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JACKSON V AEGLIVE June 20

th

Dr. Charles Czeisler

Dr. Charles Czeisler
Sleep Mediine! "ar#ard Medial Sh$$l
%lainti&&s E'pert (itness
(Hearing prior to jury entering)
Judge: (ant t$ )a*e +$ur appearanes,
Mr. Panish: -es. G$$d )$rnin.! +$ur h$n$r. /rian %anish &$r %lainti&&s.
Mr. Kosko: G$$d )$rnin.! +$ur h$n$r. Mihael K$s*$&& &$r %lainti&&s.
Mr. !oyle: Ke#in /$+le &$r %lainti&&s.
Ms. "ahan: Kathr+n Cahan &$r the De&endants.
Mr. Putna#: Mar#in %utna) &$r the De&endants.

Ms. $te%%ins: Jessia Ste00ins Ste00ins &$r the De&endants.


Judge: S$)e0$d+ 1anted t$ tal* t$ )e,
Ms. "ahan: -es! +$ur h$n$r. (e 1ere 2ust handed a de)$nstrati#e and a dis 1ith p$1erp$int
*ind $& slides $n it that 1e thin* are .$in. t$ 0e pr$0le)ati &$r puttin. in $ur li#e $nneti$n.
And l$$*ed at the)! and I 0elie#e %lainti&&s3 $unsel th$u.ht it 1as ad#isa0le t$ address the)
1ith +$ur h$n$r 0e&$re the 1itness ta*es the stand and the 2ur+ is 0r$u.ht in.
Judge: O*a+. (hih 1itness are 1e tal*in. a0$ut,
Mr. Panish: Dr. Czeisler.
Judge: O*a+. Dr. Czeisler.
Mr. Putna#: Dr. Czeisler.
Judge: "e3s an e'pert4 ri.ht,
Mr. Kosko: "e3s a sleep e'pert! +es.
Judge: And he has a slide presentati$n,
Mr. Kosko: (ell! there are su))ar+ slides. (e an .i#e the) t$ +$ur h$n$r. And the+3re 2ust
.$in. t$ 55 1e thin* the+3ll help )$#e the testi)$n+ al$n..
Mr. Panish: All ri.ht. (h+ d$n3t +$u .i#e the) t$ the ler*,
Judge: (ell! is there s$)e reas$n 1h+ it 1asn3t .i#en t$ the de&ense earlier,
Mr. Panish: -es. /eause it3s a de)$nstrati#e! and 2ud.e3s $rder 1as &$r an+ de)$nstrati#e
e'hi0it! t$ sh$1 it t$ the) 0e&$re the 1itness! s$ 1e3re $)pl+in. 1ith that. C$ntrar+ t$
+esterda+! Ms. Ste00ins didn3t sh$1 us the de)$nstrati#e 0e&$re she used it. (e &$ll$1ed the
$rder and .a#e itt$ the).
Judge: O*a+. Is it an issue $& needin. ti)e t$ re#ie1 it! $r are there $02eti$ns! $r +$u 2ust d$n3t
*n$1 +et,
Ms. "ahan: (ell! I3) l$$*in. at the) n$1! and I ha#e $02eti$ns t$ the). 6he &irst 55 1e an
l$$* at the %$1erp$int! 1hih 1as! I thin*! 2ust printed &$r +$u! a nu)0er $& these 55 I thin* she
has t1$ per pa.e.
Mr. Panish: I thin* 1e sh$uld identi&+ it 1ith the nu)0er s$ 1e an *n$1 1hat 1e3re tal*in.

a0$ut spei&iall+.
Ms. "ahan: 6he &irst $ne I ha#e sa+s! 7Sleep! the 0eha#i$ral state .enerated 0+ the 0rain.7
Mr. Panish: O*a+.
Ms. "ahan: I d$n3t *n$1 1hat nu)0er +$u 1ant t$ .i#e the).
Judge: 6he+3re pa.inated at the 0$tt$)! 7pa.e 8.7
Ms. "ahan: %a.e 8 has 55
Mr. Kosko: E'use )e. -$ur h$n$r )a+ ha#e t1$ $n a pa.e! and Ms. Cahan has $ne. 6he &irst
$ne is la0eled! 7Sleep!7 and it3s a su))ar+ slide $& 1hat sleep is.
Ms. "ahan: I& he3s .$in. t$ la+ the &$undati$n &$r this $ne in his testi)$n+! that3s O*a+. It
d$esn3t see) t$ 0e 55 it d$esn3t see) t$ 0e ited t$ an+thin.!0ut i& he3s .$in. t$ testi&+ 0ased $n
his e'periene! that3s &ine. 6hat3s n$t s$)ethin. he testi&ied t$ at his dep$siti$n! 0ut I thin* it3s
pr$0a0l+ &air 0a*.r$und.
Judge: O*a+. It see)s t$ 0e 0a*.r$und! +$u an a.ree $n! it see)s.
Ms. "ahan: 6hat3s &ine.
Judge: Desripti$n $& 0i$l$.ial needs $& sleep.
Ms. "ahan: 6he &$ll$1in. t1$! pitures $& dia.ra)s $& the 0rain! I thin*! are &ine. 6he
&$ll$1in. $ne that sa+s 7(a*e!7 and then sa+s 7sta.e 9:;!7 that3s n$t s$)ethin. that 1as
addressed at all at his dep$siti$n. I d$n3t *n$1 1hat the+ plan $n usin. this &$r.
Judge: (hat is that,
Ms. "ahan: I d$n3t reall+ *n$1.
Mr. Kosko: 6h$se are sh$1in. the 0rain 1a#es durin. sleep. (hat 1e3re .$in. t$ 0e sh$1in.!
+$ur h$n$r! is 55 this is all in $nneti$n 1ith his testi)$n+ that he has .i#en! and his $pini$ns he
has .i#en at his dep$siti$n a0$ut 1hat sleep depri#ati$n )eans! and h$1 55 and this is
0a*.r$und &$r sh$1in. 1hat happens 1hen +$u3re a1a*e4 1hat happens 1hen +$u3re asleep4
1hat the sta.es $& sleep are! and 1h+ pr$p$&$l inter&erers 1ith sleep! 1hih is the 1h$le thrust 55
that3s 1h+ he3s here! t$ tal* a0$ut 1hat the e&&ets $& pr$p$&$l is $n natural sleep. 6he &at that
the+ didn3t as* the ri.ht <uesti$ns is n$t 55 d$esn3t ha#e an+thin. t$ d$ 1ith the &at that 1e didn3t
disl$se th$se $pini$ns &ull+! and in &at! he .a#e a rep$rt 55
Judge: Let3s tal* a0$ut this partiular slide here.

Mr. Kosko: -eah.


Judge: D$es this ha#e an+thin. t$ d$ 1ith pr$p$&$l! $r is this 2ust sh$1in. 1a#es durin. sleep
$r 55
Mr. Kosko: -es. It3s sh$1in. 1a#es durin. n$r)al sleep! and then he is .$in. t$ disuss 1hat
the di&&erent parts $& the 1a#es are4 1hat the+ )ean in ter)s $& 0eha#i$r! 1h+ 1e need th$se
parts. And then he3s .$in. t$ sa+ 55
Judge: I thin* +$u3re l$$*in. at a di&&erent 55
Mr. Kosko: And then he3s .$in. t$ sa+ 1hat pr$p$&$l d$es t$ that. And then he3s .$in. t$ sa+
55
Mr. Panish: "$ld $n a se$nd. I d$n3t thin* +$u3re $n the sa)e slide.
Judge: "$ld $n. I3) l$$*in. at this =indiatin.>.
Ms. "ahan: 6his $ne =indiatin.>.
Mr. Kosko: -$ur h$n$r! are +$u l$$*in. at the $ne 1ith the 0rain 1a#es! $r the $ne 1ith the
7Sleep+ 0rain7,
Judge: 6his $ne 2ust sa+s! 7(a*e.7
Mr. Kosko: -es. 6hat3s 2ust sh$1in. the 0rain 1a#es in the 1a*e state! a1a*ened state! and the
0rain 1a#es in the di&&erent sta.es $& sleep. And 1hat is .$in. t$ 0e sh$1n is 55 I )ean! he an
desri0e it! 0ut it s$unds *ind $& sill+ &$r hi) t$ desri0e it 1hen he an sh$1 it! h$1 pr$p$&$l
inter&eres 1ith the sta.es $& sleep. It sa+s under the 7Opini$ns!7 1e had n$. ?@ 7Dr. Murra+3s
ni.htl+ ad)inistrati$n $& pr$p$&$l t$ anesthetize MJ ad#ersel+ a&&eted his a0ilit+ t$ per&$r) and
his a0ilit+ t$ learn his danes in rehearsals.7 and this is .$in. t$ supp$rt that.
Judge: O*a+. I d$n3t thin* A there d$esn3t see) t$ 0e a dispute as t$ 1hether it a&&ets it $r n$t. I
thin* the dispute has t$ d$ 1ith this partiular desripti$n 55
Ms. "ahan: Bi.ht. And! +$ur h$n$r 55
Judge: 55 $& 55 55 the issue is that there 1as n$ testi)$n+ 1hats$ 55 I .a#e Dr. Czeisler the &l$$r
t$ tell )e e#er+thin. a0$ut his $pini$ns at his dep$siti$n. "e $&&ered n$ testi)$n+ 1hats$e#er
a0$ut the di&&erent sta.es $& sleep. "e did $&&er an $pini$n that Dr. C$nrad Murra+3s ni.htl+
ad)inistrati$n $& pr$p$&$l t$ anesthetize Mr. Ja*s$n ad#ersel+ a&&eted his a0ilit+ t$ per&$r)
and learn his danes in rehearsals durin. that inter#al! 0ut he said n$thin. a0$ut h$1 pr$p$&$l
a&&ets the 0rain! h$1 pr$p$&$l a&&ets sleep. 6hat 1as atuall+ 1hat Dr. /r$1n testi&ied a0$ut!
and I understand the+3#e eleted n$t t$ all hi). /ut that d$esn3t )ean the+ an ha#e Dr. Czeisler
$)e in and sa+ thin.s he3s ne#er testi&ied a0$ut.

Mr. Kosko: "e said it. "e said at n$. ?! he said that Dr. Murra+3s ni.htl+ ad)inistrati$n $&
pr$p$&$l t$ MJ a&&eted it. And then he sa+s later $n! $ne $& the $ther $pini$ns 55 1hih is als$
related t$ this 55 and he als$ said in 55 in &at! he spei&iall+ said! 7pr$p$&$l ad#ersel+ a&&ets
B.E.M. sleep.7 and h$1 an 55 &irst $& all! there 1as a 0i. rep$rt that he .a#e t$ +$u! and +$u 2ust
55 this is +$ur s+n$psis $& his rep$rt that +$u3re allin. his $pini$ns.
Judge: S$ a rep$rt 1as pr$#ided,
Mr. Kosko: a #er+ #$lu)in$us rep$rt.
Judge: O*a+. All ri.ht. 6his has 55
The clerk: -$ur h$n$r! I3) s$rr+. I thin* the 1itness is in the $urtr$$). Is that O*a+,
Judge: Ma+0e he sh$uld step $ut.
Mr. Panish: "e an step $ut.
Judge: -es. -$u an step $ut.
(&r. "'eisler e(ited the courtroo#)
Mr. Kosko: I an .i#e +$ur h$n$r a $p+ $& his rep$rt. It3s reall+ their s+n$psis $& his $pini$ns.
Judge: (ell! 1hat d$es the rep$rt $n sleep in spae ha#e t$ d$ 1ith this, I .uess I3) 2u)pin. the
.un! 0ut 55
Mr. !oyle: -$ur h$n$r! +$u ha#e the 55 als$! the rep$rt 1as attahed t$ his dep$siti$n! 1hih is
l$d.ed 1ith +$ur h$n$r.
Judge: O*a+.
Ms. "ahan: And! +$ur h$n$r! t$ 0e lear! the rep$rt is 90 pa.es. 6he &indin.s relatin. t$ Mr.
Ja*s$n! there3s t1$ seti$ns@ seti$n 0 starts $n pa.e 2C! and it sa+s! 7preli)inar+ &indin.
re.ardin. Mr. Mihael Ja*s$n74 and seti$n ! 1hih starts $n pa.e 2D! sa+s! 7preli)inar+
$pini$ns.7 and there3s n$ disussi$n in there 1hats$e#er $& the e&&ets $& pr$p$&$l $n $ne3s a0ilit+
t$ sleep! 1hat it d$es t$ the 0rain 1a#es. Si)pl+ n$t a su02et that 1as tee3d up 0+ the rep$rt as it
relates t$ Mr. Ja*s$n $r an+thin. addressed 1ith hi) at the dep$siti$n.
Mr. Panish: It is. (e 55
Mr. Kosko: (e 2ust read that4 that the ni.htl+ ad)inistrati$n $& pr$p$&$l a&&eted 55
Judge: O*a+. Ms. Cahan! i& that3s in the dep$siti$n! h$1 is that n$t s$)ethin. that he $pined t$

in the dep$siti$n,
Ms. "ahan: /eause he said the 0asis &$r that $pini$n is@ 7Generall+ spea*in.! 1hen pe$ple
aren3t .ettin. en$u.h sleep! it a&&ets their a0ilit+ t$ en$de e'perienes int$ )e)$ries and 0uild
$n their )e)$ries.7
Judge: O*a+.
Ms. "ahan: N$thin. a0$ut pr$p$&$l a&&etin. that! n$thin. a0$ut the sta.es $& sleep! n$ne $&
that detail. 6hat is 1hat Dr. /r$1n did! and I .uess the+ eleted n$t t$ all hi). /ut this is n$t
s$)ethin. Dr. Czeisler 1as testi&+in. t$ $r addressed in his rep$rt 1ith respet t$ Mr. Ja*s$n.
S$ the+3re ta*in. an $pini$n and .i#in. it a Ne1 &$undati$n that 1asn3t disussed at his
dep$siti$n.
Mr. Kosko: (ell! the+ an r$ss5e'a)ine hi)! i& that3s the ase. /ut 1e ha#e the $pini$ns! all
the $pini$ns! and this is all 0a*.r$und t$ the $pini$ns. Let the) 55
Judge: O*a+. S$unds li*e he has the $pini$n! it 2ust d$esn3t ha#e the 55
Ms. "ahan: /rand5ne1 &$undati$n.
Judge: In the dep$siti$n! )uh $& the &$undati$n! 1asn3t that e'pl$red durin. the dep$siti$n,
Ms. "ahan: I as*ed hi) the &$undati$n! and 55
Judge: O*a+. And 1hat did he sa+,
Ms. "ahan: 6he &$undati$n! he said! 1as 1athin. the 6his Is It #ide$! he th$u.ht! and readin.
thr$u.h testi)$n+ 1here it said Mr. Ja*s$n 1as sl$1 55 I 0elie#e it 1as Mr. %a+ne $r Mr.
Orte.a! he 1as a little 0it sl$1 t$ pi* up the dane )$#es.
Judge: And n$1 he3s .$in. t$ sa+ s$)ethin. else. And s$ +$u an i)peah hi) t$ the &at that
he ne#er )enti$ned it in his dep$siti$n4 ri.ht,
Ms. "ahan: -es! +$ur h$n$r! 0ut the la1 is 55
Mr. Kosko: +es. As e#er+ $ther 1itness has 0een i)peahed 1hen the+ didn3t sa+ s$)ethin.
In their dep$siti$n. And Mr. %hillips! 1h$ didn3t sa+ an+thin. at all in his dep$siti$n and
suddenl+ had re&reshed )e)$r+ 1as i)peahed! li*e! ?0 ti)es. "e an3t 0e pre#ented &r$)
testi&+in. 1hen he has the sa)e $pini$n. All 1e3re d$in. is the &$undati$n 55
Ms. "ahan: And! +$ur h$n$r! I as*ed the &$undati$n &$r his $pini$n at his dep$siti$n! and it 1as
s$)ethin. entirel+ di&&erent. Apparentl+! n$1 the+ 1ant hi) t$ tal* a0$ut 1hat Dr. /r$1n 1as
tal*in. a0$ut. /ut the pr$0le) is! this is n$t the appr$priate 1itness. 6his is n$t n$r)al

i)peah)ent. 6his is an e'pert. And under the rules! the purp$se &$r an e'pert dep$siti$n is t$
a#$id un&air surprise at trial. "e3s a sleep e'pert. "e3s 0een d$in. this &$r ;0 +ears. I3#e studied
up $n it! 0ut I3) n$t at his le#el! and it3s n$t &air t$ )e t$ ha#e a 0rand5ne1 &$undati$n &$r an
$pini$n .rand&athered in &$r the &irst ti)e 1hen he ta*es the stand.
Mr. Panish: -$ur h$n$r! he .a#e an $pini$n. Ender the ase la1 he .a#e his $pini$ns in
dep$siti$n. "e3s n$t .i#in. a ne1 $pini$n. 6hat3s as lear as da+.
Jud.e@ I3) .$in. t$ den+ +$ur )$ti$n. I d$n3t *n$1 e'atl+ 1hat +$ur )$ti$n 1as. It started $&&
1ith the slide sh$1! 0ut it3s *ind $& turned int$! an I e'lude his $pini$ns alt$.ether. And )+
understandin. 55 i& that3s +$ur )$ti$n! that3s denied.
Ms. "ahan: And that3s n$t )+ )$ti$n! +$ur h$n$r. I3) n$t see*in. t$ e'lude the $pini$ns he
$&&ered at the dep$siti$n. I had a <uesti$n as t$ 1hat this slide 1as! 0eause this is n$t s$)ethin.
he tal*ed a0$ut at his dep$siti$n $r sa1 0e&$re. And n$1 I3) hearin. that it3s a Ne1 0asis &$r an
e'istin. $pini$n! and I thin* that3s inappr$priate under 2$nes #s. M$$re! )5$5$5r5e! D0
al.App.;th ??F! it3s a 2000 ase. As 1ell as additi$nal ase la1.
Mr. Panish: -$ur h$n$r! he3s .i#in. the sa)e $pini$ns. "e3s all$1ed t$ .i#e the 0a*.r$und! his
trainin. and e'periene in sleep. And s$)e $& this has t$ d$ t$ eduate the 2ur+ $n a l$t $& this &$r
his $pini$ns. 6hat3s all he3s d$in.. "e3s n$t .i#in. ne1 $pini$ns. And J$nes #s. M$$re deals 1ith
a d$t$r 1h$ didn3t .i#e the standard5$&5are $pini$n in his dep$siti$n! and later the+ tried t$ as*
the d$t$r! 7(hat is +$ur $pini$n $n the standard $& are,7 and the 2ud.e didn3t all$1 it 0eause
that .$es t$ his spei&i $pini$n.
Ms. "ahan: -$ur h$n$r! he 1asn3t put &$r1ard as a pr$p$&$l e'pert! he 1as put &$r1ard as a
sleep e'pert. And his $pini$ns are a0$ut h$1 55 1hat $uld ha#e 0een d$ne t$ 55 is it appr$priate
55 1$uld an appr$priate sleep e#aluati$n! 1hih $nsists $& h$1 +$u dia.n$sis a sleep pr$0le)!
and i& that had 0een d$ne! 1hether that 1$uld ha#e a&&eted Mr. Ja*s$n. 6his is s$)ethin. ne1!
0ut 1e an 55
Mr. Kosko: D$es 2ud.e 1ant additi$nal ar.u)ent,
Judge: I3) n$t e'ludin. hi) alt$.ether. It s$unds li*e he .a#e +$u $pini$ns in the dep$siti$n4
he laid the 0asis &$r his $pini$n. I& +$u thin* n$1 he has $ther 0ases he didn3t )enti$n! then +$u
i)peah hi). I 1ant t$ tal* a0$ut this partiular e'hi0it! 0eause that3s 1hat +$u 0r$u.ht t$ )+
attenti$n. It 1asn3t presented t$ +$u at the dep$siti$n,
Ms. "ahan: N$.
Mr. Panish: N$.
Judge: O*a+.

Mr. Panish: /ut it3s illustrati#e $& the $pini$ns that he .a#e at his dep$siti$n.
Judge: O*a+.
Mr. Panish: It3s a de)$nstrati#e e'hi0it t$ illustrate the $pini$ns 0+ the e'pert. And pursuant t$
+$ur rule! it 1as t$ 0e +$ur rule! the+ re<uested it 0e .i#en t$ $unsel 0e&$re the 0e.innin. $& the
da+. 6hat3s e'atl+ 1hat 1e3#e d$ne here. Just as the+3#e d$ne 1ith their de)$nstrati#es! and
1e3#e d$ne 1ith $ther de)$nstrati#es.
Judge: O*a+. (hat d$es this sh$1, An+thin. a0$ut pr$p$&$l, 6his is all *ind $& .eneral 55
Mr. Kosko: that3s )$stl+ 0a*.r$und.
Judge: 6here3s s$)e in the 0a* there.
Mr. Kosko: and at the end it ties it all t$.ether.
Judge: (ell! the end is the pr$0le)! 7sleep #ersus pr$p$&$l.7
Mr. Kosko: (ell! 0ut that .$es t$ $ur $pini$ns 55 t$ the $pini$ns that he3s .$in. t$ e'press!
1hih is the pr$p$&$l inter&ered 55 2ust as the $pini$n stated! that that is .$in. t$ 0e his $pini$n.
(e said it3s .$in. t$ 0e his $pini$n! and this sh$1s it as t$ 1h+ it3s true.
Judge: /ut it 1asn3t presented at the dep$siti$n,
Ms. "ahan: 6hat3s a0s$lutel+ ri.ht! +$ur h$n$r.
Mr. Kosko: 6his didn3t e'ist at the dep$siti$n.
Mr. Panish: 6he e'hi0it 1asn3t presented. "e .a#e his $pini$n. And he an stand up there and
1rite it $n a 0$ard. I )ean! 1hat3s the di&&erene,
Judge: "e $uld! +es.
Mr. Panish: S$ 1hat3s the di&&erene,
Ms. "ahan: S$ his $pini$n! +$ur h$n$r! is ne1! and that3s the pr$0le). (hat he said in his
dep$siti$n 1as la* $& sleep )a+ ha#e aused pr$0le)s &$r Mr. Ja*s$n in learnin. dane )$#es
1hile he 1as a1a*e. "e didn3t sa+! 7Ad)inistrati$n $& pr$p$&$l auses pr$0le)s in pe$ple 1h$
are a1a*e.7 6hat is n$t s$)ethin. e#en Dr. /r$1n testi&ied t$! and Dr. /r$1n 1as presented as
the e'pert $n pr$p$&$l! and 1hat pr$p$&$l d$es t$ the 0$d+ and the 0rain.
Mr. Kosko: (ell! that3s atuall+ n$t <uite s$. Dr. /r$1n 1as an anesthesi$l$.ist! n$t a sleep

e'pert. "e3s an anesthesi$l$.ist. And 0eause the anesthesia is n$1 part $& the ase! and it
see)ed t$ 0e $neded 0+ the $ther side! there 1as n$ need t$ 0rin. Dr. /r$1n in. 6his is the
sleep e'pert! and he is .$in. t$ in &at sa+ he didn3t .et sleep. And he3s .$in. t$ 55 that3s e'atl+
1hat he3s .$in. t$ sa+. "e3s .$in. t$ sa+ the reas$n he didn3t .et sleep is 0eause the pr$p$&$l
1as n$t .i#in. hi) sleep. It 1as .i#in. hi) the illusi$n $& sleep and that he didn3t .et sleep! and
that3s e'atl+ 1hat he3s .$in. t$ sa+.
Judge: Beread the $pini$n that +$u read earlier,
Ms. "ahan: 7Based upon the findings summarized above, and the other materials that I
reviewed in connection with my evaluation of this matter and relevant scientific information,
it is my medical and scientific opinion that Dr. Conrad Murray's nightly administration of
propofol to anesthetize Mr. ac!son adversely affected his ability to perform and his ability to
learn dances in rehearsals that occurred during that interval.7 And 1hen 1e as*ed hi) a0$ut
that in his dep$siti$n! he said that3s 0eause he 1asn3t sleepin.! n$t 0eause he 1as 55 s$)ethin.
1ith 55 the pr$p$&$l a&&eted hi).
Mr. Panish: 6hat3s the sa)e thin..
Judge: All ri.ht. (ell! this is 1hat I3) .$in. t$ d$. D$ +$u ha#e $02eti$ns t$ all this $ther 0asi
&$undati$n $nernin. sleep,
Ms. "ahan: I d$n3t *n$1 55
Judge: It see)s t$ )e i& he disussed that in the dep$siti$n! this sh$uldn3t 0e a pr$0le). At least
e#er+thin. up t$ the last pa.e.
Ms. "ahan: 6he $ne that 1e ha#e 55 that3s all ne1! 0ut I didn3t reall+ ha#e an issue 1ith it. 6he
$nes 1e ha#e a real pr$0le) 1ith is 7Sleep #ersus pr$p$&$l anesthesia7 55
Judge: O*a+.
Ms. "ahan: 55 as 1ell as the last $ne 55
Judge: O*a+.
Ms. "ahan: 55 that &$ll$1s it! and the separate de)$nstrati#e. /eause these appear t$ 0e 0ased
$n Dr. Murra+3s p$lie inter#ie1! 1hih is n$t in e#idene. And as +$ur h$n$r *n$1s 1ell! an
e'pert an &$r) $pini$ns 0ased $n hearsa+ 0ut an3t .rand&ather in spei&i in&$r)ati$n that3s
hearsa+ thr$u.h their testi)$n+. S$ it3s this $ne =indiatin.>! and I d$n3t *n$1 i& the+ pr$#ided
+$u 1ith 55
Judge: 6his is 1hat I3) .$in. t$ d$@ I3) .$in. t$ stri*e the last pa.e. 6he rest $& it is all
&$undati$nal he testi&ied t$ 1ith his e'pertise. -$u an use that. I d$n3t thin* there is an+thin.

pre#entin. hi) &r$) .$in. t$ the 0$ard and 1ritin. n$tes as t$ 1hat his testi)$n+ is.
Mr. Kosko: D$ 1e ha#e a 0$ard,
Ms. "ahan: S$! +$ur h$n$r! 2ust s$ the re$rd is lear 55 0eause s$)e $& us ha#e $ne slide per
pa.e! and the $ther ha#e t1$ slides per pa.e 55
Judge: -es.
Ms. "ahan: 55 1hat +$u3re e'ludin. at this ti)e is the slide headed! 7Sleep #ersus pr$p$&$l
anesthesia7,
Judge: -es.
Ms. "ahan: And the $ne that has the headin. $& 7M$nda+! June 22nd! and 6uesda+! June 29rd7,
Judge: Bi.ht.
Ms. "ahan: And 1e 1$uld ta*e 55 d$ +$u ha#e a C$p+ $& this e'hi0it G9?58, I3) happ+ t$ hand
up )ine.
Judge: N$. And in &at! I3) .$in. t$ )a*e sure this .ets t$ the &ile s$ it3s lear 55
Mr. Putna#: 6han* +$u! +$ur h$n$r.
Judge: 55 1hat 1e3re all tal*in. a0$ut.
Mr. Panish: Are 1e all read+,
Ms. "ahan: -$ur h$n$r! G9?58 appears t$ 0e a ti)eline $& the ad)inistrati$n $& the pr$p$&$l and
$ther dru.s 0ased $n June 2?th $r June 2;th.
Mr. Kosko: I3) .$in. t$ as* 55
Ms. "ahan: %lease let )e &inish.
Mr. Kosko: I ap$l$.ize.
Ms. "ahan: /ased $n Dr. Murra+3s p$lie inter#ie1. And! a.ain! that3s 0ased $n hearsa+ and
that3s n$t appr$priate.
Mr. Kosko: I3) .$in. t$ use it as a h+p$thetial.
Ms. "ahan: It3s still n$t appr$priate.

