Jim McDougal was an interesting man. He was the friend, financial adviser and confidant of some very bright and very powerful people. He enjoyed more than his 15 minutes of fame that most of us are entitled to
according to Andy Warhol. Yet there are a number of loose threads in his
story that most have never heard of, and many don't seem to want to know
about. From a purely medical aspect his final illness points out that even celebrities can have really poor care, if we are to believe the limited
amount of data that has been grudgingly released.
Some background might be helpful to the uninitiated. Long ago Jim and
his wife were partners with another couple, Bill and Hilary Clinton. They
participated in a land development scheme that to put it as charitably as
possible did not do well and resulted in real and maybe not so valid losses, at least for tax purposes. But the fact was that he was tried, and after a period of several years was found guilty and sent to jail. The role of others in the failure and financial hanky panky is a matter of some
debate, and it sort of depends on whether you are a member of one or another political party. What has not really been discussed or even really
investigated is the most interesting part -- the medical aspects.
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Let's start with the facts -- we do have an autopsy which shows (I quote from official records):
- Severe hypertensive atherosclerotic cardiovascular disease (This means that he had heart disease from high blood pressure, and hardening of the arteries)
- Cardiomegaly (his heart was enlarged to 546 grams, a normal male would be 350-400 grams, so he had a big heart, and it was not from being a wonderful giving gentleman, it was because his high blood pressure had not been treated adequately enough)
- Left ventricular hypertrophy (this means that the wall of his heart was thickened, again this would mean that he could have a severe heart problem because not enough oxygen would be available to meet the extra demands on his heart in case of stress or strain, or cold)
- Occlusive coronary atherosclerotic disease (hardening of the arteries of his heart which would cause chest pain if he were under stress or frightened or cold (more on this later)
- Scars of carotid endarterectomy ( He had hardening of the arteries of his neck and an operation was done to clear away the cholesterol filled plaque or narrowing, like rust in an old pipe)
- Status post aorto-femoral bypass grafts ( This means that he had hardening of the arteries of his legs bad enough to require surgery, and, I believe he used a cane)
Once in jail he was given Prozac, an antidepressant, but evidently not
other drugs according to some witnesses. (There was Prozac in his blood at autopsy. There is no evidence that he received high blood pressure medicine.)
He was asked to give a urine specimen, and did not, saying he could not (an effect of antidepressants). The jail people gave him Lasix ( a diuretic) to force his urine (a drug he did not require otherwise). He was placed in a cold (60-degree) cell in isolation. He complained of chest pain but he was not under observation when he collapsed and died after transfer to the hospital.
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Now the fascinating part is that here is a man in a nationally discussed case, under supervision in a jail, who is known to have high-blood
pressure, known to have high cholesterol, and has had not one but two surgical operations directed at the effects of his cholesterol, and they are not
treating his cholesterol. He gets a drug he does not need, when they simply
could have given him several glasses of water or tea and waited and he would have given them their requested urine sample.
Just think about it, a famous witness dies a needless death with clearly
less than adequate medical care. If this is the case with this celebrity,
what would you guess is the care of the average Joe/Jane who does not meet the radar of a close examination because they are only important to their loved ones.
It seems to me that a closer look at this McDougal Medical Mayhem might be instructive. Maybe he really received excellent care that was not documented. Maybe?
David Nash is a medical doctor and clinical professor of medicine.