablets and gave her a prescription for 60 of them, which was unusual in quantity especially since he saw her frequently. On the date of her death … her housekeeper put the bottle of pills on the night table. It is reported that the housekeeper and Marilyn's personal secretary and press agent, Pat Newcomb, were co-operating in the plan to induce suicide."

It goes on to say that on the same day, Kennedy had booked out of the Beverley Hills Hotel and flown to San Francisco where he booked into the St Charles Hotel, owned by a friend. "Robert Kennedy made a telephone call from St Charles Hotel, San Francisco, to Peter Lawford to find out if Marilyn was dead yet."

Lawford called and spoke to Monroe "then checked again later to make sure she did not answer". The document claims the housekeeper, Eunice Murray, who had been hired by the actress on the advice of Dr Greenson, then called the psychiatrist.

"Marilyn expected to have her stomach pumped out and get sympathy for her suicide attempt. The psychiatrist left word for Marilyn to take a drive in the fresh air but did not come to see her until after she was known to be dead."

---

This sounds like the wildest rantings of tabloid journalism except for a few key points: it is an official FBI document received before RFK's murder and distributed to a small number of high-level FBI officials.

It was declassified only on December 6, 1984, for a person/s unknown and released in October 2006. It is a well written, highly detailed document noting specific phone calls, hotels and names, and reflects the FBI culture of its time, referring, for example, to The Diary of Anne Frank as a "slanted, left-wing picture".

[...]

The document says it is "reported" that Lawford made "special arrangements" with Monroe's psychiatrist, Ralph Greenson, who was treating her for "emotional problems and getting her off the use of barbiturates" and on her last visit to him prescribed 60 tablets of the barbiturate Seconal, "which was unusual in quantity especially since she saw him frequently".

The story reported becomes ghastly: Monroe's housekeeper, Eunice Murray, and her press agent, Pat Newcomb, were "co-operating in the plan to induce suicide. Newcomb was rewarded for her co-operation by being put on the federal payroll … of the Motion Pictures Activities Division of the US Information Service."

[...]

The housekeeper called Monroe's psychiatrist on her behalf, after she had "taken the bottle of pills", and the psychiatrist "left word for Marilyn to take a drive in the fresh air, but did not come to see her until she was known to be dead.

[...]

The report says the coroner appointing a psychiatric board of inquiry (an "unheard-of procedure") was instigated "so the findings could be recorded that she was emotionally unbalanced", to "discredit any statements she may have made before she died".

[...]

What does one make of all this? I have no dog in this fight. The FBI document is undoubtedly genuine. Its scandalous, terrible contents are released to the general public with no editorial comment from the FBI. Many of the details have emerged piecemeal over the years in different accounts by different people. Were the media and others just spoon-fed bits of this narrative in an attempt to discredit the Kennedys, or did they come across evidence themselves that lends this account credibility?