Mr. Kosko: I3) .$in. t$ sa+! 7D$ +$u ha#e an understandin.!7 sa)e <uesti$n 1e as* e#er+
$ther 1itness. 7D$ +$u ha#e an understandin. as t$ 1hat the ad)inistrati$n $& dru.s 1ere durin.
the $urse $& that e#enin.,7 and 7(hat is +$ur understandin.,7 G$in. t$ sh$1 it.
Ms. "ahan: -$ur h$n$r! I )ean! 1e3d 0e happ+ t$ ha#e the entire p$lie inter#ie1 $)e int$
e#idene. I& that3s 1hat the+ 1ant t$ d$ at this ti)e! 1e d$n3t ha#e an+ $02eti$n. /ut as it stands
ri.ht n$1! that A 2ust turnin. it int$ a "+p$thetial 1ith that le#el $& detail $n the hart 1ith
preise ti)es is n$t &i'in. the hearsa+ pr$0le)! it3s 2ust snea*in. ar$und it.
Judge: O*a+. See i& it 55
Ms. "ahan: -$u 1ant t$ stipulate t$ the ad)issi0ilit+ $& the p$lie inter#ie1,
Mr. Kosko: N$t at this ti)e.
Mr. Panish: N$t the 1h$le thin.! n$.
Mr. Kosko: I3ll stipulate t$ the ad)issi$n $& th$se 55
Judge: I3) .$in. t$ stri*e it! 0ut i& he .ets up here! and he dra1s $ne...
Ms. "ahan: (ell! I3ll $02et at that ti)e! then! +$ur h$n$r.
Mr. Panish: All ri.ht. Are 1e read+ t$ .$, I assu)e 1e3re n$t ta*in. a 0rea*,
Judge: N$.
Mr. Panish: All ri.ht. Hair en$u.h.
(the jury enters the courtroo#)
&irect e(a#ination %y Michael Kosko:
I. -$u ha#e en$u.h le. r$$),
A. 6hat3s 1hat I3) tr+in. t$ &i.ure $ut.
I. G$$d )$rnin.! d$t$r.
A. G$$d )$rnin..

I. D$t$r! 1here d$ +$u li#e at the urrent ti)e,


A. I li#e in the /$st$n area in Massahusetts.
I. And 1here are +$u &r$) $ri.inall+,
A. I .re1 up in Chia.$.
I. (here in Chia.$,
A. On the s$uth side $& Chia.$.
I. And did +$u .$ thr$u.h +$ur 0asi sh$$lin. in Chia.$,
A. -es. I did 0asi sh$$lin. in Chia.$. (ent t$ .rade sh$$l in Chia.$ and then 1ent t$ hi.h
sh$$l in $ne $& the su0ur0s $& Chia.$.
I. And then a&ter hi.h sh$$l! did +$u .$ t$ $lle.e,
A. I did.
I. (here did +$u .$,
A. I 1ent t$ "ar#ard C$lle.e in Ca)0rid.e! Massahusetts.
I. And did +$u ha#e sh$larships,
A. I had an h$n$rar+ &resh)an sh$larship.
I. An h$n$rar+ &resh)an sh$larship,
A. -es. And as I re$llet! there 1as a J$hn "ar#ard sh$larship.
I. -$u3re .$in. t$ ha#e t$ *eep +$ur #$ie up. 6he a$ustis in here are 55
A. I3ll .$ a little l$ser t$ the )ir$ph$ne.
I. 6hat3s .reat.
A. I3) 1$nderin. i& 55
Judge: )t #oves. *o. +ike this, %ack and orth (indicating).

The -itness: .kay.


I. O*a+. And did +$u .raduate &r$) "ar#ard C$lle.e,
A. -es! I did.
I. N$1 +$u3re li*e a tal* sh$1 h$st.
A. 6here +$u .$. It3s a little t$$ sh$rt! $ther1ise.
I. And +$u .raduated &r$) "ar#ard,
A. -es. I .raduated &r$) "ar#ard C$lle.e in 8GF;.
I. And +$u .raduated 1ith h$n$rs,
A. -es! I did. Ma.na Cu) Laude.
I. Ma.na Cu) Laude, And &$ll$1in. +$ur .raduati$n &r$) "ar#ard! 1hat did +$u d$, Did +$u
$ntinue +$ur eduati$n,
A. -es! I did.
I. (here did +$u .$,
A. Stan&$rd Medial Sh$$l.
I. Stan&$rd. 6hat3s ri.ht up the r$ad here.
A. -es! it is.
I. And +$u 1ent t$ )edial sh$$l. Did +$u .raduate &r$) )edial sh$$l,
A. -es! I did.
I. Get a de.ree in )ediine,
A. -es. I .$t an M.D.
I. And then a&ter +$u .raduated &r$) )edial sh$$l! did +$u $ntinue +$ur eduati$n,
A. -es. (ell! I atuall+ 55 s$ it 1as a $nurrent pr$.ra) I 1as in alled )edial sientist
trainin. pr$.ra)! 1hih is an M.D. and %h.D. %r$.ra). And I reei#ed a %h.D. in the neur$ and
0i$0eha#i$ral sienes! and then I reei#ed )+ M.D.

I. S$ +$u .$t t1$ de.rees@ an M.D. de.ree 55 that3s a D$t$r $& Mediine,
A. 6hat is $rret.
I. And a %h.D. De.ree! 1hih is a55
A. D$t$r $& %hil$s$ph+.
I. 55 D$t$r $& %hil$s$ph+, And the D$t$r $& %hil$s$ph+ de.ree 1as in 1hat &ield,
A. Neur$ and 0i$0eha#i$ral sienes.
I. Neur$ and 0i$0eha#i$ral sienes. 7neur$!7 d$es that ha#e t$ d$ 1ith the 0rain,
A. -es.
I. And the $ther part 1as,
A. /i$0eha#i$ral sienes.
I. /i$0eha#i$ral sienes, (hat are 0i$0eha#i$ral sienes,
A. 6hat is the siene related t$ h$1 0i$l$.+! in this ase! the neur$sienes! $r the 0rain! a&&ets
$ur 0eha#i$r.
I. And s$ that 1as +$ur %h.D.! in that &ield,
A. -es.
I. And then a&ter +$u 55 +$u $)pleted that pr$.ra)! 1as that in 8GD8,
A. -es. I $)pleted the pr$.ra) in 8GD8.
I. And then did +$u ta*e a p$siti$n as a Seni$r Hell$1,
A. -es! I did.
I. And 1here 1as that p$siti$n as a Seni$r Hell$1,
A. 6hat 1as at "ar#ard uni#ersit+ at the J$hn H. Kenned+ Sh$$l $& G$#ern)ent. 6he )edial
sh$$l. It 1as a 2$int pr$.ra).
I. -$u *n$1! &$r s$)e reas$n! the )ir$ph$ne is s$undin. a little )u&&led t$ )e.

Mr. Kosko: does it sound that -ay to the jury/ )t sounds a little #uled to all o us. )
don0t kno- -hat -e can do.
I. Ma+0e i& +$u put it 0a* in the 55
A. O*a+. I3ll tr+ puttin. it 0a* in.
I. I *n$1 part $& the pr$0le) is! it3s n$t tall en$u.h.
A. "$1 a0$ut this, D$es that 1$r*,
I. 6hat3s a little 0etter.
A. Is that 0etter, 6here. G$$d.
I. O*a+. G$$d. S$ 1e ha#e +$u at the J$hn H. Kenned+ sh$$l $& .$#ern)ent as a Seni$r
Hell$1. And is that a&&iliated 1ith "ar#ard,
A. -es. 6hat3s the 55 at "ar#ard Eni#ersit+! and there3s a pr$.ra) 0et1een the "ar#ard Medial
Sh$$l 55 the Kenned+ Sh$$l $& G$#ern)ent! and the "ar#ard Sh$$l $& %u0li "ealth and
pr$.ra) in health p$li+.
I. In health p$li+, And then did +$u $ntinue and 0e$)e a pr$&ess$r at "ar#ard,
A. -es.
I. Di&&erent sta.es@ Assistant pr$&ess$r! da5da5da! and then +$u &inall+ 0ea)e a pr$&ess$r at
"ar#ard,
A. -es! that3s aurate.
I. And that 1as in 8GGD. In 200;! I see in +$ur resu)e that there3s s$)ethin. alled a /aldin$
pr$&ess$r $& sleep )ediine. Hirst $& all! 1hat is this p$siti$n! a /aldin$
pr$&ess$r, Is that a Chair in this area,
A. -es. S$ that3s a pr$&ess$rship. As a pr$&ess$r $& )ediine! the )edial sh$$l! 1hen it
reei#es a Gi&t &r$) a D$n$r! it s$)eti)es esta0lishes a li&eti)e p$siti$n in a partiular &ield! in
a partiular disipline. And 1e 1ere &$rtunate t$ reei#e d$nati$ns that esta0lished the &irst three
pr$&ess$rships in sleep )ediine in the 1$rld in 200; in the "ar#ard )edial sh$$l in the
di#isi$n $& sleep )ediine. And I 1as na)ed 0+ the Dean $& the )edial sh$$l t$ 0e the
inu)0ent $& $ne $& th$se end$1ed pr$&ess$rships.
I. And d$ +$u still h$ld that p$siti$n,

A. I d$.
I. N$1! the 55 durin. the $urse $& +$ur areer! 1hen 1as it that +$u reall+ started t$ stud+ sleep
)ediine,
A. (hen I 1as an under.raduate 1hen I &irst 0e.an t$ l$$* at $ne $& the *e+ &at$rs that
re.ulates it! 1hih is the ti)in. $& $ur end$.en$us iradian rh+th).
I. O*a+! sir. End$.en$us iradian rh+th).
A. 6he internal l$* in the 0rain.
I. (hat is it,
A. 6he internal l$* in the 0rain that $ntr$ls the ti)in. $& 1hen 1e sleep and 1a*e! and the
ti)in. $& the release $& h$r)$nes. 6hat3s 1h+ 1e sleep at ni.ht and 1e are a1a*e durin. the da+.
I. S$ that 0i$l$.ial l$* is s$)ethin. that3s alled the iradian rh+th),
A. 6hat3s ri.ht. 6he 0i$l$.ial l$* dri#es the iradian rh+th)s.
I. And +$u started stud+in. that 1hen +$u 0ea)e 55 1hen +$u 1ere an under.rad,
A. 6hat3s ri.ht.
I. Did +$u $ntinue +$ur stud+ $& that thr$u.h the #ari$us )edial sh$$l:%h.D. pr$.ra)! et
etera,
A. -es. I 0e.an 1$r*in. $n the dail+ +le $& $rtis$l as a dail+ pr$2et! &$r 1hih I reei#ed a
Su))a Cu) Laude e#aluati$n. And then I did )+ d$t$ral dissertati$n at Stan&$rd $n the
iradian rh+th)s $& 0$d+ te)perature! the ther)al re.ulati$ns! the ti)in.! a.ain! $& the release
$& $rtis$l! and als$ $ther h$r)$nes.
I. O*a+. And 55
A. And the ti)in. $& sleep and 1a*e.
I. And alth$u.h +$u are a )edial d$t$r! d$ +$u treat patients,
A. N$! I d$ n$t.
I. And +$u3re n$t in the pratie $& )ediine,

A. I d$n3t pratie )ediine.


I. N$1! in )$#in. thr$u.h +$ur urriulu) #itae! I see that there are the 1$rds 55 7iradian7
sh$1s up a l$t. And that3s 1hat +$u desri0ed as the 0$d+ l$*. "$1 d$es the 0$d+ l$* a&&et
sleep,
A. It re.ulates the ti)in. $& 1hen 1e sleep and 1a*e. It re.ulates the ti)in. $& 1hen 1e are
e#en sleepin.! and it re.ulates the a0ilit+ t$ )aintain the $ns$lidati$n $& sleepin. at ni.ht. S$
this internal l$*! ir$niall+! sends $ut the str$n.est dri#e &$r 1a*in. near the end $& $ur 1a*in.
da+ in the e#enin.. It pr$#ides us a se$nd 1ind that all$1s us t$ sta+ a1a*e &$r 1hat is a
)arath$n in the ani)al *in.d$)! 1hih is 8C h$urs. S$)e pe$ple push it &urther! 0ut )$st
ani)als ta*e little atnaps e#er+ &e1 )inutes. -$u 1al* +$ur d$.! and as s$$n as +$u .et 0a*!
+$ur d$. .$es t$ sleep! and +$u .$ t$ 1$r*. /ut 1e ha#e this )arath$n $& 1a*e&ulness! and the
1a+ the hu)an 0rain is a0le t$ ahie#e that A and 1e dis$#ered this in )+ la0$rat$r+ 55 is that
1e A is that in the late e#enin.! it sends $ut this dri#e! s$rt $& a&ter the lunh! a&ter lunhti)e! the
dri#e &r$) the internal l$* t$ sta+ a1a*e 0e$)es str$n.er and str$n.er. N$1! s$)eti)es
thr$u.h li.ht e'p$sure! 1e push that e#en later and later! 0eause li.ht is the p$1er&ul
s+nhr$nizer $& +$ur internal l$*. It sends a )essa.e t$ the internal l$*! this is da+ti)e! +$u
sh$uld 0e a1a*e4 and dar*ness sends an$ther )essa.e t$ the internal l$* that this is ni.htti)e!
and it is the ti)e t$ sleep.
I. N$1! d$es that ause pr$0le)s &$r pe$ple 1$r*in. 1h$ are 1$r*in. pe$ple! 1h$ ha#e ni.ht
2$0s! &$r e'a)ple,
A. It d$es. (hen edis$n )ade it p$ssi0le &$r us t$ ha#e arti&iial li.ht! suh as 1e ha#e here in
the $urtr$$)! 1e an n$1 &lip $n and $&& a S1ith! 1hih is 55 sends a p$1er&ul si.nal t$ the
0rain! shi&tin. $ur iradian rh+th)s. And i& 1e turn $n that s1ith and ha#e li.ht e'p$sure at
ni.ht! that sends a $n&usin. si.nal t$ the 0rain. It suppresses the release $& the natural h$r)$ne
)elat$nin that n$r)all+ all$1s us t$ &ailitate sleep at ni.ht and atuall+ shi&ts the iradian
rh+th)! )a*in. it harder &$r us t$ .$ t$ sleep at the ti)e 1e 1ant.
I. N$1! in additi$n t$ pe$ple 1h$ 1$r* the ni.ht shi&t 1h$ an 0e a&&eted 0+ this! is this
s$)ethin. that a&&ets! &$r e'a)ple! sp$rts tea)s,
A. -es! it d$es.
I. And ha#e +$u! durin. the $urse $& +$ur areer! had $asi$n t$ $nsult &$r sp$rts tea)s
1h$se pla+ers are 0$thered 0+ this han.e in iradian rh+th)s,
A. -es. 6he &irst sp$rts tea) that as*ed )e t$ 1$r* 1ith the) 1as the p$rtland trail0lazers!
1hih is a pr$&essi$nal 0as*et0all tea). And the+ had 2ust l$st a series $& .a)es in 1hih the+
had tra#eled t$ the east $ast! and $ntated )e and as*ed i& I $uld help the) deal 1ith that
tra#el shedule.

I. And ha#e +$u dealt 1ith $ther sp$rts tea)s t$ deal 1ith that pr$0le) $& the shi&tin. $& ti)e
z$nes! and the li*e,
Ms. "ahan: .%jection, your honor. 1elevance.
Judge: .verruled.
A. -es! I ha#e. I3#e helped the Minnes$ta 6i)0er1$l#es and the /$st$n Celtis! 1$r*in. 1ith
d$ ri#ers. And als$ ha#e d$ne s$)e 1$r* 1ith the /ruins! and n$1 e)0ar*in. 1ith 1$r*in.
1ith the Bed S$'.
I. -$u ha#e n$t said a l$t $& #er+ p$pular thin.s in this $urtr$$) s$ &ar.
A. It is 55 I didn3t sa+ the la*ers! &$r e'a)ple.
I. N$t +et. And I d$n3t 1ant t$ 55 I3#e 0een as*ed t$ as* this <uesti$n. I didn3t 1ant
t$ as* it! 0ut the <uesti$n is this@ Is D$ Bi#ers .$in. t$ $)e t$ the Clippers,
A. I h$pe n$t.
I. -$u h$pe n$t. O*a+. N$1! the 55 s$ +$u3#e d$ne that *ind $& $nsultin. &$r the sp$rts tea)s.
"a#e +$u als$ 55 are 55 d$es this s$rt $& disrupti$n $& iradian rh+th)s! d$es that a&&et )usial
.r$ups $n t$ur! )usiians! and that s$rt,
A. -es! it an! 1hen the+3re tra#elin. in di&&erent ti)e z$nes. And! als$! the nature $& per&$r)in.
late in the da+ s$ that 55 +$u *n$1! the a#era.e per&$r)er 1ill tell )e! 1hether per&$r)in. at a
0as*et0all .a)e $r per&$r)in. at a $nert! that i& 55 &irst $& all! +$u an3t usuall+ ha#e dinner
0e&$re +$u d$ a )a2$r per&$r)ane $r 0e&$re an n0a .a)e $r 0e&$re a h$*e+ .a)e! s$ the+3re
all *e+ed up &$r that ati#it+. E#en the a#era.e ni.htshi&t 1$r*er! 1hen the+ 1$r*! let3s sa+! the
;@00 p). 6$ )idni.ht shi&t! uni#ersall+ the+ rep$rt the+ an3t 2ust .$ h$)e and .$ t$ sleep!
0eause the+ are *e+ed up &r$) 1$r*! 1hether the+3re )a*in. tires &$r )ihelin tire $)pan+ $r
pr$duin. a paper $r 1$r*in. &$r a utilit+. And t+piall+! the a#era.e 55 the a#era.e da+shi&t
1$r*er &inishes at ?@00! 1inds d$1n in the e#enin.! has ti)e t$ rela'! 1ath s$)e tele#isi$n!
1hate#er the+3re .$in. t$ d$! and it3s )an+ h$urs 0e&$re the+ atuall+ then 1ind d$1n and .$ t$
0ed4 1hereas an e#enin. shi&t 1$r*er! 1hen the+ &inish at )idni.ht! it ta*es the) at least a
$uple $& h$urs a&ter the+ .et h$)e 0e&$re the+ an 1ind d$1n and .$ t$ 0ed.
I. And! &$r e'a)ple! )usiians 1h$ are $n t$ur! the+ als$ ha#e altered shedules,
A. 6he+ ha#e altered shedules! 0eause n$t $nl+ 1ill the+ 0e per&$r)in. until )idni.ht! 2@00 in
the )$rnin.! 0ut then 55 and then the+ ha#e t$ eat and! et etera! 0ut then the+ als$ )a+ 0e in a
di&&erent part $& the 1$rld. And s$ the+3re 55 there3s a $n&lit! then! 0et1een 1hat ti)e $& da+ it
is in their 0$d+! and the ti)e $& da+ that it )a+ 0e 1here the+3re tra#elin.. S$ I3#e 55

I. Is that a $))$n e'periene &$r these .r$ups,


A. 6hat 1$uld 0e a $))$n e'periene.
I. "a#e +$u $nsulted &$r an+ )usial .r$ups 1ith re.ard t$ their pr$0le)s in dealin. 1ith
sleep issues,
A. -es! I ha#e.
I. (hat .r$ups ha#e +$u $nsulted &$r,
A. (ell! )$st n$ta0l+! the B$llin. St$nes! and their lead sin.er.
I. And! 0+ the 1a+! ha#e +$u atuall+ 55 and I *n$1 +$u ha#e per)issi$n t$ sa+ this! 0ut 55
0eause 55 0ut d$ +$u atuall+ 55 +$u 1$r*ed 1ith Sha<uille O3Neal,
A. -es! I ha#e. In &at! he all$1ed us t$ #ide$tape a $nsultati$n in 1hih 1e e#aluated 1hether
$r n$t he had sleep apnea and 1e 0r$u.ht dia.n$sti re$rdin. e<uip)ent t$ his h$)e!
$nduted an e#aluati$n! and had a tea) $& pe$ple &r$) $ur di#isi$n $& sleep )ediine 55 1hih I
direted t$ .$ there 55 and set thin.s up! 0eause! $0#i$usl+! it 1$uld 0e a little t$u.h i& Mr.
O3Neal 1ere t$ $)e int$ $ur lini. 6here 1$uld 0e a )$0 sene. "e said that that 1$uldn3t
1$r* $ut #er+ 1ell. /ut he all$1ed us t$ $)e int$ his h$)e. "e 1anted t$ d$ this t$ help
eduate the pu0li! 0eause 1e ha#e a sleep and health eduati$n pr$.ra). And s$ he all$1ed us
t$ put the entire &il) $& his epis$de! 1hih has 0een d$1nl$aded )illi$ns $& ti)es! $& his .$in.
thr$u.h the dia.n$sti e#aluati$n.
I. And! 0+ the 1a+! an$ther .r$up $& pe$ple 1h$! I 0elie#e! ha#e pr$0le)s 1ith sleep are
astr$nauts.
A. -es.
I. "a#e +$u 1$r*ed 1ith astr$nauts,
A. -es. I3#e 1$r*ed 1ith the NASA3s astr$naut pr$.ra) &$r 2? +ears in helpin. de#el$p
pr$.ra)s helpin. astr$nauts dealin. 1ith the sleep issues in spae. S$! &$r e'a)ple! the sun rises
and sets e#er+ G0 )inutes 1hen +$u3re in spae! s$ that i)p$ses a Ver+ di&&erent s$rt $& da+li.ht!
i& +$u 1ill! than 1e 1$uld ha#e here $n earth and auses disrupti$n $& the internal l$* that
dri#es the ti)in. $& sleep and 1a*in.. And s$ I3#e 55 &$r a deade! I led the sleep and
hr$n$0i$l$.+ tea) &$r the nati$nal spae 0i$)edial researh institute $& NASA! and I3#e 0een
d$in. in#esti.ati$n and helpin. i)ple)ent 55 in &at! &$r the last 80 +ears! 1e ha#e re$rded the
sleep $& the astr$nauts $n the internati$nal spae stati$n and the spae shuttle! and 1e did sleep
re$rdin.s in spae.
I. Did +$u atuall+ partiipate in d$in. these sleep re$rdin.s $& astr$nauts,

A. -es. (e trained the astr$nauts in h$1 t$ set up the re$rdin.s! and instru)ent the). (e
re$rded the sleep $& senat$r 2$hn .lenn 1hen he 1as in spae! and a Nu)0er $& $ther astr$nauts
$n #ari$us )issi$ns. It 1as *ind $& $$l 1athin. the data $)e d$1n &r$) spae and see EAG
re$rdin.s! and see the di&&erent sta.es $& sleep the+ 1ere in 1hile the+ 1ere in spae.
I. N$1! in additi$n t$ +$ur $nsultin.! teahin.! +$u3re en.a.ed in $n.$in. researh! I ta*e it4 is
that ri.ht,
A. 6hat3s ri.ht.
I. And d$ +$u .et .rants! as the head $& the sleep pr$.ra) at "ar#ard! &r$) #ari$us instituti$ns
re.ardin. 55 1h$ are stud+in. sleep,
A. -es. (e 55 the 1a+ it usuall+ 1$r*s is that! as in#esti.at$r! as a researh sientist! I 1$uld
su0)it a pr$p$sal! pr$p$sed researh .rant t$ the .$#ern)ent. And it ta*es G t$ 82 )$nths &$r it
t$ 0e re#ie1ed. And then i& 1e3re lu*+ en$u.h t$ 0e seleted a)$n. the .rant pr$p$sals that
1ere su0)itted! 1e 1$uld 0e a1arded t$ arr+ $ut the researh pr$p$sed.
I. And ha#e +$u 0een in#$l#ed in $n.$in. researh,
A. I3#e 0een $ntinu$usl+ supp$rted thr$u.h the .rant pr$.ra) &$r a0$ut 2? +ears.
I. D$t$r! 1hat is the institute $& )ediine,
A. 6he institute $& )ediine is an $r.anizati$n that 1as esta0lished 55
I. Spea* a little sl$1er! please.
A. 6he Institute $& Mediine is an $r.anizati$n that 1as esta0lished 0+ the .$#ern)ent! 0ut it3s a
separate! independent $r.anizati$n! t$ pr$#ide p$li+ ad#ie t$ the Enited States .$#ern)ent and
t$ $thers $n )atters $& health $& the nati$n.
I. Are +$u a55 1hat3s in#$l#ed in .ettin. app$inted t$ the Institute $& Mediine,
A. 6here is a seleti$n pr$ess.
I. "$1 )an+ appliants are there, Or h$1 )an+ ph+siians are there,
A. 6here are a0$ut D00!000 ph+siians in the Enited States.
I. "$1 )an+ .et app$inted eah +ear,
A. C?.

