Joan Rivers Vocal Problems- Was There Malpractice During Her Endoscopy?


Screen Shot 2014-08-28 at 9.51.20 PM

Joan Rivers was my client around the time  of her late husband Edgar’s death. She was referred to me by her ear nose and throat physician Dr. Edward Kantor  in Beverly Hills to help her learn to not abuse her vocal cords and to help her use her speaking voice more effectively.  So it came as no surprise when I learned today that  she went in for an endoscopic procedure at Yorktown Endoscopy Center in NYC so that her doctors  could get a closer look at the function of her vocal muscles.

We all remember Joan as having a machine gun like gutteral sounding hoarse voice as we not only heard her verbal jabs during her comedy routines, but  her vocal jabs to her laryngeal muscles and vocal cords. When a person sounds hoarse and often lose their voice,  it is not uncommon to have a laryngeal endoscopic procedure done so that the physician can visualize the vocal cords to check for how they function or  whether there is  paralysis, vocal nodules,  or vocal ulcers. 

Screen Shot 2014-08-28 at 9.50.46 PM

The procedure using a  transnasal flexible laryngoscope  or laryngeal oral scope is  used for  this office-based diagnostic procedure which is extremely well tolerated and  performed on patients of all ages from newborns to someone who was 81 like Joan Rivers.

Before the endoscope is inserted topical anesthetic is placed in the nasal cavity to avoid stinging and burning during the procedure.Then they sit in an upright position and the scope is passed along the floor of the nose into the back of the throat to a level just above the vocal cords.It is essentially a painfree simple procedure. 

Next the  patient is asked to breath deeply and say the “ah: sound which allows the physician to directly observe the structure and dynamic motion of the  vocal cords which they can view on a video screen .There are no side effects of the procedure and the anesthesia spray usually wears off in about an hour. 

So if Joan was undergoing this simple non invasive non life threatening procedure, what happened? Why was her airway cut off? Did someone do the procedure improperly? Was a technician doing the procedure or was it a licensed physician? Was this a case of malpractice? I have to ask these questions because it seems odd to me that her airway would be closed off.

Also lets say her airway was closed off,  why did a clinic of  this kind or any kind not have life saving equipment to open her airway? If she had a heart attack, why was there no immediate cardiac life saving devices on the premises? Why was she deprived of oxygen for any length of time?  Why wasn’t she given oxygen immediately? This bothers me. Why were there not life saving emergency devices available and if they were why weren’t they implemented asap? 

I am so disturbed by this for several reasons. First,  I knew Joan personally along with her daughter Melissa and I know the horrible toll it will take on Melissa and her son, not to mention the toll it will take on Joan, if she survives.

Secondly I had personal experience with something like this happening in my own family. My dearest brother Manny was intubated improperly by a doctor who was only a doctor for 7 months. As a result my brother became a vegetable and died. I can never get over this and carry this severe emotional  pain with me  my throughout my life. So I cry for Joan and for Melissa and for her son Cooper as I know exactly how they feel to know that someone they loved had to die  or become incapacitated in such a horrific manner. 

I have no doubt that with the resources available to Melissa there will be a thorough investigation as to what actually happened and who may be possibly  responsible.

Screen Shot 2014-08-28 at 10.46.37 PM


It is so devastating that Joan was looking and feeling so good as it was reported hours earlier. Now her life is changed forever- and not for the better .

Joan is now in a medically induced coma and depending  on how long she was deprived of oxygen to her brain, she will most likely never be able to do what she did before. For some people that may be viewed  as a relief because  they found her humor politically incorrect and mean spirited. For others who enjoyed her humor and her views it is a great loss.

Joan’s politics, point of  view, and humor aside, no one should be going into a non invasive relatively simple procedure and end up potentially brain damaged in in a medically induced coma where they may never be able to speak  or live.




Toxic CNN Anchor Creates Hostility Driving Joan Rivers Off Set But Obama Gay Michelle “Tranny” Joke May Be River’s Undoing

Screen Shot 2014-07-06 at 11.18.18 PM


There is nothing more TOXIC then someone being the instigator and then trying to make out like they are the victim. That is what happened with the passive aggressive actions of CNN anchor Fredericka Whitfield. Whitfield was the one who instigated the hostile tone of the interview by calling Joan mean when Joan appears on Fashion Police, calling Joan out on making fun of serious situations like Casey Anthony’s dead daughter and critiquing Joan’s book cover of her new book Diary of a Mad Woman where Joan is wearing fur.

