I still remember where I was that brisk November morning when I got the call, on my way into a Minnesota hospital where my husband was a patient.

The nurse on the other end sounded young, and surprisingly nonchalant.  "Oh, hi, Mrs. Riordan.  Lawrence is fine, but. . ."

I knew the 'but' couldn't be good.

". . .but he took a fall in the bathroom this morning."

My husband had only recently been transferred to a regular patient room after three months critically ill in intensive care.  He was not mobile, and needed a lot of assistance.  Getting him onto a commode generally required a minimum of two attendants, possibly three. 

Two nursing assistants had placed him on a toilet that morning, out of reach of a red cord, and left him.  When they didn't return, he did the only thing logical to someone in that situation.  He reached for the cord, across the room.

That particular event resulted not only in broken ribs, but in a delay in progressing to the rehab unit, and eventually, in an unanticipated trip back to intensive care.  He had been abandoned by his caregivers.

That I was only a few minutes later than usual getting into the hospital that morning annoyed me.  I wondered, as a patient advocate, if I could have prevented the misadventure.

The simplest of facts loomed like a Hunter's Moon on the horizon.  I shouldn't have to have been there. 

Watching these past several weeks the trial of Dr. Conrad Murray, the physician accused of involuntary manslaughter in the death of pop superstar Michael Jackson, has brought into sharp focus the most fundamental of principles in the practice of medicine:

First, do no harm.

Medical students are taught from the outset of their education that it is the first order of being a physician--in the Latin, primum non nocere.  It should be tattooed on the forearm of every practicing medical professional, emblazoned in their consciousness, prominently displayed on hospital walls.

Patients and loved ones place their trust in medical professionals when at their most fragile and disadvantaged.  While they appreciate it might not always be possible to heal, they assume physicians will not harm.  

In prosecuting the case, the state of California has argued that Conrad Murray had ultimate responsibility for the care of Michael Jackson, and whether or not he administered the lethal dose of propofol, an anesthetic generally given in a hospital setting, he is still liable for his death on the basis of negligence and medical abandonment.  

I will always remember where I was when I got another call, on a late September morning a year ago.

"Mrs. Riordan, your husband arrested, but we got him back. . ."

I was disbelieving, again, just a few minutes away from arriving at the hospital near our home where my husband was a patient.  He hadn't had cardiac difficulties in the past.  I couldn't understand what had happened.  He'd gone down to radiology for an MRI scan, accompanied by his nurse.  I'd left the hospital only briefly, unable to go with him.

As I stood over my husband's bed that next morning, after gathering the family, after absorbing the shock that he was now on a ventilator following cardiac arrest, I shared my disbelief with the physician.

"I don't think it was anything to do with his heart," he told me.  "We overdosed him on morphine to get him to hold still."

I was dumbstruck, dumbstruck not only that they'd done it, but that he'd admitted it, and particularly after I clearly told medical personnel on admission that he was hypersensitive to morphine and shouldn't have it. 

That singular turn of events changed the course of a hospitalization which was initially for infection.  The infection ultimately cleared.  The setbacks didn't.

Whether the patient in question in the Conrad Murray trial was a mega celebrity or someone's son, someone's father, someone's brother, someone's uncle, the fundamental issue remains the same.  It is a matter of public trust that physicians do no harm, implicit in the understanding of all medical ethics.  

Today, in a Los Angeles courtroom, a jury of twelve men and women agreed. 

Dr. Conrad Murray was found guilty this afternoon of involuntary manslaughter in the June 2009 death of Michael Jackson and remanded into custody in Los Angeles Superior Court.

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