I. And are +$u a )e)0er $& the Institute $& Mediine,


A. -es. I 1as eleted t$ the institute $& )ediine.
I. In 1hat &ield d$ +$u ad#ise the .$#ern)ent thr$u.h the Institute $& Mediine, (hat is +$ur
&ield $& speialt+ there,
A. 6he 1a+ it 1$r*s at the institute $& )ediine! +$u3re n$t di#ided int$ speial &ields $&
speialt+! 0ut I 1as ad)itted as a Me)0er and ha#e ser#ed $n #ari$us panels in the institute $&
)ediine a0$ut speial issues that ha#e 55 are a )atter $& 55 1here p$liies are 0ein. de#el$ped.
I. O*a+. N$1! is the 55 durin. the $urse $& all $& this 1$r* that +$u d$! teahin.! and
researhin. and e#er+thin.! ha#e +$u als$ had an $pp$rtunit+ t$ 55 1ell! l$$*in. at 55 t$ 0e a
)e)0er $& #ari$us s$ieties! pr$&essi$nal s$ieties! in the &ield $& )ediine,
A. -es! I ha#e.
I. And are +$u 55 ha#e +$u held $&&ie in )an+ $& these pr$&essi$nal s$ieties,
A. I ha#e ser#ed as the president $& the sleep researh s$iet+! and I3#e 0een a )e)0er $& the
sleep researh s$iet+.
I. 6he sleep researh s$iet+,
A. 6he sleep researh s$iet+ and the A)erian Aade)+ $& Sleep Mediine &$r )an+ +ears. I
ha#e ser#ed as a )e)0er $& the 0$ard $& the Nati$nal Sleep H$undati$n! and I a) n$1
Chair)an5elet $& the Nati$nal Sleep H$undati$n 0$ard $& diret$rs. And I ha#e ser#ed $n a
nu)0er $& di&&erent panels. I3) a Me)0er $& the A)erian Aade)+ &$r the Ad#ane)ent $&
Siene and S$iet+ &$r 55
I. At the Institute $& Mediine! 1hat *inds $& panels d$ +$u ser#e $n,
A. I ser#ed $n panels e#aluatin. 55 $ne 1as a panel $n the .$#ern)ent that 55 the ar)+ had 0uilt
a tan* that pe$ple $uld sur#i#e in &$r F2 h$urs! 0ut the+ had n$ plae &$r the) t$ sleep in this
partiular tan*. And the+ as*ed )e t$ ser#e $n a panel e#aluatin. h$1 this 1$uld 0e depl$+ed!
and 1hat *ind $& issues and hazards 1$uld 0e ass$iated 1ith this. And there 1as a panel $n
1$r*l$ad transiti$n. I als$ ser#ed $n! &$r the ES C$n.ress! the $&&ie $& tehn$l$.+ assess)ent! a
panel $n ha#in. t$ d$ 1ith shi&t 1$r* in $ur s$iet+. I testi&ied 0e&$re $n.ress $n 55 &$r the panel
e#aluatin. shi&t 1$r* pr$duti#it+ and health in $ur s$iet+. I d$n3t ha#e a $p+ $& )+ CV in
&r$nt $& )e.
I. 6hat3s O*a+.

A. Vari$us $ther panels I3#e ser#ed $n.


I. I thin* 1e .et the piture. In additi$n t$ that! sir! and t$ all $& that 1$r* +$u3re d$in. and
$nsultin.! and 1ith the #ari$us $r.anizati$ns and ser#in. $n panels! ha#e +$u als$
pu0lished artiles in learned 2$urnals in the &ield $& sleep,
A. -es! I ha#e.
I. And d$ +$u ha#e $#er 820 $ri.inal rep$rts in peer5re#ie1ed 2$urnals,
A. -es! I d$.
I. And 7peer5re#ie1ed 2$urnals!7 2ust s$ 1e an understand 1hat the+ are! are the+ 55 1ell! these
are 2$urnals that d$t$rs and $ther sientists pu0lish in4 is that $rret,
A. 6hat3s $rret. S$ 55
I. "$1 d$ +$u .et int$ a peer5re#ie1ed 2$urnal, (hat has t$ 0e d$ne t$ .et an artile
pu0lished,
A. A 1ritten rep$rt is a &indin. that 55 n$t a Be#ie1 $& the literature. It )eans +$u ha#e d$ne
$ri.inal researh t+piall+ supp$rted 0+ $ne $& th$se .rants I desri0ed. -$u d$ researh &$r &$ur
$r &i#e +ears4 +$u $)e up 1ith a &indin.! and +$u rep$rt the results $& the researh. /eause i&
+$u d$n3t rep$rt the results $& the researh! then n$ $ne *n$1s 1hat +$u3#e spent the &unds $n
&r$) the .$#ern)ent t$ d$ this ati#it+. S$ 1hat I al1a+s li*e t$ tell the students is! i& +$u d$n3t
pu0lish it! n$ $ne 1ill *n$1 that it happened. S$ it is an $0li.ati$n t$ pu0lish the results $& the
researh that the pu0li has supp$rted.
I. And then 55
A. -$u su0)it the results! and then a panel A the edit$r $& the 2$urnal in#ites pe$ple 1h$ are
e'perts in that &ield t$ e#aluate 1hat +$u3#e su0)itted t$ &ind $ut i& it3s 0een 55 i& it has 0een
ri.$r$usl+ arried $ut and )erits pu0liati$n in the sienti&i literature.
I. And these panel $& e'perts! are the+ alled ad h$ $))ittees,
A. 6he+ 1$uld 0e alled peer re#ie1ers.
I. And are +$u $n the edit$rial 0$ard $& an+ 2$urnal,
A. I3) $n the edit$rial 0$ard $& the 2$urnal $& sleep. /elie#e it $r n$t! there is a 2$urnal.
I. 6here is a J$urnal $& Sleep. D$es it put +$u t$ sleep,

A. It sh$uldn3t. 6he artiles are atuall+ #er+ e'itin..


I. And in additi$n 55 and s$ +$u desri0ed t$ us 1hat the $ri.inal rep$rts are. In additi$n t$ that!
ha#e +$u d$ne re#ie1 artiles,
A. -es! I3#e 55
I. And 1hat3s the di&&erene 0et1een 55 +$u said the $ri.inal rep$rt! +$u desri0ed 1hat that is.
"a#e +$u d$ne )$re than F? re#ie1 artiles,
A. -es. S$ re#ie1 artiles is 1here +$u tr+ t$ s+nthesize. S$ there are )an+ rep$rts@ 6his auses
this4 this d$es this. I& 1e shi&t the iradian s+ste) 1ith li.ht $r 55 n$1! +$u ha#e t$ tr+ t$
s+nthesize th$se t1$ t$.ether. And the re#ie1 artiles are 1ritten t+piall+ &$r pe$ple 1h$ 55 s$
the .r$up $& sientists 1h$ are deepl+ in#$l#ed in $ne partiular area 1ill 0e readin. eah $ther3s
$ri.inal rep$rts all the ti)e. /ut then there )a+ 0e s$)e$ne sli.htl+ $utside the area 1h$ still
1ants t$ understand 1hat that 55 1hat3s .$in. $n. And s$ +$u 1ill 1rite a re#ie1 artile! 1hih
s+nthesizes the 1$r* that3s 0een arried $ut! let3s sa+! in the past ? $r 80 +ears! and puts it
t$.ether either &$r $ther sientists $r liniians.
I. And that3s 1hat a re#ie1 artile is,
A. 6hat3s a re5 55
I. -$u re#ie1 literature,
A. E'atl+.
I. And 0+ the 1a+! in these peer5re#ie1ed 2$urnals! 1hat r$le! i& an+! d$es )edial ethis pla+ in
the pu0liati$n in a peer5re#ie1ed 2$urnal,
A. (ell! &irst $& all! there is the ethis $& h$1 +$u $ndut the researh. S$ e#er+ 55
I. 6hat3s $ne part.
A. E#er+ $ne in a (hile +$u 1ill read a0$ut a Sientist 1h$ has &ud.ed data $r )ade up stu&& t$
.et it pu0lished! $r it )i.ht n$t .et pu0lished. And then it 1ill ha#e t$ 0e 1ithdra1n &r$) the
literature! and there is then &$re#er attahed t$ that artile a state)ent that 76his has 0een
resinded $r 1ithdra1n 0eause $& the <uesti$n $& the7 55
I. I ta*e it! that3s a 0ad )ar* 55
A. 6hat3s a #er+ 0ad 55
I. 6hat3s a n$5n$,

A. -eah. -$u3re n$t .$in. t$ .et an$ther .rant 55


I. And are there ethis in#$l#ed! als$! in h$1 +$u use hu)an su02ets,
A. -es. 6here are ethis 55 e#er+ hu)an e'peri)ent 1e d$! 1e ha#e t$ .$ 0e&$re an ethis panel.
(e present 1hat 1e pr$p$se t$ d$! and then a panel! 1hih inludes researh d$t$rs in #ari$us
areas! linial ph+siians 1h$ understand 1hat the ris*s )i.ht 0e in#$l#ed in 1hat $ur pr$edure
is .$in. t$ 0e atte)pted! and then pe$ple &r$) the .eneral pu0li 1h$ 55 an ethiist! and
s$)eti)es ler.+! and s$ $n! 1h$ sit $n a panel. And the+ sa+! is this a reas$na0le thin., D$es
the ris* $& the indi#iduals 1h$ are .$in. t$ 0e part $& this researh )erit 55 0ased $n 1hat $ne
)i.ht learn &r$) the researh! is the ris* 1$rth it! and are +$u pa+in. the pe$ple a reas$na0le
a)$unt! 0ut n$t an e'essi#e a)$unt that 1$uld $ere the) e$n$)iall+ t$ partiipate,
I. And it3s als$ 55 O*a+. And the+ als$ ha#e t$ 0e ad#ised $& the ris*s! I ta*e it,
A. -es. 6he+ ha#e a $nsent &$r) that 55
I. Let )e as* +$u an$ther <uesti$n a0$ut ethis. Is there ethis in#$l#ed in pu0lishin. papers in
sienti&i 2$urnals 55 are there ethis $nernin. $n&lits $& interest,
A. -es.
I. And are +$u &a)iliar 1ith the re<uire)ents &$r $n&lits $& interest,
Ms. "ahan: )0ll just o%ject at this point, your honor. This -as the su%ject o a #otion to
e(clude as it relates to &r. "'eisler.
Judge: )s he going to oer any opinions on this/ !ecause i he is 22
Mr. Kosko: )0# going to go %ack to this later. He #ay.
Judge: 3ell 22
Mr. Kosko: )t0s so#ething )0ll go %ack to later.
Mr. Panish: )t0s not su%ject to the #otion, your honor.
Mr. !oyle: This is so#ething dierent, your honor.
Mr. Kosko: *ot having to do -ith &r. Murray and 456 +ive. Has nothing to do -ith
that.

Mr. !oyle: Has to do -ith pu%lishing journals ethics.


Mr. Kosko: This only has to do -ith pu%lishing journals ethics at this point so -e can
understand -hat the i#port is o a pu%lication 7 -hat it #eans to %e ethical in a
pu%lication, and -hat -ould %e considered unethical in a pu%lication.
Judge: .kay.
Ms. "ahan: 4nd, your honor 22
Mr. Kosko: $o -e kno- -hat to rely upon, and the jury has to decide i a pu%lication is
ethical or 22
Ms. "ahan: 8our honor, that is outside the scope o the opinions that he0s %een allo-ed to
oer, so -e0d ask or a side%ar i -e pursue this issue.
Mr. Kosko: 8ou kno- -hat/ ) don0t -ant to interrupt this. ) -ant to keep going. $o ) -ill
ta%le that or no-, and 22 so -e can #ove on.
Judge: 4ll right.
I. I3#e .$ne thr$u.h a L$t $& +$ur redentials! sir! and I *n$1 I $uld .$ $n &$r )an+ )$re h$urs
$n this! 0ut ha#e +$u als$ $nsulted &$r #ari$us industries in the &ield $& sleep )ediine,
A. -es! I ha#e.
I. And ha#e +$u 55 1hat *inds $& industries ha#e +$u $nsulted &$r,
A. 6+piall+! industries that in#$l#e r$und5the5l$* $perati$ns. S$ the &irst $ne I 0ea)e
in#$l#ed in 1as $utside $& Salt La*e Cit+. Sand+! Etah. It 1as a he)ial )inin. $perati$n that
har#ested )aterial &r$) the .reat Salt La*e! put it int$ e#ap$rati$n p$nds.
I. (e d$n3t ha#e t$ *n$1 the details.
A. /ut the+ 1$r*ed ar$und the l$* 55
I. Just the industr+.
A. 55 and the+ needed help 1ith the 1$r*ers 1h$ 1ere ha#in. pr$0le)s sleepin. in the da+ti)e
1hen the+ 1$r*ed at ni.ht! and ha#in. pr$0le)s sta+in. a1a*e at ni.ht 1hen the+ needed t$ 0e
sheduled t$ 1$r* at ni.ht. And s$ I spent )$re than a deade tra#elin. 55 0eause 1e had
p$siti#e results 1hen 1e 55
I. 6$$ )uh in&$r)ati$n.

A. S$rr+.
I. Just 1ant t$ *n$1 1hat the industries are at this p$int.
A. E#er+thin. &r$) the eletri p$1er .enerati$n utilities! nulear p$1er plants! )anu&aturin.
tires! )anu&aturin. paper! dealin. 1ith p$lie &$res. I3#e 1$r*ed 1ith p$lie)en! &ire&i.hters!
&ederal air )arshals.
I. Air tra&&i $ntr$llers! $r n$t, H.A.A.,
A. I3#e 0een <uite ritial $& air tra&&i $ntr$ller shedules! 0ut I ha#e n$t atuall+ 0een in#ited
0+ the .$#ern)ent t$ help the) 1ith that. /ut I ha#e 55 the CIA has alled )e! the Seret
Ser#ie! #ari$us 55 the air &$re $&&ie $& sienti&i researh! 1hen the+ 1ere d$in. $perati$n
desert st$r)! 1hih in#$l#ed 55 )$st $& the &li.hts 1ere at ni.ht! and the pil$ts 1ere ha#in. t$
sleep durin. the da+ti)e.
I. N$1! in additi$n t$ that! ha#e +$u 0een $nsulted in an+ 55 &$r an+ )edial:le.al )atters in
the past, Or I sh$uldn3t sa+ )edial:le.al. I )ean le.al )atters. La1suits.
A. -es. I ha#e ser#ed as an e'pert 1itness in the past.
I. O*a+. And appr$'i)atel+ h$1 )an+ ti)es, (ell! &irst let )e as* this@ h$1 )an+ ti)es ha#e
+$u appeared in $urt,
A. 6his is eas+ t$ re)e)0er &$r )e! 0eause it3s s$)e1hat stress&ul. /ut I thin* less than hal& a
d$zen ti)es. I thin* three $r &$ur ti)es.
I. 6hree $r &$ur ti)es, And that3s $#er the $urse $& +$ur areer,
A. -es.
I. And +$u ha#e $nsulted! I ta*e it! in s$)e1hat )$re ases than that,
A. -es.
I. And ha#e +$u 0een $nsulted in ases 1here +$u re&used t$ testi&+,
A. -es.
I. /eause +$u didn3t 0elie#e it,
A. -es. I3#e als$ 0een &ired &r$) ser#in. as an e'pert 1hen the $pini$n that I $&&ered 1as n$t
appealin. t$ the att$rne+s 1h$ as*ed )e &$r ad#ie.

I. And are +$u 0ein. paid &$r +$ur ti)e,


A. -es.
I. And appr$'i)atel+ h$1 )uh per h$ur are +$u 0ein. paid,
A. JG?0.
I. H$r h$1 l$n. ha#e +$u 0een har.in. that,
A. I thin* a0$ut 80 +ears.
I. 80 +ears. And at JG?0 an h$ur! an +$u please *eep +$ur ans1ers sh$rt,
A. -es.
I. 6han* +$u. And 1hat did +$u re#ie1 in preparati$n &$r 55 1ell! <uesti$n 1ithdra1n. In
preparin. &$r this ase! ha#e +$u re#ie1ed )edial re$rds $nernin. Mihael Ja*s$n,
A. I ha#e.
I. And dep$siti$n testi)$n+,
A. -es! I ha#e.
I. And 1e3re .$in. t$ 1ant t$ tal* a0$ut +$ur $pini$ns as 1e .$ $n! 1hih 55 and I *n$1 +$u3#e
.i#en a dep$siti$n in this ase. -$u re)e)0er that,
A. -es! I d$.
I. (ith Ms. Cahan 1h$ is here,
A. -es.
I. /ut I ha#e a He1 <uesti$ns &$r +$u! t$ s$rt $& help us understand 1hat this 55 +$ur &ield $&
siene is a0$ut. And 1ere +$u *ind en$u.h t$ prepare s$)e slides that 1$uld help t$ eduate
the 2ur+ $nernin. the nature $& sleep,
A. -es! I ha#e.
I. O*a+.
Mr. Kosko: this is e(hi%it 9:;, slide <, please.

I. N$1! +$u see it $n +$ur sreen 55


A. I d$.
I. 55 and I3) .$in. t$ as* +$u i& 55 2ust the t$p sa+s! 7/eha#i$ral state .enerated 0+ the 0rain t$
&ul&ill 0asi 0i$l$.ial needs haraterized 0+.7 And 1hat is 55 &irst $& all! I 1ant t$ as* +$u! it
said! 70eha#i$ral state7,
A. 6hat3s $rret.
I. And is that 0asiall+ 1hat it s$unds li*e,
A. It is 1hat it s$unds li*e. S$ sleep is )+steri$us t$ a l$t $& pe$ple! 0ut 1hen 1e stud+ it
sienti&iall+! 1e tr+ t$ 0rea* it d$1n and understand 1hat3s in#$l#ed 1ith sleep. Sleep is
atuall+ 55 a l$t $& pe$ple thin* it3s li*e turnin. an appliane $&&! s$rt $& turnin. the 0$d+ $&&! 0ut
sleep is a #er+ ati#e pr$ess.
I. (e3re .$in. t$ .et int$ it a little 0it )$re! 0ut 55
A. /ut it3s haraterized 0+! and it &ul&ills 0asi 0i$l$.ial needs. It3s i)p$rtant t$ re$.nize it3s
.enerated atuall+ 0+ the 0rain! n$t a passi#e resp$nse! and it &ul&ills 0asi 0i$l$.ial needs and
is haraterized 0+@ redued ati#it+. S$ +$u an tell i& s$)e$ne is runnin. ar$und! the+3re n$t
sleepin.. I))$0ile p$sture. 6+piall+ +$ur e+es are l$sed! alth$u.h it is p$ssi0le t$ sleep 1ith
+$ur e+es $pen. It3s readil+ re#ersi0le. S$ i& s$)e$ne is asleep! +$u an 1a*e the) up 1ith s$)e
sti)ulati$n. 6here3s a reduti$n in sensiti#it+ t$ e'ternal sti)uli! 0ut it is n$t a $)plete l$ss $&
sensiti#it+. S$! &$r e'a)ple! the )$ther $& a ne10$rn! i& she hears the hild 1hi)per! she 1ill 55
e#en i& she is asleep! e#en i& she is deepl+ asleep! she 1ill 0e a0le t$ .et up and attend t$ the
hild. And a re#ersi0le l$ss $& $nsi$us a1areness that is readil+ re#ersi0le.
I. (h+ d$ +$u ha#e this thin. 1here it sa+s! 7re#ersi0le7 and 7readil+ re#ersi0le7, (h+ d$ +$u
sa+ that, (hat3s 55
A. /eause +$u an ta*e a Sleepin. pers$n and ar$use the)! 1a*e the) up <uite easil+! 1ith$ut
an+ )a2$r inter#enti$n. S$ i& +$u 1ere t$ e'p$se the pers$n t$ a n$ise $r sha*e the)! $r sha*e
their 0ed! $r s$)e $ther sti)ulati$n! turn $n the li.hts &$r )an+ pe$ple! that 1ill 0e en$u.h t$
a1a*en )$st pe$ple.
I. N$1! +$u als$ pr$#ide t1$ slides $n 1hat atuall+ happens t$ the 0rain 1hen 1e sleep! $r s$rt
$& de)$nstrates the 0rain! the di&&erene 0et1een the sleep state and the 1a*e state.
A. -es.

Mr. K$s*$&&@ Can +$u sh$1 us slide 2! please,


I. 6hat sa+s! 7n$r)al 1a*e&ulness.7 And 1hat are th$se little 55 I see there3s l$ts $& little tennis
0alls.
A. 6he tennis 0alls are .r$ups $& ells 55
I. O*a+.
A. 55 sientists all nulei! and it3s a Cluster $& ells that t+piall+ ha#e a spei&i 2$0. And there
are a 1h$le set $& ell lusters 55
I. I3) .$in. t$ interrupt +$u a Se$nd. S$ there are these little lusters $& 0rain ells and this is
the part $& the 0rain that 1e use t$ thin* =indiatin.>4 O*a+, S$ this is the part that3s neessar+
&$r $nsi$us a1areness and alled the ere0ral $rte'. And a L$t $& the h$use*eepin. in#$l#ed
in the 0rain is d$ne in this $ther area S$ this area $& the 0rain! &$r e'a)ple =indiatin.>! 0alane!
is in the ere0ellu).
I. -$u said 0alane is in the ere0ellu),
A. -es. S$! an+1a+! these lusters that are in the h+p$thala)us! and s$)e in 1hat3s alled the
0rain ste) here =indiatin.>! the+ send $ut )essa.es that help supp$rt 1a*e&ulness $& these areas
$& the 0rain that are resp$nsi0le &$r thin*in. and $nsi$us a1areness.
I. N$1! +$u 1ant t$ sh$1 the ne't slide,
A. -es! I 1$uld.
Mr. Kosko: .kay. "ould you go to the ne(t slide, please/
A. And this is a luster $& ells =indiatin.> 55 the &unti$n $& 1hih 1as dis$#ered 0+ $ne $& )+
$llea.ues at "ar#ard 55 and this .r$up $& ells atuall+ ati#el+ turn $&& all $& these $ther
lusters and helps t$ pr$)$te sleep. S$ 1hen this area 55 1hen the ells in this area $& the 0rain
&ire $r i.nite! the+ send a si.nal t$ turn $&& these $ther areas. And s$ 55 the anal$.+ that3s 0een
used t$ understand this is *ind $& a see5sa1 $r a &lip5&l$p s1ith. S$ +$u d$n3t 1ant t$ 0e hal&1a+
a1a*e and hal&1a+ asleep. 6hat 1$uld 0e 0ad. -$u 1ant t$ 0e either a1a*e $r asleep. And s$ the
1a+ this area $& the 55 the 1a+ this area $& the 0rain 1$r*s! is that it sends $ut a si.nal that helps
t$ )a*e sure that all these areas are n$t 55 s$ that 1e d$n3t ha#e s$)e $n&usi$n that part $& the
area is sa+in.! 7/e a1a*e!7 and part $& the 0rain is
sa+in.! 7/e asleep.7

I. S$ that3s 55 n$1! .$in. $n! this )a*es it l$$* li*e 55 1hen +$u l$$* at this slide! it )a*es it
l$$* li*e 0asiall+ n$thin. is .$in. $n 1hen +$u sleep. And I3) .$in. t$ as* +$u i& that3s true.
And I alread+ *n$1 the ans1er.
A. It3s n$t true.
I. O*a+.
A. It3s n$t true.
I. Is there stu&& .$in. $n 1hile 1e3re asleep,
A. A0s$lutel+. 6here3s a l$t .$in. $n 1hen 1e3re asleep! and it in#$l#es the repair and
)aintenane $& the neur$ns in the 0rain that supp$rt 1a*e&ulness.
I. And I *n$1 that there3s a Slide n$1 1hih sh$1s the sta.es $& sleep.
A. -es.
I. And are there di&&erent sta.es $& sleep,
A. 6here are di&&erent sta.es $& sleep.
Mr. Kosko: .kay. 4nd sho- slide no. =, please.
A. s$ a L$t $& pe$ple thin* $& sleep as +$u3re either asleep $r a1a*e. /ut! atuall+! there are t1$
)a2$r di&&erent *inds $& sleep! and $ne *ind $& sleep is alled rapid e+e )$#e)ent sleep.
I. -$u ha#e t$ .$ sl$1l+ $n this part! 0eause &$r )$st $& us! this is reall+ 0rand5ne1.
A. O*a+.
I. And 1e3re n$t "ar#ard .raduate students.
A. I understand. S$ there are di&&erent t+pes $& sleep. 6here are t1$ )a2$r ate.$ries@ $ne is
1hat3s alled rapid e+e )$#e)ent sleep! 1here +$ur e+es are dartin. 0a* and &$rth in their
s$*ets 1hile +$ur asleep.
I. O*a+. I3) 2ust .$in. t$ interrupt +$u. S$ the &irst )a2$r di#isi$n is 1hat is alled rapid e+e
)$#e)ent sleep. Is that a00re#iated,
A. B.E.M. sleep.
I. B.E.M. sleep, And in B.E.M. sleep! are +$u sa+in. that the e+es )$#e 0a* and &$rth inside

underneath the e+elids,


A. 6he+ d$.
I. "$1 <ui*l+,
A. (ell! here3s 90 se$nds $& a re$rdin. here
I. D$es $ne $& th$se s<ui..l+ lines sh$1 the )$#e)ent $& the e+es,
A. N$.
I. (hat d$es it sh$1,
A. (e3re .$in. t$ see that in a later slide.
I. O*a+.
A. 6his sh$1s 0rain 1a#e re$rdin.s,
I. /rain 1a#e re$rdin.s.
A. S$ 1hen +$u3re a1a*e! and all the di&&erent ells in that partiular part $& the 0rain are &irin.
at di&&erent ti)es! 0eause +$u3re thin*in. a0$ut di&&erent th$u.hts! 1athin. 1hat3s .$in. $n in
the $urtr$$)! and s$ $n. 6hen i& +$u put an eletr$de $n the salp! +$u d$n3t see 55 +$u d$n3t
re$rd an eletrial p$tential. /eause there3s all s$rts $& rand$) ati#ities .$in. $n 55 n$t
rand$)! 0ut all s$rts $& di&&erent ati#ities 1ith di&&erent ells &irin. at di&&erent ti)es as +$u see
di&&erent thin.s in +$ur en#ir$n)ent! and s$ $n.
I. I 1ant t$ understand the t$p $ne! 71a*e&ul state.7 1hat +$u3re 0asiall+ sa+in. is di&&erent
ells are &irin. $&& at di&&erent ti)es in +$ur 0rain 1hen +$u3re a1a*e,
A. E'atl+. And +$u d$n3t re$rd )uh $& a Si.nal 0eause thin.s are happenin. all $#er the
plae! and the+3re n$t pr$duin. 55 the+3re n$t in s+n 1ith eah $ther.
I. 6hat3s 1h+ +$u3re n$t seein. 0i. 2$lts! 0eause there3s l$ts $& little 2$lts,
A. Bi.ht. And the+ anel eah $ther $ut.
I. 6he ne't $ne d$1n 55
A. I 2ust 1ant t$ sa+ that in rapid e+e )$#e)ent sleep! the $ne that3s d$1n here the 0rain 1a#e

re$rdin. l$$*s al)$st the sa)e as up here


I. -es! it d$es.
A. S$ $ri.inall+ 1hen E.E.G. re$rdin.s 1ere &irst )ade! the sientists th$u.ht the+ 1ere a1a*e
here. 6he+ l$$*ed asleep! 0ut the+ 1ere a1a*e! 0eause the+ didn3t realize the+ 1ere asleep.
I. And 1hat is an E.E.G.,
A. An E.E.G. is a 0rain 1a#e re$rdin. 1here +$u put eletr$des! and +$u3re )easurin. 0illi$ns
$& 2$lts $& p$tential eletrial han.es in the salp.
I. S$ +$u3re )easurin. eletrial 1a#es,
A. -eah. S$ 1hen +$u send 55
I. And the na)e $& it is alled,
A. 6he tehnial na)e 55
I. Sl$1 d$1n. Is an eletr$enephal$.ra),
A. 6hat3s $rret.
I. O*a+. And that3s an E.E.G. And are these dra1in.s that 1e3re seein. the pr$dut $& E.E.G.S,
A. It is. And s$ 1hen s$)e$ne has an epilepti seizure 55
I. -es.
A. 55 +$u )i.ht see a 0i. 1a#e $n the salp! 0eause all the ells are &irin. at $ne 0eause
the+3re ha#in. a seizure.
I. I see.
A. S$ in rapid e+e )$#e)ent sleep! the 0rain l$$*s li*e it3s a1a*e. And ulti)atel+! 1hen it 1as
dis$#ered that sleepin. 55 &irst $& all! parad$'iall+! 0eause pe$ple 1ere pr$&$undl+ asleep! 0ut
the 0rain 1a#es l$$*ed li*e the+ 1ere a1a*e.
I. E#er+ n$1 and then! I .$ li*e this =indiatin.>. I3) n$t tellin. +$u n$t t$ sa+ an+thin.! 2ust
)$#e it al$n..
A. O*a+. -$u did sa+ +$u 1anted )e t$ spea* <ui*l+.