Whitfield laughs a phony laugh and mugs for the camera when Joan walks off the set, acting surprised that Joan left yet mugging and phony smiling all the way. Initially Joan tried to explain that Fashion Police was not mean and that Joan didn’t attack the celebrities, she attacked the clothing and fashion.

Whitfield glossed over River’s answer and proceeded in a hostile tone to attack her over the Casey Anthony daughter humor. Joan once again tried to explain that you can take a horrible situation and add humor (albeit dark humor) it gives the person a moments respite from the tragedy. Rivers further went on to describe how Winston Churchill described this type of humor as a moment’s vacation. Once again Whitfield glossed over her answer and began to attack Joan over wearing fur on her book cover. Joan tried to explain and immediately went on the offensive asking Whitfield if she wore leather and told her to shut up and talk to her when she wears a paper belt.

Then Joan pulled out her earpiece and walked out. On one breath Whitfield was complimentary and on the other breath began her series of attacks. This is called passive aggressive behavior and highly toxic in my book. Rivers told Whitfield that all her questions had been “negative,” and added “You are not the one to interview a person who does humor, sorry,” before Rivers walked off. Rivers was right. She came to speak of her book, not the show and not her furs. It was the attacking staccatto and hostile tone of voice Whitfield used that got Joan worked up.

Had Whitfield said ” What would you say to people who comment on you wearing fur” instead of directly attacking Joan that she was wearing fur on the cover of her book, it would have been a different story. Had she worded her questions differently, Rivers would not have walked off the set. So needless to say I believe Joan was absolutely right not to subject herself to this amature, unprofessional, and hostile interview.

While the incident was unfortunate it put Joan high up in the press and now makes more people aware of her new book. It also put Fredericka Whitfield on the map as before this, most people had no idea who she was.

On the show Joan Rivers was defending herself in saying that she has made people laugh for 50 years.Before all of the current political correctness which permeates our society her humor obviously worked very well. She skewered the Royal family and Elizabeth Taylor as well as racial and ethnic groups without a thought. People loved this and her Vegas shows and nightclub acts around the country sold out regularly. It was the Don Rickles put people down type of humor that people seemed to love.

But today it has changed. People are much more tender and sensitive and don’t find any humor in tragedy such as Caylee Anthony’s death (me included). They will also not tolerate Holocaust jokes as Joan has made in the past or Black jokes. They will also not tolerate gay or gender identity jokes like the recent one she made about The President and First Lady.

When a reporter  recently questioned Rivers if she thought there would be a gay President in the White House she remarked that we already have one- Obama and that his wife Michelle is a tranny.

In my view it is not Joan’s walking off the CNN set that may be her undoing but this joke about the President and First Lady that in my view that hits well below the belt. It’s not funny and in my view oversteps all boundaries. Whether or not you are a fan of Obama and his wife, we can all agree that this was a pretty shocking thing to say, especially that Michelle is a “tranny.” While there has been tabloid press in the past  alluding to Obama’s being gay, there is nothing to even suggest that Michelle is transgender. It seem libelous to me.

While shock value has been what has sustained Rivers throughout the years, this shock value may be what finally does her in.

Shaquille O’Neal As TOXIC as Donald Sterling As He Makes Fun of Genetically Disabled Man


As someone who spent the early part of her career working the craniofacially deformed  individuals, including patients with Ectodermal Dysplasia, a condition affecting the  skin and teeth and sweat glands with protrusion of the upper part of the skull, and  I am completely sickened by what basketball star Shaquille O’Neal did to a  young man from Detroit, Jahmel Bionion,  who is suffering from this condition.



To me, Shaquille is now as Toxic as Donald Sterling as I am sickened by both of their egregious actions. Please don’t tell me that one is different from the other. It is not.Both O’Neil’s  and Sterling’s words and actions are devastating to others. While Sterling showed  abusive discrimination towards Blacks, Shaquille O’Neal showed the same abusive discrimination towards a genetically challenged person. I can NEVER respect Shaquille again just as I can NEVER respect Donald Sterling.


I especially can never look at Shaquille the same way after I saw the video if the young man, Jahmel Binion,  talking about how hurt he was by Shaquille O’Neal ( who was once one of Jahmel’s  hero’s ) I shed tears. below is a link to the video.


