Williams and Rivers Death: Re-evaluating the Safety of Medicine

On September 4th, Joan Rivers died. She was the second legendary performer to die within a month; the other being Robin Williams. While it is inevitable that one day we all face the ultimate demise, however, it’s the manner in which they passed away that requires a closer look.

On August 11th, Robin Williams died. Upon hearing the news I felt stomach punched and deeply saddened, however, when I found out how he died I was devastated. Following his death, the network news brought out their medical doctors to shed light on Williams’ condition of “Severe Depression”. We were told about the signs and symptoms of depression and were instructed to reach out and make contact with those suffering with this condition. While all that is well and good, something pertinent was left out. How about actually educating us on the more relevant issues? How about answering questions like what was his treatment plan? Or what medications were prescribed? Or how long had he been on them? Or were there any other medications he took? Or what adverse affects can be expected from these medications, etc., etc., etc.?

First off, Robin Williams didn’t die from depression, he died from suicide. He volitionally tied a belt around his neck and hung himself. There were also superficial cuts on both of his wrists. As I stated earlier, I was devastated upon hearing these details.

The medical treatment plan for “Severe Depression” is prescribing anti-depressant medication. Here’s something that you may want to know. All anti-depressant medication, whether it is a monoamine oxidase inhibitor like Nardil, or Marplan, or a selective serotonin reuptake inhibitor like Prozac, Paxil, Zoloft, Lexapro or Celexa, or a tricyclic antidepressants like Norpramin, Pamelor and Elavil (which has been taken off the market because of its toxic effects) or the garden variety anti-depressants like Wellbutrin, Cymbalta or Effexor, come with a Black Box Warning of increased suicide risk. In these warnings there is no leniency or special privileges even for those with a superlative résumé that covers the spectrum from playing Shakespeare, to Presidents, to famous doctors, to a space alien, or even Popeye, these warnings are inclusive for all those who take it.

Secondly, it was also noted that Williams was suffering from Parkinson’s disease (PD). Do you know the number one cause of PD? Here’s a clue…it’s not genetics. It’s medications! The number one medication causing PD is anti-psychotic medication. These medications include Risperdal and Zyprexa. In terms of anti-depressant medication, all of them have rightfully earned a place in bringing out signs and symptoms of PD. These anti-depressant medications cause a spectrum of extrapyramidal signs including tremors, a cardinal sign in PD. Extrapyramidal symptoms occur in the subcortical region known as the basal ganglion (BG) the area of the brain that is involved in fine motor activity. In PD, the substantia nigra, located in the midbrain, has a loss of dopamine production. The BG is the area of the brain most sensitive to chemicals and drugs. While its sad that Robin Williams may have had PD, it’s not surprising once you realize the cause of it. It would be nice if these medical experts would brief us on the effects from the medications that they freely dispense, rather than having us believe that PD dropped from the sky striking Robin Williams as another victim.

The news still reports that the cause of Joan Rivers’ death is unknown. Really? Perhaps I can help here. Joan Rivers and her doctor decided to go forward with an elective surgery. Rivers was reassured that her procedure was “routine” and “simple” and that it could be done as an outpatient visit. I would have loved to have been a fly on the wall when the topic of “risk-reward” surfaced. Once the surgery began, Rivers went into cardiac arrest and the “routine” procedure rapidly turned into a life threatening crisis whereby the medical team was ill-equipped in dealing with it. They needed to transport her via ambulance to Mt. Sinai Hospital where she was put in a medically induced coma. Six days later, her family decided to take her off life support. The failure of this medical staff to provide adequate or appropriate safety for their patient is the definition of negligence. It would be akin to a commercial airline flying transcontinental on a one-engine aircraft. Unless she was having a pimple removed off her tochus which may require a local only, I think it best to avoid terms like “simple” and “routine” when it comes to invasive surgery and anesthesia on an 81 year old. Just for the record the anesthesia used, Propofol, was the same drug that killed Michael Jackson.

In a span of 24 days we lost two legendary performers from the typical standard medical procedures of prescribing medications and performing surgery. When considering the status and clout that Williams and Rivers brought, you know they went to the top medical doctors, the ones being tagged as “scientific” and “evidenced-based” and a cut above the rest. The fact is Robin Williams is not the first person to commit suicide while being on prescribed anti-depressant medications and Joan Rivers will not be the last person to die from having elective surgery. While both of these performers left an indelible impression in their work, their death, on a more sobering note, ought to be a teachable moment whereby just because something is typically practiced doesn’t equal that it’s either safe or beneficial. Robin Williams and Joan Rivers unfortunately are quintessential examples of that.

Joel Berger