I. -es.
A. S$ here 1hen +$u 0e$)e dr$1s+! +$u 0e.in t$ see s$)e inrease in the size $& the 0rain
1a#es. And 1hen +$u .et int$ sta.e 8 sleep! n$1 +$u see s$)e #er+ s)all $sillati$ns here that
1ere n$t present either in rapid e+e )$#e)ent sleep $r in 1a*e&ulness.
I. And 1hen 55
A. And then these 0e.in t$ 55 n$1! this is 1hat3s alled a sleep spindle! 1hih is an$ther
$r.anized set $& 0rain 1a#es. And i& 1e e'panded this re$rdin. $ut! +$u 1$uld see that a L$t
1as .$in. $n there. And then 1e see 1hat are these 0i. 1a#es here! 1hih are alled *5
$)ple'es. And the+ represent s+nhr$nized &irin. $& s$)e $& the ells in the $rte'.
I. O*a+. N$1! 1e3re .$in. t$ ha#e t$ .$ $#er this $ne little 0it at a ti)e and sl$1l+. Hirst! +$u
sa1 the dr$1s+ state. S$ n$1! in a n$r)al pers$n .$in. t$ sleep! h$1 l$n. d$es it n$r)all+ ta*e
t$ .$ &r$) dr$1s+ t$ 55 1hat is that sta.e, I an3t read it.
A. 6his is sta.e 8. 6he na)es $& the sta.es are <uite si)ple@ sta.e 8! 2! 9 and ;.
I. And is sta.e 8 dr$1s+,
A. Sta.e 8 is dr$1s+.
I. "$1 l$n. d$es it usuall+ ta*e t$ .$ &r$) dr$1s+ t$ sta.e 2,
A. Esuall+ 1ithin 80 $r 8? )inutes. At the start $& sleep.
I. And as +$u said earl+ in +$ur testi)$n+! it3s n$t a .$$d state t$ 0e in. -$u3re 55
A. -eah. Dr$1s+! this sta.e 8 sleep! +$u an s$)eti)es hear and resp$nd t$ thin.s in +$ur
en#ir$n)ent a0$ut hal& $& the ti)e! 0ut +$u 55 hal& the ti)e +$u d$n3t resp$nd. S$ it is that
nether1$rld 0et1een that sleep and 1a*e&ulness. A transiti$nal state.
I. 6he ne't $ne! at sta.e 2! is that $ne 1here it see)s li*e it3s $sillatin.! .$in. up and d$1n 55
A. Bi.ht.
I. 55 )uh )$re #i$lentl+. And +$u said this is s$)ethin.! and I didn3t .et 1hat 1as .$in. $n in
the 0rain durin. that $sillatin. 55
A. S$ n$1 +$u ha#e s+nhr$nized &irin..
I. 7S+nhr$nized7 )eans 1hat, At the sa)e ti)e,

A. At the sa)e ti)e.


I. O*a+.
A. S$ that )eans a l$t $& the ells in the 0rain are &irin. at the sa)e ti)e! and there 55 it3s as i& the
$ndut$r $& the $rhestra is sa+in.! 7O*a+! n$1.7 s$ n$1 it3s 0ein. .enerated internall+! n$t in
resp$nse t$ e'ternal sti)uli! 0ut 0ein. .enerated internall+. And then 1hen +$u .et 55
I. I 1ant t$ sta+ $n that sta.e &$r $ne se$nd.
A. -eah.
I. S$ +$u sa+ all these ells are s$rt $& 0urstin. at the sa)e ti)e,
A. -es. O& a partiular lass $& ells.
I. Certain lass. And that3s 1hile +$u3re asleep,
A. -es. 6hat 55
I. /ut d$es that happen 1hile +$u3re a1a*e,
A. N$.
I. I& it happened 1hile +$u3re a1a*e! 1hat 1$uld happen t$ +$ur 0eha#i$r,
A. (ell 55
I. -$u3d 0e asleep,
A. -eah. -$u3d 0e asleep! +es.
I. 6hat 1$uld )ean +$u3re asleep,
A. Bi.ht.
I. S$ that the 1a#es 55 the ells are all 0urstin. at the sa)e ti)e. And then the ne't $ne! +$u
said! is,
A. Is 55 +$u ha#e a series $& these eletrial p$tential $sillati$ns that an 0e re$rded at the
sur&ae $& the salp that sh$1 that there is reurrent s+nhr$n$us &irin.. And this is ta*in. plae
three $r &$ur +les per se$nd. 6hat )eans! +$u *n$1! +$u an see that the 1a#es are sl$1in.
d$1n. S$ +$u ha#e D t$ 82! 9 t$ F! 82 t$ 8;. N$1 a "al& +le per se$nd! )eanin. it ta*es $ne

se$nd! I )i.ht ha#e t1$ $& these 1a#es t$ t1$ +les per se$nd. And these are delta 1a#es
=indiatin.>! and +$u an see the) #er+ pr$)inentl+ here in this re$rdin..
I. And then the last $ne is the 55 1hat +$u alled the B.E.M. sleep,
A. Bi.ht.
I. Bapid e+e )$#e)ent sleep,
A. E'atl+.
I. N$1! 1e3#e tal*ed a0$ut 55 +$u3#e tal*ed a0$ut these sta.es. Is there an+ .eneral 55 &irst $& all!
is there an+ .eneral peri$d $& ti)e that3s $nsidered a n$r)al ni.ht3s sleep! let3s sa+,
A. 6he a#era.e pers$n 55
Ms. "ahan: .%jection. >ague.
Judge: .verruled.
A. 6he a#era.e pers$n sh$uld $0tain a0$ut F t$ D h$urs $& sleep at ni.ht.
I. And is there s$)e s$rt $& a 55 is this pattern 8 thr$u.h ;! are the+ 55 is that the $rder in 1hih
these sta.es $ur,
A. -es! t+piall+.
I. S$ that 55 and h$1 )uh 55 1ell! $ne $ther thin. I didn3t as* +$u. -$u tal*ed a0$ut rapid e+e
)$#e)ent sleep at the end! 0ut is there als$ a part $& this 1here there is sl$1 e+e )$#e)ent! a
part $& 55
A. -es. 6hat t+piall+ ta*es plae in sta.e 8 sleep.
I. O*a+. S$ 55
A. In this transiti$nal state.
I. 55 is there an understandin. as t$ a0$ut the len.th $& ti)e eah $& these sta.es ha#e! $r d$es it
#ar+ dra)atiall+,
A. (e .$ thr$u.h 1hat is alled a sleep +le! 1hih .enerall+ ta*es a0$ut an h$ur and a "al&! $r
a little l$n.er! t1$ h$urs. And durin. a Sleep +le! +$u .$ thr$u.h a pr$.ressi$n 1here +$u3re
.$in. t$ sta.e 8! 2! 9! ;! and then +$u .$ int$ rapid e+e )$#e)ent sleep! and +$u ha#e a L$t $&

rapid e+e )$#e)ent sleep. And then +$u .$ 0a* and start .$in. thr$u.h these sta.es a.ain int$
the deep! sl$1 1a#e sleep. And that $urs thr$u.h$ut the ni.ht. S$ sleep has an arhiteture t$
it. -$u see! all $& the 55 )$st $& the $ther ells in the 0$d+! s*in ells! and $ur 0l$$d ells and A
)$st $& the)! 1e $nl+ *eep $ur 0l$$d ells! &$r e'a)ple! &$r three t$ si' 1ee*s! and then 1e
)a*e ne1 $nes. /ut the 0rain ells 1e *eep &$r $ur entire li&eti)e. S$ there has t$ 0e a peri$d $&
ti)e! 2ust li*e s$)eti)es +$u3ll .et a )essa.e &r$) the 0an* $r 1hate#er sa+in. the $)puter
s+ste) is .$in. $&&line &$r )aintenane. And the 0rain has t$ .$ $&&line s$ that 1e an )aintain
th$se ells that 1e are .$in. t$ *eep &$r li&e! 0eause 1e d$n3t )a*e ne1 $nes.
I. S$ durin. that 55
A. Durin. that peri$d $& $&&line! repair and )aintenane is the thin. 1e all sleep.
I. S$ 1hile 1e3re asleep! there are thin.s .$in. $n in $ur 0rains,
A. Bi.ht. L$ts $& thin.s .$in. $n in ter)s $& repair. Means! in essene! replae)ent $& ener.+
st$res and 55 0eause 1e dissipate $ur ener.+ durin. 1a*e&ulness. 6he 0rain uses 20 perent $&
the .lu$se 1e 55
I. 20 perent. (hen +$u sa+! 7the .lu$se!7 is that the ener.+ that 1e use,
A. 6he ener.+ that 1e use.
I. 6he 0rain uses 20 perent,
A. -es. And $ne $& the )$st hi.h de)ands! ati$ns! is the &irin. $& these neur$ns that happen
1hen 1e thin*.
I. And! n$1! +$u tal*ed a0$ut the *ind $& repair that .$es $n 1hen 1e sleep. And 2ust .i#e )e a
$uple $& sentenes $n that. (hat *ind $& repair,
A. (ell! $ne $& the thin.s 55 e#er+ ti)e 1e A all $& $ur e'perienes 1e ha#e in the da+ti)e! 1hen
that happens! the 1a+ the 0rain en$des that )e)$r+ is )a*in. an$ther $nneti$n 1ith n$t
neur$ns. S$ 1e )a*e all these ne1 $nneti$ns durin. the da+ that re&let all 1e ha#e
e'periened durin. the da+ti)e. At ni.ht! $ne $& the thin.s is that 1e prune $ut a l$t $& th$se that
are n$t i)p$rtant! and 1e $ns$lidate th$se )e)$ries 1hih are. And that pr$ess is happenin.
durin. the! in partiular! the sl$1 1a#e sleep and the n$n5B.E.M. sleep.
I. N$1! 1hat happens durin. B.E.M. sleep 1hen +$u ha#e that rapid e+e )$#e)ent, And I
thin* 55 0+ the 1a+! 1e )a+ ha#e a slide that an help us! slide C that +$u3#e prepared.
The -itness: "an -e go to the ne(t slide/

I. Oh! atuall+! d$es this sh$1 atuall+ re$rdin.s $& the 0rain 1a#es,
A. -es. 6his sh$1s the re$rdin. $& n$t 2ust the 0rain 1a#es! 0ut als$ the e+e )$#e)ents! and
s$)e )usle t$ne =indiatin.>. And here +$u an see the 0rain 1a#es at the transiti$n &r$)
1a*e&ulness t$ sleep =indiatin.>. 6his is the sleep ha)0er that 1e used =indiatin.>. And these
are the eletr$des that are re$rdin. the 0rain 1a#e ati#ities and e+e )$#e)ents =indiatin.>. S$
+$u an see 55 and these are 90 se$nds $& re$rdin.. And +$u an see! as this partiular astr$naut
0e.ins t$ &all asleep! +$u an see his e+es r$llin. ar$und in their s$*ets! and these are the
sl$1in. r$llin. )$#e)ents that are happenin.. Ne't slide.
I. 6hat3s sta.e 8. And that slide $ntains an $#erla+ t$ it as 1ell,
A. -es! it d$es. And n$1 +$u an see the transiti$n t$ sta.e 2 sleep =indiatin.>. -$u an see $ne
$& th$se s+nhr$n$us &irin.! $ne $& th$se *5$)ple'es here =indiatin.>. N$1! the sl$1 e+e
)$#e)ents are .$ne! and 1e3re atuall+ pi*in. up 0rain 1a#e re$rdin.s $& the eletr$de ri.ht
$#er the te)ple. And this represents sta.e 2 =indiatin.>. S$ n$1 the pers$n is de&initi#el+
asleep. And then the ne't slide! +$u 1ill see sta.es 9:; sleep! and 55 0ein. 0ea)ed d$1n &r$)
spae. And +$u see the $sillati$n here in the 0rain 1a#e ati#it+. S$ sleep has an arhiteture t$
it. As the 0rain is .$in. thr$u.h this repair pr$ess e#er+ ni.ht! that arhiteture is ritial as 1e
.$ &r$) A 0eause B.E.M. sleep! 1hih is in the ne't side 55
I. -eah. Let3s see the B.E.M. sleep.
A. 55 is as di&&erent a state $& $nsi$usness 0et1een rapid e+e )$#e)ent sleep and n$n5rapid
e+e )$#e)ent sleep as the di&&erene 0et1een 1a*e&ulness and sleep.
I. O*a+. Just .$ $#er that $ne )$re ti)e. Are +$u sa+in. that the rapid e+e )$#e)ent sleep is as
di&&erent &r$) the rest $& it as 0ein. a1a*e is di&&erent &r$) sleep,
A. -es.
I. And h$1 is it di&&erent &r$) 55
A. 6here are three )a2$r states $& $nsi$usness 55
Judge: 4sk you, don0t talk over each other, %ecause our court reporter is having a hard
ti#e, and the rest o us are having a hard ti#e 22
Mr. Kosko: ) apologi'e, your honor. )t0s #y ault.
A. S$ there are three sta.es $& $nsi$usness@ $ne is 1a*e&ulness4 the $ther is n$n B. E.M. sleep!

and the third is the rapid e+e )$#e)ent sleep. S$ in rapid e+e )$#e)ent sleep! +$u see the 0rain
1a#es are l$$*in. li*e the pers$n 55 the+3re #er+ si)ilar as t$ 1hat 55 i& the pers$n 1ere a1a*e.
And n$1 +$u see the e+es are dartin. ar$und in their s$*ets. I& the pers$n 1ere 1athin. a
tennis )ath! +$u 1$uld see the e+es .$in. 0a* and &$rth and 0a* and &$rth! and it is atuall+
in realti)e. S$ it is n$t sped up! as )an+ pe$ple thin*. And there are s$)e $nditi$ns in 1hih A
there is an area $& the 0rain that paral+zes the )usles 1hile 1e3re in rapid e+e )$#e)ent sleep
55
I. %aral+zes 1hat )usles,
A. 6he )usles that 1e 1$uld $rdinaril+ A the s*eletal )usles that 1e 1$uld use t$ 1al* and t$
run and t$ )$#e $ur ar)s. And i& that area is da)a.ed! then pe$ple 1ill atuall+ at $ut their
drea)s. And s$ a at 1ill 0e hasin. )ie in their rapid e+e )$#e)ent sleep! and s$ $n.
I. S$ in this rapid e+e )$#e)ent sleep! is the 0rain re#ie1in. the e#ents $& the da+,
A. In the rapid e+e )$#e)ent sleep! the 0rain is atuall+ inte.ratin.! s$ a l$t $& the )e)$ries
that 1ere st$red in the deep! sl$1 1a#e sleep 55
I. O*a+. S$ that3s 55
A. 55 and then the rapid e+e )$#e)ent sleep! 1e3re inte.ratin. the )e)$ries.
I. O*a+. Keep 55 I3) s$rr+. I interrupted +$u.
A. In the rapid e+e )$#e)ent sleep! 1e3re inte.ratin. the )e)$ries that 1e had st$red 1ith sl$1
1a#e sleep 1ith all the $ther )e)$ries 1e had learned pre#i$usl+. S$ 1e ha#e the ne1 da+3s
)e)$ries $)e in and are $ns$lidated! and 1e laid the) d$1n in sl$1 1a#e sleep! and all
these ne1 )e)$ries $)e in! and 1e ha#e t$ inte.rate the) 1ith 1hat 1e alread+ ne1. And that
see)s t$ happen durin. rapid e+e )$#e)ent sleep. 6hat3s 1here 1e inte.rate all this in&$r)ati$n
1e 2ust learned t$da+ 1ith all $ur pre#i$us li&e e'perienes. And 1e! atuall+! als$! durin. rapid
e+e )$#e)ent sleep! 1e are a0le t$ atuall+ )a*e sense $& thin.s that )i.ht ha#e 0een 55 that 1e
)i.ht n$t ha#e re$.nized durin. the da+ti)e. H$r e'a)ple 55
I. Can I interrupt +$u,
A. -es. A0s$lutel+.
I. I 1ant +$u 55 .i#e an e'a)ple. Supp$se there3s a 0as*et0all pla+er 1h$ durin. the da+ is
pratiin. &$ul sh$ts 55
A. -es.

I. 55 &r$) the &ree5thr$1 line. And he d$es it &$r t1$ h$urs durin. the da+! and he3s .$in.! li*e!
C0 perent &r$) the &ree5thr$1 line. (hat happens t$ the 0rain durin. that peri$d $& ti)e 55
A. 6he area $& the 0rain 55
I. 55 at ni.ht 1hen he3s sleepin.,
A. 6he area $& the 0rain that he is usin. t$ thr$1 that 0as*et0all! that ni.ht! that 55 let3s sa+ he3s
ri.ht5handed. 6he area $& the ri.ht 55 that $ntr$ls the )$#e)ent $& the ri.ht hand! the area $n
the le&t side $& the 0rain that $ntr$ls the ri.ht hand )$#e)ent! 1ill ha#e )uh deeper sl$1
1a#e sleep l$all+ ri.ht in that spei&i area On the $ther hand! i& +$ur ar) 1ere in a Slin.! then
the area that $ntr$ls that area $& the ar) has )uh less sl$1 1a#e sleep! 0eause there3s )uh
less t$ re$rd 1hat happened. Si)ilarl+! i& +$u learn a Set $& n$tes $n a pian$ $r 1hate#er! i&
+$u3re d$in. 55 learnin. h$1 t$ $perate a 2i.sa1! 1hate#er! that ni.ht +$u3ll ha#e )uh deeper
sl$1 1a#e sleep in the area $& the 0rain that $ntr$ls the )$#e)ent $& that part $& +$ur 0$d+! as
+$u are learnin. that. And then +$u 1ill atuall+ d$ the tas* )uh 0etter the ne't da+ 1hen +$u
a1a*en. S$! &$r e'a)ple! studies that ha#e 0een d$ne in ani)als. 6here are spei&i ells in the
0rain! i& an ani)al is in a )aze! these are alled 7plae ells.7 -$u an tell 1hat plae in the )aze
the ani)al is standin. 0+ 1hih ell is &irin.. Kind $& $$l. And s$ the ani)al &i.ures $ut the+3re
all dead ends in the )aze! 0ut i& it &$ll$1s a ertain path! it .ets a %iee $& heese in the end.
6hen 1hen the ani)al is sleepin.! a)azin.l+ en$u.h! the+ an l$$* at 1here the ani)al is
standin. durin. sleep! and +$u an see that the ani)al is re)e)0erin. the path $#er and $#er
a.ain! hundreds $& ti)es! rehearsin. the path 1here it .ets the heese. And 1hen the ani)al is
a1a*e! it an run thr$u.h that )aze )uh )$re <ui*l+ and the l$ser t$ the heese 0eause
learnin. and )e)$r+ $ns$lidati$n happened durin. sleep. (hen I 1as .r$1in. up! )+ )$)
1$uld sa+! +$u ha#e t$ sleep 0e&$re +$u learn s$)ethin. in $rder t$ 0e a1a*e in lass. /ut 1hat
su0se<uentl+ has 0een learned! sleep is essential in $ns$lidatin. )e)$ries and that sleep
a&ter1ards! 1e learn s$)ethin. that is partiularl+ i)p$rtant.
Mr. K$s*$&&@ )a+ 1e ha#e the ne't slide,
I. O*a+. 6his slide 55 1hat d$es this slide sh$1! d$t$r =indiatin.>,
A. 6his is sh$1in. the ne't le#el $& arhiteture. I3#e sh$1n +$u $n $ther slides! there are
di&&erent spei&i sta.es. /ut the arhiteture $& sleep is suh that +$u atuall+ .$ thr$u.h these
sta.es in a #er+ $rderl+ )anner.
I. (hat is the 7(7 &$r,
A. 7(7 is 1a*e4 7B7 is &$r rapid e+e )$#e)ent sleep4 sta.e 84 sta.e 24 sta.e 9! and sta.e ;. And
then the desi.nati$n &$r sl$1 1a#e ati#it+! and this +$u need a $)puter t$ d$ the anal+sis! and
it inte.rates all $& th$se 0i. 1a#es! th$se s+nhr$n$us &irin.! and sa+s h$1 )uh ener.+ is
present. S$ 1hen +$u ha#e a l$t $& th$se deep sl$1 1a#es at the 0e.innin. $& the ni.ht! and

+$u3re in sta.e ; sleep! that 1$uld 0e a hi.h ener.+! deep sl$1 1a#e sleep $ns$lidatin. a l$t $&
)e)$r+.
I. (hat are th$se red areas $n the upper 55
A. 6hese are illustratin. 1hether the indi#idual is in rapid e+e )$#e)ent sleep. 6his is that
di&&erent state $& $nsi$usness I 1as tal*in. a0$ut. (e spend a0$ut 2? perent $& the ni.ht in
rapid e+e )$#e)ent sleep! 0ut it3s n$t all at $ne. And ritial t$ the $r.anizati$n $& sleep! it has
t$ $ur in these e#er+ h$ur and a "al& t$ t1$ h$urs.
I. S$ that3s the +le,
A. 6hat3s the +le.
I. (ell! O*a+.
Mr. Kosko: 4nd the ne(t slide, please/ .kay. 3hy does the %rain need sleep/
A. 6he 0rain needs sleep in $rder t$ &ul&ill a Series $& 0asi 0i$l$.ial needs. As I )enti$ned! 1e
*eep $ur 0rain ells &$r li&e. And s$ 1e need t$ repair and )aintain th$se $nneti$ns t$ deide
1hih $nneti$ns are i)p$rtant! and shed the $nes! prune the $nes that are less i)p$rtant!
0eause 1e d$n3t ha#e en$u.h r$$) in $ur s*ull t$ )a*e eah $ne $& the $nneti$ns ta*e spae!
n$r d$ 1e ha#e en$u.h ener.+. (e $ns$lidate )e)$r+ durin. sleep4 1e inte.rate dail+ learnin.
1ith pri$r e'perienes! and 1e re&ill the &uel tan* $& all these ner#e ells 0+ rest$rin. the ener.+
st$res $& the ells re<uired &$r 55 and that re<uires the 0rain t$ 0e $&&line.
Mr. Kosko: 4nd the ne(t slide, please. : -hy does 22 -e talked a%out -hy the %rain needs
sleep to restore the cells. 3hy does the %ody need sleep/
A. 6his is s$)ethin. $nl+ dis$#ered at 55 in the past 8? +ears. S$ in the 0e.innin. 1e &elt sleep
1as 2ust &$r the 0rain! 0ut it turns $ut 55 and it3s pi$neerin. 1$r* dis$#ered 0+ a 1$)an at the
Eni#ersit+ $& Chia.$ 1h$ dis$#ered that the 0$d+ needs sleep! t$$. And 1e d$n3t )eta0$lize
.lu$se. I& 1e eat s$)ethin.! 1e ha#e a Glass $& s$da $r 1hate#er! in $rder t$ )eta0$lize su.ar
1e ha#e t$ use .lu$se $r su.ar t$ )eta0$lize 55
I. -$u3re usin. 55 7)eta0$lize!7 +$u )ean $n#ert that su.ar t$ ener.+,
A. -es.
I. And s$ in $rder t$ $n#ert the su.ar int$ ener.+! 1hat has t$ happen,