What Shaquille did is awful!! It is NOT funny to make a face and mock someone else, especially if they are disabled.  Shaq of all people should know better as there by the grace ofGod goes he.

If it wasn’t for basketball,  Shaquille too may have found himself victimized and made fun of due to his giant size . While he has served as a volunteer reserve officer with the Los Angeles Sherrif’s department when he was a Laker, as law enforcement was one of Shaquille’s childhood dreams, the reality is that his extreme height and size would have made him ineligible  for any police department or law enforcement organization due to their height  and weight regulations.  Had he not been a celebrity. He could have been easily turned away from many a job opportunity because of his size and height.


Even though the internet is filled with people who feel as horribly as  I do about what Shaquille did to this young man , he has yet to offer up an apology, or a face to face meeting with the young man, or to help repair the damage he contributed to  this young man’s self esteem. If he does happen to apologize to the young man, in my view it is too little too late.  He needed to do it immediately, not after there was public disdain.


Just as I have boycot tDonald Sterling, I am doing the same to Shaquille O’Neal, whom I once considered one of my favorite basketball players. I can’t  even look at him for the added abuse he did to Jahmel’s already fragile self esteem.  Just as what Donald Sterling said and did is unforgivable, Shaquille O’neal’s Toxic and sickening actions are unforgivable as well.





Oscar Pistorius Body Language in the Courtroom Casts Doubt



While his family denies  that disabled champion runner Oscar Pistorius took acting lessons to prepare himself for trial and others swear that he did take lessons, the bottom line is that something is not right in terms of how he presents himself in the courtroom.

As a jury consultant  and someone who has prepared witnesses for trial, I can assure you that acting lessons are the absolute worst thing a person can do to prepare themselves. People need to be genuine and show genuine emotion and speak in a manner. They need to show body language that will not alienate a jury, but rather objectively allow them to hear the message.

In observing Oscar Pistorius’ body language throughout the trial, I noticed many things that are rather odd. His emotions often do not seem to match the situations being discussed or his body language seems to be over the top as far as his emotions are concerned.

He seems to be tuning out which will not endear himself to the judge who, is the only one who will be deciding his fate.


The one thing that I noticed is that he is always covering his ears. In  essence he doesn’t want to hear all the gory details about what he did to Reeva. He wants to block it out and that is what he is doing by literally blocking his ears. But that behavior is off putting.  He needs to sit there without his hands over his ears and listen to every word. If he shed emotion, it needs to be genuine . He needs toface the details of what he is accused of doing.



Not only does he cover his ears, but he covers his head with his papers as you see in the photo above. It is akin to someone wanting to  pull the blankets over their head and not leave their bed or the house. This signals extreme shame and guilt  over what he did. He wants it to all go away as he is in essence, hiding.



As well as not wanting to hear the details at the trial, he also does not want to see them. He does not want to see the results of his actions via the gory photos  as he tightly shuts his eyes and pinches the bridge of his nose in a self comforting gesture.


Screen Shot 2014-04-22 at 9.33.34 AM The gesture where he pulls down the skin on his face is a self mutilation type of gesture which often occurs when a person is feeling guilty and there is no way out. It is a  literal form of  self punishment as we see Pistorius doing here.

Screen Shot 2014-04-22 at 9.32.44 AM

This photo is of Pistorius’ aunt and uncle crying. With their furrowed brows and squinted eyes, they show genuine tears of  sadness at what happened  in this tragic situation.

Screen Shot 2014-04-22 at 9.32.29 AM

In contrast here are Pistorius tears. He hides his face as he cries which to many observing him may indicate that he is faking his cry. Usually when one is in emotional pain, they don’t care who sees them cry. They just express their sorrow and upset openly. Many may feel this is contrived and he may have something to hide.


Screen Shot 2014-04-22 at 9.32.15 AM

He cries too often and his recovery time from his cry is too fast. When people recover too quickly from a cry to a normal non crying facial posture it takes them time to recover. He does it almost immediately which may indicate that he is doing all of this crying for affect.

Screen Shot 2014-04-22 at 9.31.51 AM

The above cry seems too intense . This facial gesture would occur if someone is in severe extreme grief, where they cannot contain themselves or control their emotions.  His hand over his mouth shows that there is something he doesn’t want to reveal. And his tightly squinted eyes are not congruent with the crying emotion he is attempting to display. With a squinty eyed cry the mouth is usually open. That is not the case here.