A. (e ha#e t$ release ertain h$r)$nes! partiularl+ the h$r)$ne insulin 0+ the panreas! and
the release that pre#ents us &r$) .ettin. dia0etes re<uires sleep. I& 1e d$n3t .et en$u.h sleep! i&
1e are de&iient in sleep! then that re.ulati$n $& that )eta0$lis) 1ill n$t .$ 1ell. And that3s 1h+
55 and it3s i)p$rtant in re.ulatin. appetite. I& 1e d$n3t .et en$u.h sleep! 1e are hun.rier! and i&
1e are 55 and here I3) tal*in. a0$ut hr$ni partial sleep l$ss. S$ i& 1e3re $nl+ sleepin. &$ur $r
&i#e h$urs a ni.ht! then 1e use )$re ener.+! 0eause 1e3re sta+in. a1a*e l$n.er! 0ut 1e eat
)$re than the .ap. S$ 1e end up .ainin. 1ei.ht! usuall+! i& 1e3re $nl+ sleepin. &$ur $r &i#e
h$urs a ni.ht. Li#er &unti$n! the resistane t$ in&eti$n. I& I3) e'p$sed t$ a #irus that auses the
$))$n $ld! +$ur susepti0ilit+ t$ that in&eti$n 1ill 0e )uh .reater i& +$u3re n$t .ettin.
en$u.h sleep $n a re.ular 0asis.And the ner#$us s+ste) &unti$ns 55 e#en &at ells need sleep. S$
i& +$u ta*e &at ells $ut $& s$)ethin. n$t .ettin. en$u.h sleep! the+ 1ill n$t )eta0$lize as 1ell
as ta*in. it &r$) an indi#idual 1h$ has 0een .ettin. en$u.h sleep. S$ n$t 2ust 0rain &unti$n! 0ut
als$ 0$d+ &unti$n! 1hih the 0$d+ needs sleep.
Mr. K$s*$&&@ is this a .$$d ti)e! +$ur h$n$r,
(lunch %reak)
&irect e(a#ination %y Mr. Kosko:
I. (hen 1e le&t! d$t$r! 1e 1ere tal*in. a0$ut 1h+ the 0$d+ needs sleep! and the *inds $&
thin.s that an happen i& the 0$d+ d$esn3t .et en$u.h sleep4 is that $rret,
A. 6hat3s $rret. I& a pers$n is $nl+ sleepin. &$ur $r &i#e! si' h$urs a ni.ht! an inade<uate
a)$unt $& ti)e &$r sleep! then +$u an see that it a&&ets appetite! inreases appetite! dereases
$ur resistane t$ in&eti$n! as I )enti$ned 0e&$re! and all these $ther thin.s that e#en the
a0d$)inal &at ells need sleep.
I. N$1! 1hat happens is there 1hen the pers$n is t$tall+ depri#ed $& sleep, (hat happens 1hen
a 1hen a )a))al is t$tall+ depri#ed $& sleep,
A. Ma+ I ha#e the ne't slide,
I. D$ +$u ha#e a slide that 1ill sh$1 that,
A. -es. S$ it turns $ut that sleep is neessar+ &$r li&e. Just in the sa)e 1a+ as eatin. is neessar+
&$r li&e! $r drin*in. &luids is neessar+ &$r li&e! s$! t$$! is sleep neessar+ &$r li&e. S$ i& +$u 1ere
t$ ta*e an ani)al li*e a rat and depri#e it $& &$$d! $n a#era.e! the+ an .$ a0$ut 8F da+s 0e&$re
the+ die i& the+ d$n3t ha#e &$$d. It turns $ut i& the ani)al d$esn3t is n$t all$1ed t$ sleep! it 1ill
als$ die. S$ rats $)pletel+ depri#ed $& sleep l$se their 0$d+ 1ei.ht! the+ 0e$)e sra1n+ and

dishe#eled! the+3re una0le t$ )aintain their 0$d+ te)perature! s$ their ther)$re.ulat$r+ s+ste)
.ets $&& *ilter. And 1hen the+3re depri#ed $& all sleep! the+ die in an a#era.e $& a0$ut three
1ee*s. And i& the+3re seleti#el+ depri#ed $& rapid e+e )$#e)ent sleep! the+ last a little l$n.er4
0ut 0+ a0$ut &i#e 1ee*s! the+ die. S$ it is A sleep turns $ut t$ 0e neessar+ &$r li&e.
I. O*a+. S$ &irst! +$u used a 1$rd there! 1hih is the 7ther)$re.ulat$r+ s+ste).7 1hat is the
ther)$re.ulat$r+ s+ste),
A. 6hat3s the s+ste) in the 0$d+ that helps us t$ )aintain $ur 0$d+ te)perature. S$ 1e3re A
)a))als are n$t li*e $ld A s$ alled $ld50l$$ded ani)als! li*e a &r$.! 1hih 1hate#er the
te)perature it is in the $utside 1$rld! that3s the te)perature $& the ani)al. (e ha#e a
ther)$re.ulat$r+ s+ste) that *eeps $ur 0$d+ te)perature at a0$ut as e#er+$ne *n$1s! a0$ut
GD.C de.rees! and it h$lds it stead+ there. 6here is atuall+ a dail+ +le! s$ it3s l$1er at ni.ht and
hi.her durin. the da+ti)e. /ut the 0$d+ de&ends the te)perature t$ 0e at 1hate#er set p$int is
appr$priate &$r that ti)e $& da+.
I. And 1hat happens i& an indi#idual is t$tall+ depri#ed $& sleep! t$ the ther)$re.ulat$r+
s+ste),
A. 6he ani)al 0e.ins t$ n$ l$n.er 0e a0le t$ )aintain the appr$priate te)perature! and the 0$d+
te)perature atuall+ dereases.
I. N$1 and that3s n$1! +$u als$ ha#e in +$ur slide that there ha#e 0een studies 1hih sh$1
1hat happens 1hen the BEM sleep! the rapid e+e )$#e)ent sleep! is pr$hi0ited,
A. -es. S$
I. And 1hat happens 1hat happens i& +$u 2ust eli)inate the rapid e+e )$#e)ent sleep 0ut the
rest $& the sleep +le re)ains intat,

A. I& +$u eli)inate 2ust the rapid e+e )$#e)ent sleep! the ani)als 1ill als$ die. It ta*es a little
l$n.er. It ta*es $n a#era.e a0$ut &i#e 1ee*s instead $& a0$ut three 1ee*s. /ut e#en i& the+3re
all$1ed t$ .$ int$ all the $ther sta.es $& sleep 0ut n$t rapid e+e )$#e)ent sleep! the+ an3t
sur#i#e 1ith$ut that sta.e $& sleep! s$ it3s neessar+ &$r li&e.
I. N$1! d$es sleep als$ it s$rt $& )a*es sense aid in per&$r)ane, (hen there is a 1hen a
pers$n is depri#ed $& sleep! d$es that a&&et per&$r)ane,
A. -es! it d$es. In &at! in these in these A in indi#iduals 1h$ are depri#ed $& sleep! it a&&ets their
$.niti#e &unti$n and their a0ilit+ t$ $ns$lidate )e)$r+. Man+ $& the thin.s that 1e tal*ed
a0$ut in ter)s $& the &unti$ns $& sleep are i)paired i& the pers$n d$esn3t .et the sleep that the+
need.

I. And $.niti#e I3) s$rr+.


A. And $.niti#e per&$r)anes! and s$ $n. One $& the thin.s I didn3t )enti$n in this slide is that
i& ani)als are depri#ed $& sleep and the+ are! let3s sa+! l$se t$ the three51ee* )ar*! and the+3re
sh$1in. all the si.ns! the+3re sra1n+! the+3re dishe#eled! the+3re l$sin. 1ei.ht! their 0$d+
te)perature is n$t a0le t$ sta+ at the n$r)al te)perature and then i& at the last )$)ent the+
atuall+ all$1 the ani)als t$ sleep a.ain $& $urse! s$)eti)es! the+ d$n3t st$p the e'peri)ent
s$$n en$u.h and the+ still die. /ut in th$se 1h$ d$ n$t die! 1ithin $ne t$ three da+s! the+ ha#e
$)pletel+ re$#ered. And s$ the lettin. the) sleep! a.ain! an resue the) s$ that the+ an
re#erse the deteri$rati$n that the+3#e 0een su&&erin. thr$u.h t$tal sleep depri#ati$n.
I. N$1! +$u ha#e a slide that sh$1s s$)e $& the areas in 1hih sleep depri#ati$n a&&ets
per&$r)ane. Ne't slide! please,
A. -es. (hen +$u3re depri#ed $& sleep! let3s sa+ i& +$u pull an all5ni.hter and +$u3re a1a*e &$r
)$re than 2; h$urs. I))ediatel+ 1e an 0e.in t$ detet han.es in per&$r)ane. S$ $ne $& the
&irst thin.s that han.es is +$ur reati$n ti)e. And s$ 1hat 1$uld n$r)all+ ta*e +$u! let3s sa+! a
<uarter $& a se$nd t$ resp$nd 1ill n$1 ta*e +$u three ti)es as l$n.. And s$ 1hat I3) tr+in. t$
e'plain! &$r e'a)ple! t$ s$)e $& the sp$rts pla+ers! 1h+ 1$uld this )atter! 1ell! +$u *n$1! the+
ha#e t$ ha#e )illise$nd aura+! resp$nd t$ 0l$*in. a sh$t $r d$in. 1hate#er4 and it3s .$in.
t$ ta*e the) three ti)es l$n.er i& the+! &$r e'a)ple! sta+ a1a*e all ni.ht and tr+ t$ pla+ a .a)e
the ne't da+. 6hat3s $n a#era.e. It als$ inter&eres 1ith 0alane. And the e&&et $n 0alane is s$
pr$&$und that there are atuall+ sientists in Hinland 1h$ are tr+in. t$ de#el$p a li*e $ne $&
th$se (ii ta0les that +$u )i.ht stand $n 1here +$u an l$$* at 0alane and use it as a tra&&i st$p
t$ see! +$u *n$1! i& s$)e0$d+ has n$t is sleep depri#ed! and the+3re tr+in. t$ dri#e a )$t$r
#ehile! an the+ stand and st$p s1a+in.. /eause +$ur a0ilit+ t$ )aintain +$ur 0alane is
i)paired i& +$u are sleep depri#ed.
It als$ inreases distrati0ilit+! s$ +$u 0e$)e )$re easil+ distrated 0+ e'trane$us thin.s i& +$u
are sleep depri#ed. 6hat3s $ne $& the thin.s that happens t$ dr$1s+ dri#ers. -$u *n$1! the+ )a+
0e readin. the 1hat3s $n the panel tru* as it3s passin. the) instead $& l$$*in. and &$usin.
their attenti$n 0eause the a0ilit+ t$ &$us attenti$n and n$t 0e distrated is i)paired 0+ sleep
l$ss. Jud.)ent is i)paired 0+ sleep l$ss! and pe$ple ta*e hanes that the+ 1$uldn3t $ther1ise
ta*e 1hen the+ are sleep depri#ed. It! $& $urse! i)pairs )e)$r+ and the a0ilit+ t$ $ns$lidate
)e)$r+ and re)e)0er thin.s. It de.rades reati#it+! it inreases the ris* $& lapse $& attenti$n. It
als$ inreases the ris* $& aut$)ati 0eha#i$r. N$1! aut$)ati 0eha#i$r is a phen$)en$n 1here
+$u )a+ 0e dri#in. al$n. $n the hi.h1a+ and +$u d$n3t re)e)0er h$1 +$u .$t &r$) p$int a t$
p$int 0! at least dri#in. a ar d$in. that. %art $& +$ur 0rain )a+ 0e asleep and part $& it is a1a*e
as +$u3re dri#in.. In partiular! the area ri.ht 0ehind +$ur &$rehead! 1hih is )$st susepti0le t$
sleep depri#ati$n! 1hih is the area $& 2ud.)ent and $ntr$l! )a+ 0e atuall+ ha#e alread+
he*ed $ut and )a+ 0e asleep 1hile +$u3re still part $& +$ur 0rain is still turnin. the steerin.
1heel! and s$ $n! 0ut it )a+ n$t st$p &$r auti$nar+ si.nals and s$ $n.
S$ that3s 1hat )a*es it s$ dan.er$us t$ dri#e in the state $& aut$)ati 0eha#i$r! 0eause +$u

d$n3t resp$nd appr$priatel+ t$ +$ur en#ir$n)ent. O0#i$usl+! sleep depri#ati$n inreases the ris*
$& &allin. asleep4 and alth$u.h that )a+ see) $0#i$us! )$st pe$ple thin* 1hen the+3re A 0eause
there are a )illi$n dr$1s+ dri#in. rashes e#er+ +ear. A0$ut 2?0!000 pe$ple a da+ n$d $&& and
&all asleep at the 1heel! and the+3re surprised 0+ it 0eause the+ d$n3t realize that 1hen +$u .et
tired en$u.h! the 0rain )a+ seize $ntr$l and +$u )a+ in#$luntaril+ )a*e the transiti$n &r$)
1a*e&ulness t$ sleep. And an$ther thin. that happens is pe$ple 0e$)e &ast and sl$pp+. S$ the+
1ill atuall+ instead $& n$r)all+ pe$ple 1ill sl$1 d$1n t$ )aintain their aura+ i& a tas* .ets
)$re di&&iult4 0ut a sleep5depri#ed pers$n 1ill 2ust 1ant t$ .et it $#er 1ith
And speed thr$u.h it.
I. I 1anted t$ as* +$u a0$ut the sl$pp+. ($uld a pers$n 1h$ is sleep depri#ed 1h$ is n$r)all+ a
rather &astidi$us pers$n 1$uld the+ s$)eti)es ha#e s$)e sl$pp+ 0eha#i$r! &$r e'a)ple! in their
pers$nal e&&ets $r their 0edr$$)s $r the li*e,
A. -es! de&initel+! 0eause 1hen a pers$n is e'hausted! the+ d$n3t tend t$ tend t$ the sa)e
issues! the+ 1ill +$u *n$1! it3s interestin.. As I )enti$ned in the last slide! e#en the rats 0e$)e
dishe#eled 1hen the+3re depri#ed $& sleep. 6he+ st$p .r$$)in. the)sel#es appr$priatel+! and s$
$n.
I. And the ne't slide! please. I thin* it sh$1s $ne $& the thin.s +$u 1ere 2ust +$u 1ere tal*in.
a0$ut! the ad#erse
A. /+ the 1a+! e#en i& +$u lean s$)e0$d+ up and ha#e the)! +$u *n$1! put $n their )a*eup
and d$ e#er+thin. else! the a#era.e pers$n an re$.nize i& s$)e0$d+ has 0een sleep depri#ed $r
n$t 2ust 1ith a in t1$ $r three se$nds 0+ a ph$t$.raph $& the)! e#en i& the+3#e ta*en a sh$1er
and leaned up and s$ $n! 0eause 1e an tell 2ust &r$) the appearane! 2ust 0+ l$$*in. at
s$)e$ne.
I. N$1! the +$u ha#en3t tried that $n )e +et! ha#e +$u,
A. N$ $))ent.
I. Is there an ad#erse e&&et $& sleep de&iien+ $n )$$d,
A. -es. -$u *n$1! 1e all re$.nize in little *ids i& the+ ha#en3t .$tten en$u.h sleep! )$thers 1ill
$&ten sa+! +$u *n$1! that the+3re irrita0le! 7J$hnn+ hasn3t slept 1ell last ni.ht!7 and that3s 1h+
the+3re r+in.. (hat 1e d$n3t realize is that this pr$pert+ $& sleep l$ss $ntinues e#en int$
adulth$$d! and s$ pe$ple 0e$)e inreasin.l+ #$latile in ter)s $& their e)$ti$n. 6he+ )a+ &l+
$&& the handle! the+ )a+ 0e$)e the+ ha#e di&&iult+ &$usin. and sustainin. their attenti$n. I&
the+3re presented 1ith the sa)e i& the+3re presented 1ith the sa)e! let3s sa+! distur0in. i)a.e!
0rain sans ha#e 0een d$ne t$ sh$1 that the e)$ti$nal part $& the 0rain! 1hih has a tehnial
na)e alled an eni.)a =ph$neti> A that little luster $& 0rain ells 1ill reat 1ith ten ti)es the

resp$nse i& +$u d$ 0rain i)a.in. $n s$)e0$d+ 1h$ is sleep depri#ed than s$)e$ne 1h$ is 1ell
rested.
And this is 1h+ I tr+ t$ tell the pr$&essi$nal sp$rts pla+er i& +$u ha#en3t .$tten +$ur sleep! then i&
the re&eree alls +$u &$r a &$ul! 1hate#er! at 0as*et0all! then +$u )a+ .et a tehnial &$ul and 0e
thr$1n $ut $& the .a)e 0eause +$u )a+ n$t 0e a0le t$ h$ld +$ur e)$ti$ns in he* and n$t
hallen.e the re&eree. %e$ple als$ interestin.l+ en$u.h! the+ 1hen it .$es $n hr$niall+! the+
are at ris* $& 0urn $ut! depressi$n! and e#en suiidal ideati$n. And all th$se! +$u *n$1! an lead
t$ depressed )$$d! 1hih is *ind $& parad$'ial 0eause at the 0e.innin. 1hen +$u3re &irst sleep
depri#ed! s$)e pe$ple! +$u *n$1! a&ter the+3#e sta+ed up all ni.ht! the+ s$)eti)es &eel a &eelin.
$& euph$ria! and the+ 0e$)e s$rt $& slap5happ+ and punh+! as s$)e pe$ple all it! 7I 1as up all
ni.ht! I3) a little punh+.7 the+3ll .i#e an inappr$priate resp$nses. E#entuall+ 1hen it3s hr$ni it
leads t$ a depressed )$$d. %e$ple ha#e )$re 0$d+ $)plaints! their susepti0ilit+ the+ are )$re
sensiti#e t$ pain 1hen the+ are sleep depri#ed! the+ tend t$ e'periene )$re s+)pt$)s $&
an'iet+ and e#en paran$ia and distur0ed th$u.ht.
I. And then the ne't slide! please. D$es this sh$1 e'plain 1hat 1e3re seein. in this slide. Hirst
$& all! 1hat *ind $& an i)a.e is this,
A. 6his is this is an i)a.e $& a 0rain san4 and in this partiular there are all s$rts $& di&&erent
t+pes $& 0rain sans. 6his partiular 0rain san is l$$*in. at the utilizati$n $& .lu$se in the 0rain!
1hih is the )ain ener.+ s$ure $& the 0rain. And in this slide! +$u an see in the areas that are
illustrated in 0lue! the .lu$se is n$t 0ein. used #er+ e&&eti#el+. And this is a $)paris$n $& a
rested 0rain 1ith a 0rain that has n$t .$tten en$u.h sleep! that has 0een a1a*e all ni.ht. 6his is
1$r* that 1as d$ne at the (alter Beed ar)+ h$spital! )+ $llea.ues there. And +$u an see that
the areas that are .ettin. that are .ettin. that are turnin. 0lue! 1hih is t$ sa+ that the+3re n$t
utilizin. .lu$se #er+ 1ell! the+3re n$t utilizin. the ener.+ s$ure and the &uel 1ell! th$se are the
pre&r$ntal $rte'! the area I said 1as 0ehind the &$rehead resp$nsi0le &$r 2ud.)ent and $ntr$l.
S$ th$se areas! it3s *ind $& li*e! +$u *n$1! in the in the n$rtheast! i& the ar en.ine is $ld! it3s
n$t .$in. t$ 1$r* #er+ 1ell. It d$esn3t happen here in LA! 0ut s$ that3s .$in. st$ne $ld. 6he
interi$r parietal $rte'! 1hih is the area $& the 0rain that inte.rates sens$r+ in&$r)ati$n $)in.
&r$) the e+es and ears and t$uh! is als$ n$t utilizin. ener.+ #er+ 1ell. And then in a #er+
i)p$rtant part $& the 0rain! the thala)us! 1hih rela+s sens$r+ in&$r)ati$n &r$) the in&$r)ati$n
that 1e3re .ettin. &r$) $ur senses t$ the area $& the 0rain that $ntr$ls )$#e)ent is #er+
seri$usl+ de.raded 1hen 1e ha#e 0een a1a*e all ni.ht.
I. O*a+. S$ n$1 I 1ant t$ .$ thr$u.h a $uple $& th$se seti$ns 1ith +$u t$ 2ust see 1hat it
)eans in pratial ter)s. 6he area 1a+ $#er $n the ri.ht! 1hih +$u sa+ is the pre&r$ntal $rte'!
that $ntr$ls 2ud.)ent and $ntr$l,
A. -es.

I. And d$es the 0lue! the #er+ dar* 0lue )ean it3s n$t
A. -es! an+thin. that3s
I. n$t .ettin. &uel $r 0urnin. &uel,
A. An+thin. that3s 0lue is n$t 0urnin. &uel as 1ell as it sh$uld 0e. S$ +$u an see and that3s used
as a an indiati$n that that area $& the 0rain is i)paired.
I. And h$1 d$es that $n#ert t$ the &unti$n $& that area, In $ther 1$rds! h$1 1$uld h$1
1$uld that )ani&est itsel&,
A. S$ that 1$uld )ean and 1e thin* that these *inds $& 0rain i)a.e supp$rt the e'peri)ental
results that 2ud.)ent is i)paired 1hen pe$ple are sleep depri#ed. S$ that has 0een $0ser#ed
e'peri)entall+! and it is $nsistent 1ith the 0rain i)a.in. studies.
I. N$1! is there s$)ethin. alled 7e'euti#e &unti$nin.7 1hih tal*s a0$ut a pers$n3s a0ilities
t$ $r.anize thin.s,
A. -es! that is it is the pre&r$ntal $rte' that is ritial &$r e'euti#e &unti$n.
I. ($uld that 0e i)paired in a pers$n 1h$ is sleep depri#ed,
A. -es! de&initel+.
I. (hat is e'euti#e &unti$n,
A. S$ e'euti#e &unti$n is h$1 1e )a*e the deisi$ns as t$ 1hat 1e3re .$in. t$ d$ as a hu)an
0ein.! h$1 1e resp$nd 1hen 1e ha#e t$ deide 1hether s$)ethin. is appr$priate $r
inappr$priate! ri.ht $r 1r$n.! 1hether 1e ha#e t$ )ana.e a situati$n. And the a0ilit+ t$ d$ that
is .$in. t$ 0e de.raded.
I. -$u3re sh$1in. a 0rain here. "$1 )uh h$1 )uh la* $& sleep did the pers$n in this san
ha#e,
A. Just $ne ni.ht.
I. Just $ne ni.ht. O*a+. N$1! the in&eri$r parietal $rte'! 1hat
D$es that d$,
A. 6hat3s an area $& the 0rain that is resp$nsi0le &$r inte.ratin. in&$r)ati$n &r$) all A all $& $ur
di&&erent senses. S$ the sense $& t$uh4 the sense $& taste4 the sense $& s)ell4 the sense $& hearin.4
and! $& $urse! the sense $& #isi$n. All $& these di&&erent senses! that in&$r)ati$n is inte.rated in
that area $& the 0rain! 1hih is als$ i)paired! s$ $ur a0ilit+ t$ ta*e in 1hat3s .$in. $n in $ur

e'ternal en#ir$n)ent is .$in. t$ 0e i)paired.


I. And that
A. S$! &$r e'a)ple I3) s$rr+ t$ interrupt +$u.
I. I 1as interruptin. +$u all )$rnin..
A. S$! &$r e'a)ple! i& +$u present $n a $)puter sreen i)a.es t$ si)ulate a pers$n 0ein. a0le
t$ see $02ets in their #isual &ield! and t$ re$.nize the)! and t$ resp$nd t$ the)! the+ 1ill )a*e
ten ti)es as )an+ )ista*es a&ter 0ein. up all ni.ht and )issin. i)a.es in the #isual &ield as
1hen the+3re 1hen the+3#e slept. And! $& $urse! that3s #er+ i)p$rtant &$r )an+ $upati$ns.
I. And $ipital,
A. 6he $ipital $rte' is 1here 1e inte.rate in&$r)ati$n $n #isi$n $)in. in &r$) the &r$) the
&r$) the $pti ner#es and the &r$) the e+e0all! 0asiall+.
I. O*a+. And s$ that3s i)paired s$)e1hat &r$)
A. -es.
I. a ni.ht3s sleep l$st, And that #er+! #er+ dar* 0lue seti$n in the enter 1hih sa+s 7thala)us
rela+s sens$r+ in&$r)ati$n!7 1hat is a.ain! the thala)us,
A. Be)e)0er! that 1as in the enter $& the 0rain! and it 1as at$p the 0rain ste). And that is
ritial &$r rela+in. sens$r+ in&$r)ati$n t$ the )$t$r $rte'. S$ 1e3#e n$1 inte.rated all $& $ur
senses! and n$1 1e3re .$in. t$ send the )essa.es up t$ the t$ the thin*in. part $& the 0rain
1here 1e re.ulate $ur )$#e)ents! and s$ that3s .$in. t$ 0e ritial &$r! +$u *n$1! seein. 1here
the step is and then )$#in. t$1ard it and n$t &allin. d$1n.
I. N$1 +$u ha#e an$ther slide 1hih sh$1s 1hat happens t$ the #isual disri)inati$n 1hen in
A 1ith re.ard t$ sleep,
A. -es! ne't slide.
I. Ne't slide! please.
A. S$ this is this is a0$ut learnin.. S$ this )$rnin. I tal*ed a0$ut the i)pat $& sleep l$ss $n
learnin.! and this A the e'peri)ent that is illustrated here 1hih 1as $nduted 0+ )+ $llea.ue
%r$&ess$r Sti*.$ld at the "ar#ard )edial sh$$l! pu0lished in the 2$urnal $& nature
neur$siene a0$ut 89 +ears a.$! 1as a pi$neerin. e'peri)ent in 1hih he sh$1ed the
i)p$rtane $& sleep t$ learnin.. S$ in this e'peri)ent! $n da+ zer$ A and I3) s$rr+ it d$esn3t
sh$1 1hat the a'es are $n the h$riz$ntal a'is4 0ut that3s da+ 0! 8! 2! 9! ;! and a 1ee* later $n da+

F.
I. S$ that3s se#en da+s as sh$1n 0+ that 0 thr$u.h F,
A. E'atl+.
I. And the
A. And $n the #ertial a'is is i)pr$#e)ent in the speed at 1hih the+3re d$in. a #isual
disri)inati$n tas*.
I. (hat3s that,
A. S$ the #isual disri)inati$n tas* is a tas* that the+ ha#e t$ the+ ha#e t$ re$.nize di&&erent
letters $n a sreen! $r learn h$1 t$ d$ a tas*. And in this partiular ase! the+ 1ere trained in the
tas*! +$u *n$1! identi&+ the e3s that are $n their side! $r s$)e unusual tas*. 6he+3re trained in the
tas* $n da+ 0! and then the+ .et n$ &urther trainin. &$r the &$ll$1in. 1ee*. And 1hat pr$&ess$r
Sti*.$ld $0ser#ed 1as that a&ter sleepin. $ne ni.ht! the+ sp$ntane$usl+ .et 0etter $n the test in
a 1a+ that d$es n$t $ur i& he trains the) )$re durin. the sa)e da+. In &at! he did e'peri)ents
and he sh$1ed that i& +$u trained the) in the )$rnin. and test the) in the e#enin. and the+
didn3t sleep in the inter#al! the+ d$n3t .et 0etter. /ut i& the+ sleep ri.ht a&ter1ards! the+ .et 0etter4
and then i& the+ sleep the ne't ni.ht! the+ .et 0etter4 and eah su0se<uent ni.ht! the+3re .ettin.
0etter.
I. (hen +$u sa+ 70etter!7 the+3re .ettin. 0etter at d$in. the tas*,
A. -es! and s$ the+ an d$ it &aster and &aster. It3s li*e that rat I 1as tellin. +$u a0$ut .ettin.
thr$u.h the )aze t$ the piee $& heese. 6he+3re .ettin. there &aster and &aster 1ith$ut an+
&urther trainin..
I. (ith$ut an+ pratiin. in 0et1een,
A. Bi.ht! e'atl+.
I. S$ i& the the$r+ h$lds true! then! the+ 1$uld *eep .ettin. 0etter 1ith a .$$d ni.ht3s sleep up
thr$u.h da+ ;,
A. -es.
I. (ith$ut e#en pratiin.,
A. (ith$ut e#en pratiin..

I. And 1hat3s
A. E#en a 1ee* later! the+3re n$t d$in. 0adl+! e#en th$u.h the+ ha#en3t pratied it &$r a 1ee*.
I. S$ 1hat is that attri0uted t$,
A. As I )enti$ned this )$rnin.! 1hen 1e are sleepin.! 1e are .$in. thr$u.h and repla+in. the
e#ents! and 1e3re als$ $ns$lidatin. th$se )e)$ries! s$ 1e3re atuall+ pratiin. 1hat 1e
learned durin. sleep.
I. And i& +$u d$n3t .et sleep! is there a slide that sh$1s 1hat happened,
A. -es. Ne't slide. S$ i& +$u didn3t sleep that ni.ht! then e#en i& +$u sleep! the ne't ni.ht a&ter
the s$ +$u )issed a sleep a&ter da+ 0! then +$u slept a&ter da+ 8! slept a&ter da+ 2! 0ut +$u ne#er
.et the sleep5related i)pr$#e)ent.
I. S$ that sh$1s 1hen d$ +$u ha#e t$ sleep t$ start .ettin. the i)pr$#e)ent,
A. -$u ha#e t$ sleep $n the ni.ht a&ter learnin..
I. S$ i& +$u3re learnin. a tas*! and +$u d$n3t .et a ni.ht3s sleep a&ter +$u learn the tas*! that
1h$le thin. +$u sh$1ed us earlier a0$ut i)pr$#in.! i)pr$#in.! i)pr$#in. d$esn3t happen,
A. E'atl+.
I. And 1hat a0$ut 1hat3s sh$1n $n da+ 9 there,
A. 6hat3s e#en a&ter t1$ su0se<uent ni.hts $& sleep! the+ then tested the)! and the+ sh$uld ha#e
0een as .$$d as the+ 1ere! +$u *n$1! in the in the d$tted lines4 0ut the+! instead! ha#e n$
si.ni&iant i)pr$#e)ent at all.
I. N$1 +$u an ta*e that d$1n! 2$sh. 6han* +$u #er+ )uh.
A. And that slide! 0+ the 1a+! sh$1s that it is n$t that the+ 1ere +$u *n$1! the+ 1ere &ull+
re$#ered &r$) the sleep l$ss at that p$int! s$ the+ 1eren3t tired! 0ut the+ still $uldn3t d$ as 1ell
$n the tas* 0eause the+ ha#e ne#er $ns$lidated that )e)$r+.
I. N$1! 1hat happens t$ indi#idual &irst $& all! is there a desire &$r sleep that pe$ple ha#e,
A. -es! )$st de&initel+.
I. And 1hat happens 1hen the+ 0e$)e sleep5depri#ed, (hat happens t$ that desire,
A. It inreases.

I. Is sleep used as a &$r) $& t$rture s$)eti)es,


A. It is.
I. Can +$u .i#e e'a)ples $& that &r$) +$ur e'periene and 0a*.r$und and in&$r)ati$n,
A. It is $ne $& the it3s 0een used as a )eth$d $& t$rture &$r )an+! )an+ +ears4 and it3s A it 1as
e#en! un&$rtunatel+! used t$ t$rture pe$ple in the )iddle east in an e&&$rt t$ .et the) t$ $n&ess t$
thin.s and un&$rtunatel+! it3s n$t a .$$d )eth$d. -$u an .et pe$ple t$ $n&ess t$ thin.s! 0ut
the+ )a+ n$t ha#e d$ne the)! 0ut the+3re s$ e'hausted and it is s$ pain&ul t$ 0e sleep depri#ed
that it3s 0een &$und that pe$ple 1ill $n&ess t$ thin.s that the+ didn3t d$ 2ust t$ 0e a0le t$ .et
s$)e sleep. In &at! Menahe) 0e.in! 1h$ used t$ 0e 1h$ 1as t$rtured 1ith sleep depri#ati$n
he 1as t$rtured 1ith )an+ di&&erent thin.s in the .ula. in the S$#iet Eni$n. And he said! 1hen
he 1r$te his )e)$irs! that sleep depri#ati$n 1as 0+ &ar the 1$rst &$r) $& t$rture! 1$rse than an+
ph+sial thin.s the+ $uld ha#e d$ne.
I. S$ the pe$ple 1h$ ha#e su&&ered &r$) sleep depri#ati$n! d$ the+ l$$* &$r 1a+s t$ .et sleep,
A. -es.
I. And is there s$)ethin. alled 1hat is sleep5related an'iet+, Is there suh a thin..
A. 6here is. It is! it3s part $& a t+pe $& ins$)nia. It3s related t$ pri)ar+ ins$)nia in 1hih pe$ple
1ith ps+h$ph+si$l$.ial ins$)nia an atuall+ ha#e 1hat $uld 0e desri0ed as an $#er5
$nern &$r l$sin. sleep 0eause the+ d$n3t 1ant t$ su&&er the $nse<uenes $& n$t $& tr+in. t$
&unti$n 1hen the+ had n$t slept 1ell.
I. D$es this happen 1ith pe$ple 1h$ ha#e had pr$0le)s 1ith ins$)nia in the past,
A. -es.
I. And! n$1! this leads #er+ <ui*l+ and niel+ int$ the <uesti$n $& 1hat is ins$)nia,
A. S$ ins$)nia is a $)plaint $& the A $& di&&iult+ sleepin.. Either di&&iult+ &allin. asleep!
di&&iult+ sta+in. asleep! $r di&&iult+ 1a*in. up t$$ earl+. N$1! 1e used t$ thin* that pe$ple
neatl+ &it int$ $ne $& these ate.$ries4 0ut it turns $ut that D0 perent $& the pe$ple 1h$ ha#e $ne
$& th$se thin.s ha#e )$re than $ne. S$ the+ )i.ht ha#e di&&iult+ &allin. asleep as 1ell as
di&&iult+ 1a*in. up durin. the ni.ht! $r di&&iult+ 1a*in. up t$$ earl+ and di&&iult+ sta+in.
asleep! $r all three. S$ that3s! in .eneral! the 1hat ins$)nia is. /ut ins$)nia $)es in se#eral
di&&erent &la#$rs. 6here 1ithin it an either 0e pri)ar+ $r it an 0e se$ndar+! &$r e'a)ple! t$ a
)edial $nditi$n
I. O*a+. Let3s tal* a0$ut pri)ar+ &irst. (hat is that,

A. S$ pri)ar+ ins$)nia is there are a nu)0er $& di&&erent t+pes4 0ut! &$r e'a)ple! it an 0e
ps+h$ph+si$l$.ial ins$)nia! )eanin. that the indi#idual t+piall+ it3s hr$ni in nature! s$
pri)ar+ ins$)nia 1$uld n$t 0e s$)ethin. 1here! +$u *n$1! +$u the air $nditi$ner 1as t$$
$ld $ne ni.ht and +$u had tr$u0le sleepin.. -$u )a+ ha#e had ins$)nia! 0ut +$u d$n3t ha#e
pri)ar+ ins$)nia. S$ pri)ar+ ins$)nia i)plies that it is hr$ni4 and that it has 0een .$in. $n
&$r at least a )$nth! three )$nths! si' )$nths! dependin. $n 1hih de&initi$n +$u 1ant t$ read.
/ut it is hr$ni.
I. D$es 7hr$ni7 )ean that the+ al1a+s ha#e ins$)nia,
A. N$4 0ut it )eans that the+ ha#e it &$r a sustained inter#al $& ti)e. It3s n$t 2ust that it 1as t$$
$ld in the r$$) last ni.ht! $r the 0ed 1as un$)&$rta0le.
I. /ut +$u3re tal*in. a0$ut pri)ar+,
A. -es.
I. And then +$u said there3s s$)ethin. alled se$ndar+ ins$)nia,
A. (ell! )a+ I &inish 1hat I 1as sa+in. a0$ut pri)ar+,
I. -es.
A. I3) s$rr+. S$ 1ith the pri)ar+ ins$)nia! 1ith the ps+h$ph+si$l$.ial ins$)nia! pe$ple 1ith
that are $&ten h+per ar$used! e#en durin. the da+ti)e! and the+ ha#e the+ ha#e an $#er5$nern
a0$ut the ina0ilit+ t$ sleep! and the+ )a+ ha#e learned the+ )a+ ha#e ass$iati$ns 1ith the
0edr$$) $r 1ith sleep that are atuall+ ne.ati#e ass$iati$ns &$r the) t$ .et the sleep that the+
need. 6hen there is an$ther $nditi$n alled parad$'ial ins$)nia in 1hih the rep$rt $& the
ins$)nia +$u *n$1! pe$ple sa+! 7I didn3t sleep at all ni.ht!7 0ut i& +$u d$ an atual re$rdin.!
+$u )a+ &ind that the+ sleep &i#e $r si' h$urs. S$ the $)plaint the a)$unt $& sleep that the+
thin* that the+3re .ettin. is less than the+3re atuall+ .ettin.. N$1! at least )easurin. their sleep
1ith an E.E.G. Mahine 0ut it )a+ 0e that the+3re a0le t$ their sens$r+ s+ste) )a+ n$t 0e
turned $&&! and the+3re the researh is n$1 sh$1in. that the+ )a+ atuall+ 0e )$re distur0ed
than it see)s. An+1a+! there is parad$'ial ins$)nia. 6hen there3s a phen$)en$n alled
7ad2ust)ent sleep dis$rder.7 and that an 0e an ins$)nia ass$iated 1ith a spei&i stress$r $r a
spei&i situati$n 1here the pers$n an3t sleep 1hen the+ are at their in5la1s! $r the+ an3t sleep
1hen the+ are at their +$u *n$1! in ass$iati$n 1ith a ti)e that the+ ha#e t$ prepare &$r e'a)s
i& the+3re in sh$$l! $r s$ and that3s alled ad2ust)ent sleep dis$rder. And then there3s ins$)nia
ass$iated 1ith sleep h+.iene. N$1! 7sleep h+.iene7 s$unds it3s n$t a0$ut 0rushin. +$ur teeth.
Sleep h+.iene is li*e i& +$u ha#e an irre.ular sleep:1a*e shedule! $r i& +$u ha#e alertin. i& +$u
d$ a l$t $& alertin. ati#ities 0e&$re 0edti)e! +$u3re $n a #ide$ .a)e 1ith +$ur 0udd+ and +$u3re
pla+in. ri.ht up until and then +$u 1ant t$ shut the li.hts $&&.

I. D$ *ids su&&er &r$) that a l$t,


A. -es! the+ d$.
I. %la+in. #ide$ .a)es &$r *ids! is that a .$$d thin. &$r the) t$ 0e d$in. at ni.ht,
A. N$4 and it happens a0$ut 9 0illi$n h$urs a 1ee* $lleti#el+ in $ur hildren. 6he industr+ .$al
is t$ .et it up t$ 20 0illi$n h$urs a 1ee* 0+ the end $& this deade! 0ut that3s an$ther st$r+. It an
0e a p$$r sleep en#ir$n)ent! s$ li.hts $n in a 0edr$$). F0 perent $& parents put a 6V. In their
*id3s 0edr$$) t$ tr+ t$ help the) t$ sleep! n$t realizin. that it atuall+ inter&eres 1ith sleep and
the+ 1ill spend three )$re h$urs a da+ $n rereati$nal )edia i& the+ ha#e a 6V. In the 0edr$$).
E'essi#e a&&eine usa.e. Man+ pe$ple d$n3t realize that a&&eine has
A. Si'5 t$ nine5h$ur hal& li&e! and the+3re s1i..in. d$1n these &i#e5h$ur ener.+ drin*s and! +$u
*n$1! an+ a&&eine ta*en a&ter lunhti)e is .$in. t$ a&&et +$ur a0ilit+ t$ sleep at ni.ht. S$ that3s
the sleep h+.iene area. And then there are a $uple $& $thers. One is idi$pathi and $ne related t$
0eha#i$ral ins$)nia $& hildh$$d. 6h$se are the pri)ar+ ins$)nias.
I. N$1! the se$ndar+ ins$)nias! 1hat are the+,
A. 6he+ an 0e se$ndar+ related t$ a )edial $nditi$n! as I )enti$ned. %ain! &$r e'a)ple. Or i&
+$u ha#e it an 0e the treat)ent! als$! $& a )edial $nditi$n! s$ +$u )a+ ha#e asth)a and +$u
ha#e t$ ta*e an inhaler. 6hat inhaler )a+ ha#e )ediati$n in it that )a*es +$ur heart rae and
)a*es it di&&iult &$r +$u t$ &all asleep. S$ it an 0e it is se$ndar+ t$ s$)ethin. else. It an 0e
se$ndar+ t$ su0stane a0use4 s$! +$u *n$1! i& +$u3re ta*in. $aine 0e&$re +$u .$ t$ 0ed! that3s
n$t .$in. t$ help +$u sleep. It3s .$in. t$ inter&ere 1ith +$ur sleep! and +$u )a+ de#el$p an
ins$)nia ass$iated 1ith su0stane a0use. Or e#en a presripti$n dru. that )a+ inter&ere 1ith
+$ur sleep. And then ins$)nia an als$ 0e ass$iated 1ith an'iet+ $r depressi$n. -$u an e#en
ha#e re0$und ins$)nia &r$) ha#in. ta*en sleepin. pills. S$ )an+ sleepin. pills! $ne +$u are
ta*in. the) &$r a series $& ni.hts! then i& +$u st$p ta*in. the)! n$1 +$u an3t sleep and +$ur
sleep is atuall+ 1$rse than 0e&$re +$u start ta*in. the sleepin. pills.
I. S$ th$se are s$)e $& the se$ndar+ auses $&
A. -es.
I. (here ins$)nia is n$t the pri)ar+ thin. +$u3re dealin. 1ith! 0ut
A. 6hat3s $rret.
I. the result $& +$ur pain $r the result $& s$)ethin. else that3s .$in. $n,
A. 6hat3s $rret.

I. O*a+. And in 200G! 1ere there a 1ide ran.e $& 0$th )edial and n$n5)edial 1a+s $& treatin.
ins$)nia,
A. -es. One $& the )$st e&&eti#e 1a+s $& treatin. ins$)nia is $.niti#e 0eha#i$ral therap+
I. (hen +$u sa+ 7$.niti#e 0eha#i$ral therap+!7 1hat is $.niti#e 0eha#i$ral therap+,
A. C$.niti#e 0eha#i$ral therap+ is a therapeuti appr$ah in 1hih t+piall+ a ps+h$l$.ist 1ill
identi&+ the ta*e a #er+ are&ul hist$r+ &r$) the indi#idual! &ind $ut 1hat thin.s in the
indi#idual3s en#ir$n)ent )a+ 0e inter&erin. 1ith sleep! tr+ t$ ad2ust th$se issues! and .$es
thr$u.h atuall+ a s+ste)ati appr$ah! &irst $& all! t$! ir$niall+! restrit sleep and s$ that that3s
all and restrit the 0edr$$) t$ sleep. S$ +$u ta*e $ut all the e'trane$us thin.s! )a*e sure that
it3s dar* and <uiet in the 0edr$$)! restrit the a)$unt $& ti)e &$r sleep at &irst. /eause $ne $&
the 0est 1a+s that +$u an )a*e sure that +$u an sleep s$undl+! i& it3s an issue $& )ultiple
a1a*enin.s! is t$ start $ut 0+ A 0+ restritin. the ti)e a#aila0le &$r sleep! and then pe$ple 1ill
usuall+ 0e a0le t$ $ns$lidate their sleep and then .raduall+ the+ add 0a* in a &e1 )inutes a da+
$r a 1ee* and 0rin. the pers$n up t$ s$ that the+3re .ettin. an ade<uate a)$unt $& sleep! 0ut it is
$ns$lidated. S$ it is a )ulti51ee*! pers$nalized! .uided appr$ah t$ the 0eha#i$ral treat)ent $&
ins$)nia4 and it is at least as e&&eti#e i& n$t )$re e&&eti#e than phar)a$therap+ than dru.s.
I. And has it 0een pr$#en e&&eti#e,
A. -es! it3s 0een pr$#en e&&eti#e.
I. And t$ s$)e e'tent! d$es the treat)ent depend $n the ause,
A. 6hat3s ri.ht.
I. I& it3s a se$ndar+! &$r e'a)ple! a se$ndar+ ins$)nia
A. 6hen +$u )a+ ha#e t$ use a pain )ediati$n t$ treat the ins$)nia. I& it3s i& it is se$ndar+ t$
pr$state pr$0le)s! s$ +$u3re .ettin. up in the ni.ht t$ #$id! t$ urinate! 0eause +$u ha#e an
enlar.ed pr$state there )a+ 0e a di&&erent appr$ah i& it3s se$ndar+ t$ a )edial pr$0le). I& it3s
se$ndar+ t$ ta*in. e'essi#e a)$unts $& a&&eine! then +$u 1$uld e#aluate! $unsel the patient
and ta*e appr$priate ati$n &r$) there.
I. (hat i& it3s se$ndar+ t$ an'iet+,
A. 6hen +$u )i.ht $nsider the d$t$r )i.ht $nsider .i#in. the patient an an'i$l+ti! s$)e
t+pe $& dru. &$r the treat)ent $& an'iet+.
I. (e3#e heard a0$ut s$)e dru.s here! Ati#an! L$razepa)! 0enz$diazepines. Are the+ dru.s
used in that $nte't s$)eti)es,

A. 6here are )ultiple di&&erent dru.s that )a+ 0e used t$ treat an'iet+! inludin. s$)e $& the
/enz$diazepine dru.s that are )$st the dru.s that are appr$#ed t$ treat ins$)nia are
0enz$diazepine reept$r a.$nists appr$#ed 0+ the HDA.
I. And are there als$ appr$#ed dru.s li*e A)0ien and the li*e,
A. -es! A)0ien 1$uld 0e a 0enz$diazepine reept$r a.$nist.
I. O*a+. Lunesta! 1e heard a0$ut! that3s 0een )enti$ned in this ase.
A. -es.
I. And Best$ril! is that an$ther $ne $& the dru.s s$)eti)es used &$r
A. H$r ins$)nia.
I. And are all $& th$se dru.s! 1hether $r n$t the use $& th$se dru.s! is that in a$rd .enerall+
1ith the standard $& are that 1as e'istin.
A. I& the+3re an appr$priate d$se and the+3re .i#en $rall+! then +es.
I. (hat3s the &irst step in tr+in. t$ treat s$)e$ne &$r a sleep dis$rder,
A. 6he &irst $ne is t$ &i.ure $ut 1hat the dis$rder is. 6here are a0$ut D? di&&erent sleep dis$rders
that ha#e 0een ate.$rized! and the+ ha#e spei&i s+)pt$)s! and s$ a d$t$r has t$ ta*e a
$)plete )edial hist$r+! $&ten a ph+sial e'a)! 0eause there are s$ )an+ sleep distur0anes
that are ass$iated 1ith )edial $nditi$ns. S$)eti)es an $#erni.ht sleep re$rdin. in a
la0$rat$r+ li*e the sleep re$rdin. that I sh$1ed 1ith the astr$nauts s$)eti)es that is indiated
&$r ertain sleep dis$rders. And s$ a are&ul hist$r+ has t$ 0e ta*en! a a ph+sial e'a)! $&ten a
sleep l$. is used! s$ a re$rdin. $& 1hen the indi#idual 1as sleepin. and 1a*in..
/eause )an+ ti)es an irre.ular shedule $& 1hen pe$ple are atte)ptin. t$ sleep and 1a*e is
$ne $& the ausal &at$rs &$r ins$)nia! and s$)eti)es a A a little de#ie that3s 1$rn $n the 1rist
that re$rds ati#it+ and an 0e used t$ )$nit$r sleepin. and 1a*in. s$)eti)es that t+pe $&
de#ie is used. And &$r eah $ne $& the dis$rders! there is there3s the A)erian Aade)+ $&
Sleep Mediine has re$))ended .uidelines &$r the dia.n$sis and treat)ent $&
I. And is it .enerall+ re$.nized as a treata0le $nditi$n,
A. -es.
I. N$1! 1e3#e heard a0$ut di&&erent )ediati$ns! and 1e3#e heard )enti$n the ase $& a
)ediati$n alled %r$p$&$l. Is %r$p$&$l a sleep )ediati$n,
A. N$4 it3s an anestheti.

I. And is there a di&&erene 0et1een an anestheti and a sleep )ediati$n,


A. -es.
I. And 1$uld it help &$r +$u t$ sh$1 $n a hart the
A. It 1$uld! atuall+.
I. s$)e $& the di&&erenes 0et1een
A. Ma+ I,
Mr. Kosko: this co#es under the heading, your honor? o ho- #any la-yers does it take
to put up an easel. &o you -ant to just -ait or a second so people can get in position -here
they can see/
Mr. Panish: they -ant to kno- i they can #ove over there.
A. I thin* i& 1e put it here! it 1ill 0e &ine.
Mr. Kosko: this -ould %e 9:@, ) %elieve.
Judge: e(hi%it 9:@, chart. (#arked or identiication, e(hi%it 9:@? chart.)
A. s$ 1hat I3) d$in. here is I3) .$in. t$ )a*e a list $)parin. natural .enuine sleep 1ith 1hat
happens durin. %r$p$&$l anesthesia. O*a+,
Ms. "ahan: your honor, )0ll o%ject to lack o oundation %eing laid as to his e(pertise in
Propool or anesthetic.
Judge: $ustained. ) you have a oundation to lay, you need to do it.
Mr. Kosko: okay.
I. D$t$r! as part $& +$ur trainin. and e'periene! and +$ur researh! ha#e +$u l$$*ed int$ the
1hat happens int$ the e&&ets $& %r$p$&$l $n sleep,
A. -es. It3s atuall+ a a #er+ h$t area $& in#esti.ati$n 0eause the &ield $& anesthesia is 1hih has
0een used &$r $#er 8?0 +ears A and )$st $& the ti)e! pe$ple ha#e the anesthesi$l$.ists ha#e
0een )$nit$rin. heart rate and respirati$n. /ut e#en th$u.h it is the 0rain that the+ are
anesthetizin.! the+ ha#e n$t 0een )$nit$rin. the 0rain t+piall+ in the $peratin. r$$)! and

there3s urrentl+ a sea han.e in in the pratie $& )ediine that is related t$ tr+in. t$ understand
usin. the sa)e *ind $& 0rain 1a#e re$rdin.s that 1e use t$ )easure sleep t$ )easure the e&&et
$& the anestheti. And there ha#e 0een a series $& e'peri)ents d$ne t$ tr+ t$ understand!
espeiall+ sine )an+ anesthesi$l$.ists use the 1$rd 7sleep7 1hen the+3re tal*in. a0$ut
anesthesia! t$ understand the e'tent t$ 1hih it is si)ilar $r di&&erent &r$) sleep. And s$ it is a
)atter that3s presented at $ur sienti&i )eetin.s in the sleep &ield! and it is $ne $& the
p$std$t$ral trainees that 1$r*ed in )+ la0$rat$r+ has .$ne $n t$ ha#e this as a )a2$r area $&
researh interest! and he is n$1 a pr$&ess$r at the "ar#ard )edial sh$$l. S$ there are )an+
pe$ple 1$r*in.
I. I3) as*in. a0$ut +$ur in#$l#e)ent.
Ms. "ahan: %eore ) do that, your honor, #ove to strike as not responsive. He didn0t testiy
to his e(pertise in this area.
Judge: )0ll allo- it. !ut you need #ore.
Mr. Kosko: tell #e a%out your involve#ent in looking into the distinction %et-een sleep
and anesthesia.
A. 1ell! I ha#e re#ie1ed the sienti&i literature and read and listened t$ letures! read papers
letures at sienti&i )eetin.s! read papers in the internati$nal sienti&i literature! and ha#e
studied the di&&erene
/et1een sleep and anesthesia.
I. s$ +$u3#e d$ne th$se studies,
A. -es.
Judge: okay.
Mr. Kosko: okay. $o can you then go ahead, please, and tell us the dierence %et-een
sleep and Propool anesthesia.
Ms. "ahan: )0# sorry, your honor. ) don0t -ant to take up ti#e -ith this, %ut #ay ) voir
dire hi# as to the e(tent o his revie- o the literature and e(perience in this area/
Mr. Kosko: she can cross2e(a#ine hi#. &id she say she -anted to strike the testi#ony/
Ms. "ahan: ) asked to >oir &ire hi# a%out the e(tent o his e(perience %ecause ) don0t
think an adeAuate oundation has %een laid as to his e(pertise.

Judge: go ahead. )0# going to allo- it.