As a body language I feel that something is off with Pristorius and his emotions. Usually I see an incongruent emotion and body language when the person is medicated or on drugs. But that emotion is usually a more dull or blank  facial appearance.

When someone shows the inconsistency of emotion as Pristorius has been doing throughout the trial, it shows me that either he has forced this on his own in terms of trying to project what he thinks the judge wants to see, or that he has been prepped  or coached in some way.

If he did take acting lessons, he did himself a huge disservice as he looks like a very bad actor trying to force emotion. It takes years to perfect acting skills, not a few weeks or months. So if he did take the lessons, they clearly did not work. On the other hand if he did not take lessons and he is acting like this on his own, he is also doing himself a huge disservice because he is not putting his position across in a genuine manner.

In the US judicial system if he was in front of a jury of his peers my belief is that he would be convicted based on his body language and vocal tone alone. Whether you want to believe it or not the truth is that juries can and have often  judged someone on these things even if all the evidence points in their favor. But Pistorius only has to convince one person whom he refers to as “My lady” throughout the proceedings.

Screen Shot 2014-04-22 at 10.02.25 AM

If My lady” uses her  legal skills along with her genuine common sense and pays attention to the defendant’s body language, facial, language, and vocal tone, she will come up with the right verdict for Oscar Pistorius as his communication skills and body language speak volumes.


Paula Deen’s Body Language, Fake Tears, Insincere Apology, and Racist Punchline Tuned Off Fans and Sponsors

Screen Shot 2013-06-27 at 6.00.36 PM

Deep down, Paula Deen did not  feel that  she did anything wrong. Hence you hear her empty sounding hollow apologies. She made three apologies, one worse sounding than the other.The body doesn’t lie and neither does the voice.

Her tears were non-tears with no liquid in them. And worse or all she used a phrase”I is what I is” which is the punchline of a racist joke.  She went from the fire into the frying pan and fried her reputation for good.

Had she said, “Look I said that 20 something years ago out of anger at one particular person.  I am ashamed of it. Let’s move on because I am not a racist and for anyone to think so is wrong.   But let us use this as a teaching moment that whether we are black or white we must eliminate that word from our lexicon because it brings hurt to everyone.Let’s stop using it in our music and  everywhere else.”

She also needed to put her money where her mouth was and say that she was starting up an educational fund where she would go to schools along with other professionals to teach children about not using hurtful words and telling racist jokes to hurt others.

But instead she got way too defensive about a black guy having a gun to her head and then ending it with an over the top dramatic statement about throwing a stone so hard that it should kill her and then shockingly saying “I is what I is.” She didn’t say “i am what I am”but made reference to  racist joke.

Here is the joke:

There was a black guy and a white guy.
They were debating over whether god was white or black.
The white guy said that there was only one way to find out and that is to
So they go up on a hill and they pray, and pray, and pray.
Finally they hear a voice say, “I am what I am.”
The white guy jumps up, and says, “Aha, I told you he was white.”
The black guy jumps up and says, “What do you mean? That didn’t prove
“Yes it did. Because if he was black he would’ve said I is what I is.”

Her insincere apology and defensive explanation on the Today show  is the reason why she has been dropped by so many including Walmart and Target and her diabetes drug company.

It is not that she said the N words over two decades ago. It is that she now showed no remorse . it was  her body language and how she said it that turned people off.

Charlie Sheen’s NON TOXIC Gesture Pays Justin Bieber Photgrapher Funeral Instead of Beiber

 Screen Shot 2013-01-10 at 2.30.10 AM

While Charlie Sheen may have caused Toxic havoc on the set of Two and a Half Men, he not so Toxic after all. First he bailed out a debt ridden Lindsay Lohan with writing her a six figure check to pay her taxes.Now in another NON TOXIC act, he is  graciously paying for  the funeral of the  29 year old photographer Chris Guerra  who was killed  while shooting photos of  Justin Bieber’s car .


Sheen said “A tragic incident like this erases the line between the photographer and the subject. It’s an unforgiving moment that begs us all to be human and work as one to prevent this in the future.”

 “As parents, we are all not supposed to bury our children. My deepest condolences to the families involved.”

While this is indeed a beautiful gesture on Sheen’s part, in my view it would have been even more powerful if Justin Bieber would have reached into his checkbook and written the check.