A. )a+ I sit d$1n,
Judge: go ahead.
>oir dire e(a#ination
By ms. Cahan:
Q. Dr. Czeisler, you've been worked in the sleep medicine field for ! years" is that ri#ht$
%. &et's see. 'es, studyin# sleep and circadian rhythms, yes.
Q. %nd about how many hours a year do you devote to your professional endeavors, if you can
estimate$
%. ('ve never done it on a yearly basis, but it is it is ( would say )* hours a week.
Q. +kay. %nd you work year round$
%. ,retty much. ( occasionally take a vacation.
Q. %nd when did you be#in first be#in lookin# into the scientific literature on anesthesia and
what it does with the brain waves and circadian rhythms$
%. &et's see. ( first became interested in that in discussions with -mory Brown, who is the
collea#ue ( mentioned. Do ( remember the year$ &et's see. ( would say he published an article in
the new -n#land .ournal ( think it was in /*0*, or and he's published some articles before that.
( be#an talkin# with him about it because ('m the director of our trainin# pro#ram on sleep
circadian and respiratory neurobiolo#y, which ('ve been directin# since 0!!1, and about ( want
to say about ten years a#o he has to have a trainee supported by our trainin# pro#ram on sleep
who is #oin# to be studyin# anesthesia, and so we be#an havin# discussions about the hemolo#y
between sleep and anesthesia, and why it was important to study to do the same kind of brain
wave recordin#s that are done to study sleep to study anesthesia in order to understand their
similarities and differences.
Q. +kay. 2o you started ('m sorry. ( want to make sure ('m #ettin# this ri#ht. 'ou started lookin#
at the literature on
Brain wave recordin#s and anesthesia around /*0*, you said$
%. ( started talkin# with him about ten years a#o about this, followed some of the research of
some of the students. %nd then he wrote % very pioneerin# article in about or a review article of
the sort that ( was describin# earlier in one of in the most widely circulated medical .ournal in

the world, which is the new -n#land .ournal of medicine. %nd he 3 he published this 3 this paper
( believe it was either in /**! or /*0*, as ( recollect, so about three or four years a#o, and was
invited to be the keynote speaker at the %merican %cademy of sleep medicine meetin#s that 3
that subse4uent year. %nd ( listened to his keynote presentation there, read his article, attended
some of his other lectures and became interested in some of those areas. ( don't remember
e5actly which article ( read in which year.
Q. But fair to say /**!6/*0* is when you started readin# the literature in this area$
%. 'es.
Q. +kay. %nd of your )* hours a week of work in the last four years or so, how much of that have
you devoted toward research or reviewin# the research or listenin# to information about brain
waves and anesthesia$
%. 7ell, it's become it's an important area, and ( actually submitted a #rant proposal to the
#overnment about two years a#o on sleep and anesthesia in the perioperative period because (
was many times the perioperative period is a particularly dan#erous period for people with
sleep disorders because of the combination of anesthetic that they #et and then in the recovery
room, if they have sleep8disordered breathin#, they are at increased risk of sudden death or
havin# a stroke if they are not monitored. %nd so some pro#rams were be#innin# to investi#ate,
and as a (9m currently the chair of the steerin# committee of the of the sleep research network,
and we are we've been tryin# to or#anize a collaboration. %nd, as ( said, ( submitted a #rant
proposal ( think a year or two a#o on screenin# of patients with sleep disorders because of the
increased susceptibility to sudden death or 3 or adverse medical conse4uences in in the
immediate period when they have had the anesthesia and the postoperative period when they're
#ettin# medications for pain. 2o and, in fact, there's .ust been established a sleep and anesthesia
society in the field. But your 4uestion about ( don't keep track of e5actly how many hours (
spend on one 3 for e5ample, writin# that #rant proposal or doin# 3 versus the work that ( do on
sleep and a#in# and the work that ( do on resettin# the circadian system with li#ht. But if ( were
to make a #lobal let me make a #lobal it's somewhere around five.
Q. ( don't know what :#lobal: means, and ( don't want to cut you off. ( .ust want you to answer
my 4uestion as to what percenta#e of how many hours of your )* hours a week that you spend
devoted to your work since /**! or /*0* do you spend reviewin# the scientific literature about
anesthesia and the effect of anesthesia on the brain$ %nd if you don't know, that's okay.
%. ( don't know. ( don't know. ;he literature itself is not that bi#.
Q. +kay. %nd do you hold yourself out as an e5pert in the effect of anesthesia on the brain$
%. ( would say yes.

Q. +kay. %nd what's the basis for that e5pertise, other than the is it is it .ust the review of the
e5istin# scientific literature that you've done since /**! and /*0*, or is there somethin# more$
%. (t would be it would be on understandin# the impact. (n particular, my interest is the
relationship between the hemolo#y or lack of hemolo#y between anesthesia and sleep, and so
('ve read many of the articles that have been written on that topic.
Q. +kay. 2o it's .ust readin# the articles in the field, that's the e5tent of your e5pertise correct$
as a e5pertise in the area of anesthesia and the effect on the brain$
%. (n relationship to its my particular interest is in its relationship to sleep and whether or not it
sub serves the same whether or not it's the same or different than sleep.
Q. 2o yes, it's .ust readin# the literature in the field$
Mr. Kosko: o%ject. He ans-ered the Auestion, ) think.
Judge: overruled. 6o ahead.
Ms. "ahan: ) just -ant to #ake sure )
%. ( don't #ive anesthesia. (f that's the
<s. Cahan: that wasn't the 4uestion. 7e'll #et there.
Q. ;he 4uestion was, in holdin# yourself out as an e5pert on anesthesia and the effect of
anesthesia on the brain, the sole basis for that is your review of the literature since /**!, /*0*$
%. 'es.
Q. 7hat literature there is, and you said there's not much$
%. (t's not a vast literature, no.
Q. 7hich is why it's hard for you to estimate what percenta#e of your professional time you've
spent reviewin# that literature in the past few years$
%. =eviewin# the literature, like ( said, ('ve a#ain to lectures on the topic and other thin#s, yes.
Q. %ppro5imately how many lectures$
%. ( don't know the answer to that 4uestion.
Q. Can you estimate more than >$ <ore than 0*$ <ore than >*$

%. (t would be less than a dozen.


Q. +kay. %nd you #ot a little bit ahead of me. 'ou said you're not an anesthesiolo#ist, ri#ht$
%. Correct.
Q. 'ou don't practice medicine$
%. Correct.
Q. 'ou don't have a D.-.%. &icense, you can't administer or prescribe any medication$
%. ;hat's correct.
Q. %nd you yourself, have you done any 3 we talked earlier about research #rants that you
applied for to do science research$
%. 'es" to do clinical research, yeah. <ost of the research that ( do is clinical.
Q. +kay. %nd have you ever applied for and received any #rants to study anesthesia's effect on
the brain$
%. ?o. ( have applied for a #rant to look at the impact of sleep disorders and their dia#nosis and
treatment on in the perioperative period related to the anesthesia and the pain treatment of
pain
Q. +kay. %nd did you receive that #rant$
%. ?o. (t was a #rant that went in, it was there were about * investi#ators from around the
country. Dr. ,hyllis zee was the principal investi#ator at northwestern university. But we did not
receive that #rant.
Q. +kay. %nd we've been talkin# #enerally about anesthesia and the brain. ?ow, it's my
understandin# that ,ropofol doesn't act the same way as all other anesthetics, correct$ (t's a
little bit different$
%. ;hat's correct.
Q. 2o of everythin# we discussed so far about the time you've spent readin# the literature about
anesthesia and the brain, how much of that is specific to ,ropofol and the brain$
%. 2ome of the work has been on the inhalant anesthetics, but most of the most of the and some
of the literature reflects that. ,ropofol has been an area of particular interest because unlike the

inhalant anesthetic, which don't dissipate the drive for sleep, ,ropofol appears to dissipate the
drive for sleep. %nd because of that distinction, there is a #reat deal of interest in ,ropofol. 2o
whereas the inhalant anesthetics, since they don't e5hibit that cardinal feature, they're
automatically it's clear that they are not they are not dissipatin# the sleep drive" and since they
don't do that, they're sort of off of the list of possible hemolo#ies to sleep. 2o the real interest in
this area, and its connection with sleep, has been focused on ,ropofol
Q. +kay. 2o can you estimate
%. in the field.
Q. =i#ht. 2o can you estimate the percenta#e of the amount of literature that there is that you've
reviewed re#ardin# anesthesia and the brain that relates to ,ropofol specifically$
%. Can you repeat the 4uestion, please.
Q. %re you able to estimate what percenta#e of the literature discussin# anesthesia's effect on the
brain that you've reviewed is specific to ,ropofol as opposed to other anesthetics$
%. ( would say most of the literature that that is kept in the area of the sleep field that ( have
reviewed has been related to ,ropofol.
Q. %nd ('ve had an opportunity to review your curriculum vitae, Dr. Czeisler" and the copy ( #ot
was 1@ pa#es lon#. %nd ( don't know if you know this off the top of your head, but ('ll represent
to you that there's no reference whatsoever to ,ropofol or Diprivan anywhere. %nd Diprivan is
the which one is the brand name and which one is the #eneric name$
%. ,ropofol is the #eneric name and Diprivan is the brand name.
Q. +kay. ( didn't see any reference
%. +ne of the brands names.
Q. ( didn't see any reference in your 1@8pa#e curriculum vitae to ,ropofol or any of the brand
names of ,ropofol in your publications or otherwise. (s that accurate$
%. ;hat's accurate.
Ms. "ahan: okay. 8our honor, ) -ould su%#it that &r. "'eisler doesn0t have the necessary
e(pertise to testiy to this chart that he0s intending to create.
Mr. Kosko: #ay ) ask a Auestion, your honor/

&irect e(a#ination %y Mr. Kosko:


I. Dr. Czeisler! are +$u re$.nized are +$u re$.nized as $ne $& the sleep e'perts in the 1$rld,
A. -es. I 1$uld n$t run ar$und sa+in. that! 0ut +es.
I. And is the <uesti$n that +$u 1ere as*ed 0+ us t$ l$$* at is the <uesti$n 0et1een 1hat is the
di&&erene 0et1een sleep and anesthesia, Is that the <uesti$n 1e as*ed +$u t$ l$$* at,
A. It 1as $ne $& the <uesti$ns! +es.
I. O*a+. N$1! the +$u d$n3t sa+ that +$u3re an anesthesi$l$.ist! ri.ht,
A. C$rret.
I. S$ +$u3re n$t .$in. t$ tal* a0$ut $ther side e&&ets $& anesthesia! $rret,
A. C$rret.
I. /ut ins$&ar as an+0$d+ is a0le t$ tell 1hat happens t$ sleep &r$) anesthesia! is there an+
<uesti$n! at least in +$ur $1n )ind! that +$u3re <uali&ied t$ .i#e that $pini$n,
Ms. "ahan: o%jection? leading.
Judge: overruled.
A. n$.
I. And ha#e +$u l$$*ed at this su02et t$ see 1hat the di&&erene is,
A. -es! I ha#e.
I. And has %r$p$&$l 0een the dru. that is )$st $&ten used in the studies that ha#e l$$*ed at the
#er+ <uesti$n $& 1hat the di&&erene is 0et1een sleep and anesthesia,
A. -es. And that3s )ainl+ 0eause a0$ut nine +ears a.$! there 1as a ritial stud+ d$ne 1hih
indiated in ani)als that %r$p$&$l! uni<ue uni<uel+ %r$p$&$l a)$n. the anesthetis dissipated
the sleep dri#e. N$r)all+ i& +$u *eep an ani)al a1a*e! and then +$u .i#e it a hane t$ sleep! it
sleeps )$re.
I. Is this a part $& +$ur &ield $& interest! sleep )ediine,

A. -es! the h$)e$stati dri#e &$r sleep.


I. H$r e'a)ple! i&
Judge: let #e ask you a Auestion. )s there any%ody -ho is an e(pert in this area/ )n other
-ords, there0s one person -ho has an e(pertise speciically in sleep and Propool/ .r is this
kind o a ne- area/
A. it is a ne1 and e'itin. e)er.in. area in the &ield $& sleep )ediine 0eause A 0eause $& this
stud+ that 1as d$ne sh$1in. that it dissipated the dri#e &$r sleep.
Judge: so there are so#e people -ho have studied ) #ean, you study their literature, then,
right/
A. that3s $rret.
Judge: and ho- ar does that literature go %ack/
A. it .$es 0a* a0$ut nine $r ten +ears. I )ean! it3s n$t a hu.e literature. And there aren3t that
)an+ studies that ha#e 0een d$ne durin. that inter#al.
Judge: so there0s %een nine or ten years o study, %ut there0s %een kind o sporadic studies
over that ti#e/
A. ri.ht.
I. Is the siene s$rt $& prett+ .$$d! th$u.h! $n reahin. a $nlusi$n as t$ the di&&erenes
0et1een %r$p$&$l and sleep,
A. -es. I )ean
Judge: %eore -e go any urther, -hy don0t -e go to side%ar.
(the ollo-ing proceedings -ere held at side%ar:)
Judge: let0s talk a%out it.
Mr. Kosko: he0s the ore#ost e(pert in the -orld on sleep. There is no%ody -ho could %e
%etter Aualiied to talk a%out the eect o anesthesia on sleep. )t0s not that he0s going to talk
as an anesthesiologist a%out ho- #uch anesthesia to use and, you kno-, the any o the
lia%ility aspects o the case. He0s going to %e talking only a%out -hat happens to the hu#an
%rain. His %ackground is in neuro%iology, he0s get a neurology %ackground, an #.d.

!ackground, he0s the -orld0s authority on sleep, he0s got a chair at Harvard to do nothing
%ut study sleep. ) just don0t see the issue. )t is a ne- and e#erging ield, as your honor
%rought out? and there0s not that #uch there? %ut -hen you hear the studies, the studies
say -hat 7 -hat the acts are, and it0s not su%tle.
Ms. "ahan: your honor, you asked right %eore -e ca#e to side%ar i there -as i there
-ere any e(perts in this area o -hat anesthesia does to the %rain. There is, and the
ore#ost e(pert on it is &r. !ro-n. 4nd -e have studies that &r. "'eisler indicated he0s
relying on, and they0re -ritten %y &r. !ro-n. 4nd i they -anted to have &r. !ro-n co#e
testiy
Judge: he cited &r. !ro-n.
Ms. "ahan: yes. He0s the e(pert a%out that. 4nd he just said this is a%out -hat anesthesia
does to the %rain. That0s &r. !ro-n. That0s his e(pertise. ) they -ant to have hi# say that
sleep deprivation causes various eects, -hich they0ve had hi# do, -e think that0s air? %ut
there0s no %asis that he has e(pertise in the ield o the neuroche#ical reactions that
Propool causes on the %rain other than revie- the literature, and any physician could have
done that.
Judge: &r. !ro-n, does he have any opinions a%out its eect on sleep, though/
Mr. Panish: no.
Ms. "ahan: the eect o Propool on sleep/
Judge: that0s -hat -e0re dealing -ith is the sleep and the Propool.
Ms. "ahan: one o the studies that &r. "'eisler indicated he0s relying on and produced to us
in response to our docu#ent reAuest is called Bgeneral anesthesia sleep and co#a.B it0s a
study %y &r. !ro-n, it0s *e- 5ngland journal o #edicine. ) think that #ay %e the study
he0s reerring to. )t has a CD<D pu%lication date as the sort o irst leading article in this
ield, Bgeneral anesthesia sleep and co#a.B he0s the guy -ho does this, and -hat they0re
doing is trying to %ack door in things Mr. !ro-n said at his deposition through Mr.
"'eisler.
Ms. $te%%ins: your honor, this e(pert the chart he -as just a%out to -rite -as a chart
co#paring the eect o sleep to the eect o Propool. That0s not -hat they0ve just no-
represented, -hich is anesthesia0s eect on sleep deprivation, or sleep deprivation0s eect
on anesthesia. )nstead it0s here0s -hat anesthesia does to your %rain, here0s -hat Propool
does to your %rain, here0s -hat sleep does to your %rain. He has not supervised any studies,
not %een in charge o any research as to -hat anesthesia does to your %rain. They have an
e(pert on that, they chose not to call hi# so he can0t %e cross2e(a#ined, and that0s the
issue.

Ms. "ahan: -e don0t have an issue -ith hi# doing the let2hand side o the chart, %ut the
right2hand side he didn0t even get the grant that he applied or in this area.
Mr. Panish: -hat does that #ean/ 8our honor, -e don0t need the -orld0s reno-ned e(pert
Judge: no, %ut you need an e(pert.
Mr. Panish: right. 4nd they can0t sho- 7 this guy is clearly Aualiied. 4. +ot o e(perts in
their ield revie- scientiic literature and rely on it. That0s allo-ed %y the evidence code
@D<.<<ED, ) %elieve it is, to do that. He doesn0t have to %e the -orld reno-ned e(pert that
they no- say &r. !ro-n is. He doesn0t have to %e. 4ll he has to %e is Aualiied, and -hat
he0s talking a%out is sleep. He is Aualiied in sleep. He can revie- #edical literature that0s
authoritative and relia%le and rely on that to or#ulate his opinions. 3hether he got a
grant or not should have no %earing -hatsoever. There are :D people applying or a grant,
-e have no idea -hat the reason -hy the grant -as rejected or given to so#e%ody else.
Judge: %ut that0s the single thing that he applied or that connected the sleep and the
Propool.
Mr. Panish: no, it0s not. That0s not his testi#ony. 4nd i -e need to take it outside the
presence o the jury in a =DC hearing, -e should %e allo-ed to lay the urther oundation,
%ecause it0s not just that that Aualiies hi# to do it. 3rite a grant -e haven0t even gone
into -hat0s involved in -riting a grant, revie- o scientiic literature and all the other
actors. That hasn0t co#e in. The act -hether or not a grant -as granted has no %earing
on -hether he0s Aualiied or not. $o no- are -e going to call in -hoever is in the ederal
govern#ent and get into -hy they gave it to this person and that person/ )t has nothing to
do as to -hether he0s Aualiied as an e(pert. That0s totally i##aterial, unless they can
%ring the surgeon general to say -e didn0t give it to hi# %ecause -e didn0t kno- i he -as
Aualiied.
Ms. "ahan: the surgeon general has nothing to do -ith it.
Mr. Panish: a lot o your Auestions don0t have anything to do -ith a proper >oir &ire.
Those -eren0t appropriate Auestions as to his Aualiications. Those -eren0t appropriate
>oir &ire Auestions, -hich he didn0t o%ject to, -hich ) -ould have.
Mr. Kosko: %y the -ay, your honor, he doesn0t have to %e an e(pert in anesthesia to talk
a%out the eect o anesthesia on sleep any #ore than he0d have to %e an orthopedist to say
-hat pain caused, or a psychiatrist to say ho- that intereres -ith sleep. He kno-s ho-
anesthesia intereres -ith sleep. That0s -hat he0s %eing called to talk a%out, and there0s no
one %etter Aualiied in the -orld. 5#ory !ro-n, -ho ) do kno-, and -ho ) have enor#ous

respect or, is an anesthesiologist, not a sleep e(pert. $o -hat they0re sort o they0re sort o
saying is -e %ring in 5#ory !ro-n to do the anesthesia side o the chart and this person to
do the other side o the chart/ They -ould have the sa#e argu#ents a%out 5#ory !ro-n
and sleep.
Ms. "ahan: t-o issues, your honor. &r. !ro-n is a retained e(pert or the#. He -as -ithin
hours o testiying -hen they pulled hi#. They can %ring hi# %ack, -e -ouldn0t o%ject to
that. They0re still in their case. ) they -ant to have the right e(pert testiy to this issue,
-e0re not o%jecting to the testi#ony co#ing in.
Judge: did !ro-n conduct any tests -ith sleep/
Mr. Panish: no.
Ms. "ahan: -hat !ro-n has pioneered doing is he does he
Mr. Kosko: no, he didn0t.
Ms. "ahan: he studies 5.5.6.0s. .ne o the things that he0s doing is -orking on getting
so#ething patented to look at the 5.5.6.0s during anesthesia, look at the %rain activity
during anesthesia %ecause he thinks that that is a %etter #easure o ho- so#eone is
reacting to anesthesia, ho- deep they are.
Ms. $te%%ins: not to do -ith sleep.
Judge: she0s not inished.
Ms. "ahan: he is so#e%ody -ho studies the eect o anesthesia on the %rain -aves, -hich
is e(actly -hat that right2hand side o the chart has %een pitched as doing. 4nd, your
honor, -hat0s also i#portant here
Judge: -ho is going to testiy a%out the relationship %et-een anesthesia and sleep/ )t
doesn0t sound like !ro-n necessarily has it. )0# not sure this -itness has it.
Mr. Kosko: he has it. He kno-s -hat sleep -aves look like. He has the literature -hich
sho-s -hat anesthesia -aves look like. He0s going to sho- that they are entirely dierent,
and that0s -hat and he0s a neurologist, he has a %ackground in neurology, in #edicine. He
is this -orld sleep e(pert. ) don0t get it. $uppose he -as just Joe $ch#oe neurologist o the
street, and -e say, Bhave you researched this topic/B Byes.B Band could you sho- #e -hat
this 7 -hat this %rain -ave says/B -e could do that.
Mr. Panish: right.

Judge: not in #y court.


Mr. Kosko: -e have the -orldFs chie 7 the %iggest sleep e(pert in the -orld, and their
sole criticis# is he0s not the top Propool anesthesia e(pert in the -orld.
Judge: is there so#e%ody -ho is an e(pert in %oth areas/ ) there0s not, then
Ms. "ahan: your honor, this is &r. !ro-n0s study that says Bgeneral anesthesia, sleep and
co#a.B and the irst i#age sho-s all the phases o sleep and -hat anesthesia does to the
%rain -aves versus -hat sleep does to the %rain -aves. 4nd he0s the guy on this. 4nd )
don0t -ant to lose the act here that -e also have an o%jection to the act that none o this
-as testiied to at his deposition, it -as not an opinion at his deposition, it -as not %rought
out, every single slide -as ne-, al#ost all o your %ackground -as ne-, and ) allo-ed it
consistent -ith
8our honor0s rulings this #orning.
Judge: so i !ro-n co#es in to testiy
Ms. "ahan: he0s the guy.
Mr. Kosko: he can0t talk a%out the sleep.
Judge: they0re saying they have no
Mr. Kosko: that0s not his e(pertise.
Mr. Panish: he doesn0t kno- that.
Judge: sounds like he does.
Mr. Panish: that doesn0t sho- that.
Mr. Kosko: he can co#e in and say the %rain -aves sho- that it0s dierent, %ut this
e(pert can say -hat that dierence #eans ro# the point o vie- o sleep, and so he can
depend on the #edical literature. This e(pert can depend on the #edical literature, -hich
is -ell esta%lished, -hich they concede is authoritative, it sounds like, to say this is -hat the
%rain -ave looks like in Propool. 4nd then -e can ask hi#, Bno-, -hat does that #ean as
a sleep scientist in ter#s o -hether or not the person is getting sleep/B and -e did say it
-as one o our opinions that -e -ere going to talk a%out Propool.
Judge: -here is that opinion/

Mr. Kosko: nu#%er @ E, ) think it is. 3hy did they say -e didn0t say it -hen -e said it/
Mr. Panish: ) can rely on #edical literature. There0s nothing -rong -ith that. The *e-
5ngland journal and all these are recogni'ed authoritative treatises.
Judge: )0# not saying he can0t.
Mr. Panish: -hy do -e have to %ring the nu#%er <, according to the#, person in the
-orld/ 3hat is the standard, that no- you need the nu#%er < person in the -orld/ The
standard is is he Aualiied in his %ackground %ased on his training and e(perience, things
he0s revie-ed, to give those opinions/ That0s the only issue that should %e assessed. 4nd he
doesn0t need to %e the -orld reno-ned e(pert on the su%ject.
Mr. Kosko: in his report, he talks a%out the Propool in his report.
Ms. "ahan: he0s pu%lished <ED or -hatever studies, he does a ton o research, he runs a %ig
la%, he0s the head o the sleep study center, and he just readily ad#itted that there0s nothing
in Propool in his @@2page resu#e, he0s never done a study on Propool or any other
anesthesia, the one grant he applied or -as rejected. ) don0t de%ate that he can read a
paper,
!ut that doesn0t #ake hi# an e(pert on the su%ject.
Judge: okay. 3hat is this this -as this this e(pert -as deposed right/ 3hat -ere his
opinions/
Ms. "ahan: as ) re#e#%er it, he said, a#ong other things, that sleep is not the sa#e thing
as anesthesia? that the eect o anesthesia on the %rain is not to create the sa#e kind o
restul sleep, the restorative unction o sleep that e(ists -ith real sleep. 4. +ot o people get
conused %y that. )nduction o Propool and #aintenance o Propool #ight leave one
eeling rereshed, %ut it0s not a co#para%le su%stitute or sleep. That0s the right2hand side
o the chart.
Judge: that0s -hat you0re trying to elicit out o the sa#e -itness.
Mr. Panish: it0s not the sa#e -itness.
Judge: -hat )0# saying is the opinions that this person rendered are the sa#e ones you0re
trying to elicit ro# this -itness.
Mr. Panish: no.
Judge: okay. 3hat is it that he0s going to say/ )0# asking Mr. Kosko.

Mr. Kosko: -e0re trying to elicit ro# this -itness that %ased on the literature, the %rain
-aves that are elicited in a Propool2induced co#a -ill have a, not the sa#e as sleep? and
%, are going to have an eect on %ehavior, and the %ehavior is going to %e the sa#e as a
sleep2deprived person. That0s -hat so his his opinion is that it0s the that 7 the %rain -ave
is easy %ecause that, he could get ro# any-here. He could get it ro# the internet.
Mr. !oyle: your honor, this is ro# &r. !ro-n0s opinions? and i you look, these are the
su##ary that he -rote o his opinions. .kay/ *ot one o these is sleep. 4nd )0ll read the#
into the record. &r. !ro-n0s su##ary o opinions. )t -as e(hi%it : to !ro-n0s deposition
on =GEG<:. .ne, Propool -e got this ro# other people, so that0s -hy -e haven0t called
!ro-n yet. !ut one, Propool and its uses and standard #edical practice. T-o, training
reAuired to saely ad#inister Propool and sedation. Three, use o Propool to treat sleep
pro%le#s. Hour, &r. Murray0s training to ad#inister Propool. Hive, &r. Murray0s
#anage#ent o Mr. Jackson during ad#inistration o Propool and other sedation? and ;,
&r. Murray0s #anage#ent o Mr. Jackson during the e#ergency situation. 3hat -e0re
asking or here is sleep it0s the eect on sleep.
Mr. Panish: -hich is not one o his areas.
Ms. "ahan: your honor, his opinion a%out the use o Propool to treat sleep pro%le#s that
they just read, that enco#passed the testi#ony that ) just reerenced a%out -hat sleep does
or the %rain versus -hat Propool does or the %rain, and the lack o co#para%le eect on
the %rain in ter#s o restoring so#eone and actually giving the# the %eneits that real sleep
gives. 4nd contrary to -hat they0re saying no-, this is the chart that they0re going to have
hi# -rite up ver%ati#. That0s not
Mr. Kosko: no. That0s oundational.
Ms. "ahan: it0s testiying to -hat anesthesia is and ho- it -orks.
The clerk: your honor, can they go on a %reak/
Judge: ) can0t talk a%out that right no-. )0# reading this. .kay. This side is not talking
a%out ho- Propool and sleep deprivation ho- Propool aects the %ehavior.
Mr. Kosko: that0s right. That0s preparatory to that discussion. This is the oundation.
Mr. !oyle: no 15M sleep. That0s -hat he0s an e(pert on. That0s the -hole point.
Mr. Kosko: he0s an e(pert on 15M sleep, and this is non215M sleep is a%nor#al. $o he0s
going to take these, and then he is going to talk a%out ho- that aects %ehavior, ho- the
lack o 15M sleep and non215M sleep and sleep in general aects %ehavior. He0s %een
talking a%out that all along. He0s %een talking a%out ho- it happens in ani#als, and he0s

going to talk a%out ho- it happens in people, and ho- it happened to Michael Jackson.
Mr. !oyle: as a sleep e(pert, he says ho- do things aect sleep/ Pain, -hatever. .ne,
Propool doesn0t allo- 15M sleep, and that0s he0s the sleep guy, and so he can say
Propool doesn0t allo- 15M sleep, and then he can talk a%out -hat that #eans -ithout
15M sleep, -hich is -hat he0s %een saying all day.
Mr. Kosko: it0s not an anesthesia Auestion. )t0s a sleep Auestion.
Judge: ho- does it aect the %ehavior/ The disheveled and all that stu like
Mr. Kosko: everything that -e see happening to Michael Jackson is consistent -ith %eing
caused %y sleep deprivation ro# the Propool, assu#ing that he had %een given it every
night. 3hat he0s going to say is that there is nothing that anesthesia is nothing %ecause o
that loss o 15M sleep, and non215M sleep, he -as not getting he -as like the rats -ho
took a long ti#e to die. 4nd here is and there0s proo. There0s a lot o proo all through this
record o -hat his %ehavior -as, ho- he ho- he 7 he -as late, ho- he had the ther#al loss
o ther#al regulation.
Judge: -earing the heavy %lankets.
Mr. Kosko: -earing the heavy %lankets, his conusion, his ina%ility to re#e#%er steps.
1e#e#%er ho- he testiied that the 15M sleep is -hat allo-s one to re#e#%er to
consolidate and re#e#%er, and it0s just it0s perect. )t0s an e(Auisite
Ms. $te%%ins: not e(actly
Judge: and &r. !ro-n, is he going to %e a%le to say that, though.
Mr. !oyle: ) have his deposition right here. Bdo you hold yoursel out as an e(pert in
sleep/B Bno.B that0s
Ms. "ahan: your honor, can ) just look at the chart part. $o the drug2induced co#a part, )
don0t think that0s a%out ho- Propool -orks on the %rain, ) don0t think he has oundation
or that. &oesn0t ulill needs, ) don0t kno- -hat that #eans. Proound unresponsiveness is
a%out ho- the anesthetic eect o Propool? again, inappropriate. *o consciousness at all,
inappropriate. &e%ata%le -hether he can say
Judge: let #e say this. 8ou0ll %e a%le to elicit those opinions on the condition that you %ring
!ro-n in. 8ou have to %ring !ro-n in to testiy to that. 8ou can ask hi#, B4ssu#e that
there is this literature that says this. 4re you a-are o this literature/B assu#e that0s the
acts, and then opinions a%out the %ehavior.

Mr. Panish: -hich issues are -e talking a%out no-/


Mr. Kosko: in other -ords, let #e just say this drug2induced co#a, this stu is any
te(t%ook o #edicine has this. This is not cutting edge. *one o this is cutting edge. The only
thing that -e0re depending on the studies or is the 15M sleep.
Judge: the literature that says that Propool does not give the sleep, that nor#al sleep.
Mr. Kosko: -hy can0t he depend on an authoritative article or that/ )t0s an article that
relates to his opinion. )sn0t that standard ) kno- in "onnecticut
Mr. !oyle: -ait a #inute. There is no article he0s the sleep e(pert. He says, okay, here0s
-hat %rain -aves look like on Propool? and he says, okay, )0# the sleep e(pert, that is not
15M sleep %rain -aves. He0s the one guy in the -orld, the %est guy in the -orld to do that.
Ms. "ahan: your honor, ) don0t kno- -hy they0re avoiding calling &r. !ro-n. )t see#s like
this -ould %e very easy to deal -ith i they -ere to call hi#. !ut to the e(tent that that
counsel is going to try to have hi# #ake the inerential leap %et-een Propool and all the
things that -ere seen in Mr. Jackson, they0re going to run into another huge pro%le# there.
4nd ) don0t kno- i this is the ti#e to discuss it, %ut the only evidence in the record and the
only evidence he0s relying on or that is &r. Murray0s police state#ent, -hich is not in
evidence and is hearsay as o no-. 1ight no-, the only thing that sho-s that Michael
Jackson had Propool in his syste# in 4pril, #ay, June CDD9 is the coroner0s reports that
sho-s he had it in his syste# the day he died. *o-, he0s talking a%out long2ter# eects o
#ultiple nights o Propool ad#inistration. The only person -ho says that is -hat &r.
Murray tells the police -here he says, B)0ve %een giving it to hi# nightly or t-o #onths.B
so i this is supposed to lay a oundation or no- inally late in the day applying this to
Michael Jackson, -ho hasn0t %een #entioned yet today, ) think they0re going to have a %ig
hearsay pro%le# there, as -ell.
Mr. Panish: -hy can0t he rely on hearsay. "an ) #ake a suggestion -e let the jury go or
no-/ 3e0re going to -ant to #ake an e(tensive oer o proo i -e have an issue on this,
and #ay%e a urther =DC to lay the oundation.
Judge: sure. 3hy don0t -e go out there.
(<@2#inute recess taken.)
(the ollo-ing proceedings -ere heard in open court, outside the presence o the jury:)

Judge: let0s talk a%out this.


Mr. Panish: -ell, your honor, -hat ) -ould like to do is Auestion hi# and lay a =DC
oundation right no- under @D<(a) or these opinions that he0s going to give. ) can do it
very Auickly.
Judge: one o the issues -as -hether he0s giving a ne- opinion no-.
Mr. Panish: -ell, that0s dierent than the o%jection right no-.
Judge: true.
Mr. Panish: okay. $o -hich one do -e -ant to address irst/
Judge: the one -e originally
Mr. Panish: okay. &octor, -e0ve heard a%out your Aualiications, your e(pertise. )n your
ield, do you regularly rely on #edical literature/
A. +es! a0s$lutel+.
Mr. Panish: -hy do you do that/
A. as I said this )$rnin.! that3s the 1a+ 1e $n#e+ the results $& $ur )edial researh t$ all $&
the $ther 0$th sientists and liniians in the area. N$ $ne pers$n an d$ all $& the di&&erent
Mr. Panish: in this case, do you have e(pertise in the area o sleep/
A. +es.
Mr. Panish: have you revie-ed literature, scientiic, relia%le, #edical literature in the area
o Propool/
A. +es! I ha#e.
Mr. Panish: have you are you a#iliar -ith the eects o Propool on sleep/
A. +es! I a).
Mr. Panish: the literature that you have revie-ed, is that is that #edically recogni'ed as
authoritative/

A. +es! it is.
Mr. Panish: can you give us a list o the journals in -hich these articles that you0ve relied
on are pu%lished/
A. +es! I an.
Mr. Panish: go ahead, please.
A. 1ell! I 1$uld need t$ l$$* at )+ $)puter.
Mr. Panish: you need your %ag/
A. )+ $)puter.
Mr. Panish: okay.
A. )a+ I,
Judge: yes, you #ay step do-n.
A. d$ +$u 1ant )e t$ start ans1erin. the <uesti$n,
Mr. Panish: yes, please. 8ou -ere telling us the na#e o the journals in -hich these articles
have %een pu%lished.
A. s$ $ne $& the 2$urnals is alled 7anesthesi$l$.+.7 there are se#eral artiles in that 2$urnal.
An$ther artile $n in the $n this t$pi als$ in 7anesthesi$l$.+.7 there ha#e 0een a nu)0er $&
the) pu0lished in 7anesthesi$l$.+!7 the ne1 En.land 2$urnal $& )ediine! in the 2$urnal sleep! in
the annual re#ie1 $& neur$siene.
Mr. Panish: okay. 4nd the journal o sleep, did you #ention that earlier today/
A. +es.
Mr. Panish: are all those journals so ar recogni'ed as authoritative in the #edical
A. +es.
Mr. Panish: you0ve got to let #e inish. in the #edical co##unity/
A. +es.
Mr. Panish: are those the type o journals and pu%lications that are co##only relied upon

%y #edical physicians and PH&.0s that do research/


A. +es.
Mr. Panish: -hy do you rely on literature to do research in your part o your research/
A. 0eause I rel+ $n peer5re#ie1ed literature 1here $ther sientists ha#e are&ull+ re#ie1ed the
)eth$ds 0+ 1hih th$se that researh has 0een $nduted! and it has passed the peer5re#ie1
pr$ess and 0een seleted &$r pu0liati$n in a reputa0le sienti&i 2$urnal. And then $ne re#ie1s
the )eth$ds that 1ere used 0eause the )eth$ds are artiulated in the artile suh that the reader
a reader #ersed in the art an )a*e an $pini$n as t$ 1hether $r n$t the+ h$ld redene in the
partiular ite) 0ein. rep$rted.
Mr. Panish: have you revie-ed all o the literature that you0re a-are o on this su%ject that
e(ists in the #edical ield/
A. I ha#e d$ne )+ 0est! +es.
Mr. Panish: are there articles and pu%lications that are peer2revie-ed, #any that are not
pu%lished %y &r. !ro-n/
A. +es! there are a nu)0er $& artiles that are n$t pu0lished 0+ Dr. /r$1n in this area.
Mr. Panish: no-, sir
Judge: did -e talk a%out &r. !ro-n earlier/ ) #ean in our cha#%ers, -e did, %ut
Mr. Panish: -hat, in ront o the jury, you0re talking a%out/
Judge: yes. Have -e done that yet/
Mr. Panish: ) think he did #ention it %riely.
A. I t$ld he 1as $ne $& )+ p$std$t$ral &ell$1s.
Mr. Panish: yeah, he did say that. !ecause he -as asking hi# like ) got t-o o the#
co#ing, one ro# #y side, one ro# their side co#ing on #e. +et #e inish up #y
e(a#ination. *o-, sir, the opinions, irst o all.
A. )a+ I sa+ $ne thin., An$ther $ne is the 2$urnal the pr$eedin.s $& the nati$nal aade)+ $&
sienes.
Mr. Panish: is that recogni'ed as authoritative/

A. +es.
Mr. Panish: is it co##on or physicians, PH&.Fs, that are -orking as e(pert -itnesses to
rely on pu%lications o others in giving their opinions/
A. +es.
Mr. Panish: the area -hich you have %een Auestioned a%out, and there0s an o%jection on
the eects o Propool and sleep, is that an area in -hich you are an e(pert in the sleep
area/
A. +es.
Mr. Panish: is that -hat you0ve done :9 plus years o -ork in/
A. in the &ield $& sleep )ediine in .eneral! +es.
Mr. Panish: and are you Aualiied to revie- #edical journal articles and interpret the# as
it relates to your ield in sleep/
A. +es. 6hese auth$rs 1ritin. these artiles ha#e used the sa)e tehni<ues that 1e ha#e 0een
usin. &$r deades in tr+in. t$ understand the i)pat $& anesthetis $n sleep.
Mr. Panish: okay. Tell us a%out that #ethodology that you0ve used or decades that these
authors have also used.
A. it3s the sa)e t+pe $& )eth$d$l$.+ that I sh$1ed +$u 1ith the astr$nauts. S$ it in#$l#es d$in.
the E.E.G. Be$rdin.s and the re$rdin.s $& the di&&erent sta.es $& sleep t$ &ind $ut 1hat
happens 1hen +$u are 0ein. anesthetized! and then there ha#e 0een studies in ani)als l$$*in. at
re0$und ins$)nia e'use )e re0$und sleep a&ter %r$p$&$l ad)inistrati$n! &$r e'a)ple.
Mr. Panish: and have you used the sa#e #ethodology in co#ing to your opinions in this
case/
A. +es.
Mr. Panish: 15M sleep. 4re you Aualiied to testiy -hat is 15M sleep/
A. +es.
Mr. Panish: and -hat is non215M sleep/
A. +es.

Mr. Panish: and the conseAuences o having 15M sleep or not having 15M sleep/
A. +es! I a).
Mr. Panish: and have you %een studying that or #any, #any years/
Judge: since #y doctor e(a#s, yes.
Mr. Panish: that0s all ) have or the oundation on the 15M and non215M.
Judge: let0s take one thing at a ti#e. &id you -ant to Auestion hi# on anything/ ) have a
co##ent, %ut ) -as thinking that ) suppose he could testiy to the opinions that he -as
going to give a%out the eect o Propool on sleep %ased on the research that he0s done in
that particular research piece on %y !ro-n, %ut it0s really up to the jury to deter#ine
-hether or not that thing that he0s relied on is relia%le, correct/ 4nd -hether it truly
supports his opinion. )t pro%a%ly -ould %e %etter i they %rought in !ro-n to prove that
act? %ut i they don0t, then the jury #ay say, -ell, that0s a act that hasn0t %een adeAuately
proved, or isn0t relia%le, or and then disregard it, and as a result, disregard his opinion. )
#ean
Mr. Panish: %eore she #akes her argu#ent can ) say one thing so she can address it/
Ms. "ahan: sure.
Mr. Panish: that0s -hat evidence code II< is or? that they are entitled to cross2e(a#ine
hi# on the contents o the periodic journal or the literature that he has revie-ed to try to
esta%lish that it0s not relia%le or not so#ething that0s co##only relied upon. )t doesn0t go
to the oundational %asis o the opinion, it goes to the -eight on -hich it should %e given %y
the trier o act. $orry. ) didn0t #ean to cut
Judge: ) guess -hat )0# saying is i the jury inds that that research is unrelia%le or
shouldn0t have %een relied on, they #ay disregard his entire opinion.
Mr. Panish: that0s -hat you0re going to instruct hi#, that the e(perts0 opinion is only as
good as the acts upon -hich it0s %ased, and you decide that yoursel %ased upon the
evidence, acts, testi#ony, e(pertise, et cetera.
Ms. "ahan: your honor, #ay%e it -ould %e %est to e(cuse the -itness at this point. ) have
an argu#ent %ased on the case la- to #ake a%out this.
Mr. Panish: all right. 3ell, do you -ant to Auestion hi# irst/

Ms. "ahan: not at this ti#e.


Judge: okay. 3ould you step do-n, please, leave the courtroo#/ $orry to distur% you.
A. I3) s$rr+.
(the -itness let the courtroo#.)
Ms. "ahan: ) don0t kno- -hat Mr. Panish -as reerring to -ith respect to II< %ecause
that0s a%out rereshing #e#ory. ) don0t think that0s applica%le here. !ut the ) actually
think your honor0s solution -hich you proposed in cha#%ers o having &r. !ro-n actually
co#e in and support this testi#ony is the right solution, and that0s %ecause the case la- is
clear that e(perts can0t rely on non2testiying e(perts0 opinions or talk a%out the data in
inad#issi%le reports. Just %ecause it0s pu%lished in the *e- 5ngland journal o #edicine
doesn0t #ean he gets to talk a%out it. ) have a couple o cases on that, 3hitield v. 1oth, <D
cal.:d @I=, a <9I= case. 4nd that case stands or the proposition that e(perts #ay testiy
that they0ve consulted other e(perts? and ) think here he said he0s talked -ith &r. !ro-n
a%out his -ork in the ield so that he can testiy that he consulted &r. !ro-n in co#ing to
his conclusions, %ut he #ay not reveal the contents o those other e(perts0 opinions. 4nd in
that case, the there0s so#e language that says -hile it is clear it is clear that doctors can
testiy as to the %asis o their opinion, this is not intended to %e a channel %y -hich
testiying doctors can place the opinion o innu#era%le out2o2court doctors %eore the
jury.
Judge: that0s -hat ) -as suggesting, -hy you can ask an e(pert, Bassu#e so and so, &r.
!ro-n co#es in and testiies that.B no- you have opinions and you can render those
opinions. ) looked that up, too. ) did so#e research on #y o-n, and that0s another -ay that
an e(pert can testiy, is they can either listen to another e(pert testiy in the courtroo# or
the Auestioner can ask a hypothetical?B assu#ing this other person co#es in and testiies to
this opinion or this act, -hat are your opinions %ased on that/B no-, that -ould #ean that
his opinions -ould %e conditionally ad#itted today.
Ms. "ahan: right. 3e0d %e ine -ith that.
Judge: on the assu#ption that !ro-n is going to co#e in and give his opinion.
Ms. "ahan: your honor, just to inish the point, to the e(tent that they are going to -ant to
say, -ell, he0s not really relying on !ro-n, he0s relying on the underlying studies that
pri#arily !ro-n and so#e other people -orked on, that0s not okay either under 6ri#sha-
v. Hord #otor co. 4nd that0s <<9 cal.app.:d IEI, it0s a <9@< case. 4nd that stands or the
principal that an e(pert #ay state that he or she relied on inor#ation contained in certain
reports, %ut #ay not testiy to the contents o the reports. 4nd another case to the sa#e

eect is "ontinental 4ir +ines, )nc., v. Mc&onnell &ouglas, C<; "al.app.:d :@@. That0s a
<99D case -here an e(pert -as per#itted to testiy that he relied on certainly cost and price
igures su%#itted to hi# %y his su%ordinates, %ut not per#itted to testiy a%out the
contents o the report. That0s the sa#e situation here.
Mr. Panish: that0s not -hat -e0re doing. )0# very a#iliar -ith 6ri#sha- versus Hord
Motor co#pany. )n 6ri#sha-, just like here, just like in every trial )0ve %een in, an e(pert
can state the %ases or his opinion including scientiic or #edical literature. Then that is not
hearsay. He0s not saying -hat the article he0s relying on those articles to give his opinion.
That0s allo-ed. That has nothing to do -ith i he0s trying to %ack door in another e(pert0s
opinion. 4ll e(perts, i they0re Aualiied, rely on relia%le, 4uthoritati v 5treatises? and the
code allo-s that.
Judge: true, %ut ) think her point is they can0t sit up there and regurgitate those things.
Mr. Panish: he0s not going to. He doesn0t have to. He can say, B#y opinion is, %ased on #y
training, e(perience, %ackground and revie- o #edical literature.B then they have a right
to cross2e(a#ine hi# on the literature. 3e can0t air#atively put it in, %ut
Judge: so you0re not going to put in.
Mr. Panish: -e0re not going to put the literature, %ut it0s not su%ject to so#e e(pert0s
opinion. He0s not trying to regurgitate -hat so#eone else is saying. He0s giving his o-n
opinion %ased on his training, e(perience and revie- o the literature? and he0s co#petent
and Aualiied to do that. )t0s a co#pletely dierent situation than 6ri#sha- -here the
plaintis0 e(pert regurgitated -hat -as in scientiic auto#otive engineering society,
Michigan, -here he and other e(perts -ere regurgitating -hat -as in the reports. He0s not
doing that. ) they -ant to get into it into cross2e(a#ination, they can say, Byou0re relying
on this report. 3ell, that doesn0t say this and that doesn0t say that.B then they have the
right to do that. !ut -e0re not trying to air#atively get in ront o the jury these reports?
and -e don0t have to do that, and it had doesn0t have to %e conditionally ad#itted on so#e
other guy testiying it %ecause he0s not relying on his opinions. He0s relying on relia%le,
authoritative #edical treatises, -hich is allo-ed under @D< o the evidence code.
Judge: okay. $o -hat is the opinion that he0s going to %e giving/ 3hat0s
Mr. Panish: okay. 3ell, he0s going to talk a%out, nu#%er <, there0s the 15M and non215M
sleep and eects o the Propool anesthetic versus regular sleep, -hich is an area in -hich
he0s an e(pert in, and -hich he0s read articles a%out and he can testiy on.
Ms. "ahan: and, your honor, the situation here is he doesn0t have an independent opinion.

4ll he his only opinion, and he said this, is he just kno-s -hat he read in the literature or
-hat he discussed -ith &r. !ro-n. ) don0t kno- -hy they0re resisting calling hi#. That
see#s like the easiest, astest solution here. !ut he doesn0t have an independent opinion, it0s
not like say he0s a cardiologist, and he0s a#iliar -ith the literature ro# authoritative
treatises, and he0s rendering a diagnosis, and part o the %asis or that is -hat he0s read in
his #edical te(t%ooks, right/ That0s not the situation. His only %asis, he hasn0t done any
independent research, he hasn0t pu%lished in the ield, he doesn0t have e(pertise in the ield,
so all he can do is regurgitate -hat he0s read and discussed -ith &r. !ro-n? and that0s
e(actly -hat these case say is not appropriate. $o ) think the solution o having &r. !ro-n
co#e testiy to support this and conditionally letting it in no- is the right one
Mr. Panish: he0s
Judge: that0s -hat )0# going to do.
Mr. Panish: your honor, he0s not
Judge: )0# conditionally ad#itting it. He can testiy to it, %ut you0re going to have to %ring
in so#e%ody else.
Mr. !oyle: just to %e clear, so#eone else to say that there0s no 15M and non215M sleep
-ith Propool/ !ecause that0s really the only
Judge: yeah. That0s -hat &r. !ro-n said.
Mr. Panish: so irst o all
Judge: -ell, he testiied to a lot o other things. ) don0t think you0re going to need all those
other things, ro# -hat -e read in cha#%ers. )t sounds like the only thing that -ould %e
necessary is that one opinion.
Mr. Panish: irst o all, ) -ant to #ake clear or the record that this -itness has testiied
that he has independent opinions %ased on his e(perience and revie- o the #edical
literature. The court is no- ruling that his opinions can %e conditionally ad#itted i -e call
&r. !ro-n to give the sa#e opinion on -hich he0s relying on. 4# ) understanding you/
Judge: you can ask hi# a hypothetical, that portion.
Mr. Panish: -hy can0t -e ask hi# directly his opinion %ased on his revie- o literature that
he did/ That0s not -hat )0# not understanding.
Mr. !oyle: your honor, to %e clear, he has a stack o articles that are not -ritten %y &r.

!ro-n that say there0s no 15M or non215M sleep on Propool. $o it0s kind o -ired that
they0re trying to -edge everything on &r. !ro-n. *u#erous people say that little link? then
he0s the sleep guy -ho says, Band -hat does that #ean in ter#s o sleep/B right/
Mr. Kosko: can ) say one other thing a%out it/ That is that -hat he0s relying on is the
pu%lished literature, -hich sho-s the pattern o sleep under Propool. That0s really all it is.
*ot any conclusions. He can dra- the conclusions. This is a cross specialty -hen it co#es to
#easuring the -aves, the %rain -aves. This is a cross specialty o neurology,
anesthesiology, sleep #edicine, et cetera.
Judge: it does appear to %e that
Mr. Kosko: so he is as Aualiied to look at those sAuiggly lines and to interpret the# or
the jury as &r. !ro-n is in that case. $o all he0s all -e -ant hi# or is to say -hat are the
patterns that are sho-n in the literature or patients -ho are anestheti'ed -ith Propool.
Ms. "ahan: and repeating the patterns that are sho-n in the literature is e(actly -hat is
not allo-ed here, and ) think your honor has ruled and it0s clear.
Judge: i you -ant to %rie it )0# going to allo- hi# to testiy? %ut like ) said, it0s
conditional to %ring in the other e(pert. ) you -ant to %rie it to #e urther, #ay%e -e
-on0t need to do that, it -ill just co#e in.
Mr. Panish: -e0ll do that. 4nd can ) also reAuest you kno-, getting &r. !ro-n to is it
possi%le to do it %y video conerence and play it later/ 3e ask hi# the Auestions and they
cross2e(a#ine hi#, so -e don0t have to #ake hi# co#e across the country/ That0s all.
Ms. "ahan: your honor, this #ay %e as si#ple as playing portions o &r. !ro-n0s
deposition, -hich they0re allo-ed to do. 3e can #ay%e stipulate to that.
Mr. Panish: all right. 3e0ll just play the depo, then. 8ou said -e could do it, ine. ) don0t
kno- i he -as asked those Auestions.
Ms. "ahan: i he -asn0t asked those Auestions, then they do need to call hi# live, %ecause
Judge: live/
Ms. "ahan: yes.
Judge: is there any need to have hi# live/
Ms. "ahan: i -e can -ork it out technologically
Mr. Panish: according to -hat you just said, there0s %asically three Auestions -e need to

ask &r. !ro-n, and they can cross2e(a#ine hi# on those three Auestions. !ut it doesn0t
#ake -e0re ine, )0# -illing to -ork it out -ith the#, do a video conerence at their oice,
-e0ll put hi# on the thing, ask those three Auestions, and they can cross2e(a#ine on those
three Auestions. !ecause other-ise, it0s just not eicient.
!ut i that0s -hat the court is reAuiring ater %rieing, ater you look at it, then so %e it? %ut
) don0t -ant to #ake the guy co#e here to testiy or ive #inutes. That doesn0t see#
eicient. $o ) -ould ask or the alternative, that0s all.
Judge: okay. ) think the alternative is reasona%le. +ook at the depo, too, %eore you
Mr. Panish: right. 3e0ll look to see i it0s covered. ) don0t recall it %eing. Ms. "ahan took
the depo, she -ould kno- %etter. &o you kno- i it0s covered in the depo/
Ms. "ahan: ) don0t kno- e(actly -hat you0re going to elicit, %ut -e can certainly igure it
out ater the act. 4nd to the e(tent that it -ould %e a ne- opinion ro# &r. !ro-n, then -e
reserve or rights on that, as -ell, %ecause they can0t just keep adding ne- opinions -ith
e(perts as -e go.
Mr. Panish: no. 8ou0re saying -e0re relying on his article. 3e0re not going on his opinions.
3e0re not saying he0s relying on &r. !ro-n0s opinions? -e0re not trying to get any o that in
in ront o the jury.
Judge: okay. 3here0s our jury/
Mr. Kosko: no- -here -ere -e/
Judge: %asically you can go ahead and do -hat you0re going to do, )0# conditionally
ad#itting it or no- on the condition that -e %ring in &r. !ro-n in so#e or#. !ut )0#
going to allo- to you %rie it urther i you -ant to convince #e other-ise, and #ay%e it
-ill just stand the -ay it is.
Mr. Putna#: and the jury -ill understand it0s presently %eing conditionally ad#itted/
Judge: )0ll tell the#. ) don0t kno- i they0ll understand -hat it #eans.
Mr. Putna#: ) think it0s i#portant that -hen a person is hearing it, they understand this is
%eing conditionally ad#itted.
Judge: all ) tell the# is
Mr. Panish: -hat are you going to say/ That0s all ) -ant to kno-.
Judge: ) can tell the# the opinions are %eing conditionally
4d#itted, and that0s it.

Mr. Putna#: perect, your honor.


Mr. Panish: that0s ine.
(the ollo-ing proceedings -ere held in open court, in the presence o the jurors:)
Judge: okay. +et0s #ove or-ard. )0# conditionally ad#itting this -itnesses0 testi#ony, so
Mr. %anish@ $n this area $nl+.
Jud.e@ +es! $n this in this area that 1e3re .$in. int$ ri.ht n$1.
I. D$t$r! 1hen 1e 0r$*e! +$u 1ere a0$ut t$ dra1 a hart. ($uld +$u n$1 please dra1 the
hart and as 1e .$ thr$u.h it! e'plain 1hat eah $& the ite)s $n the hart is! please,
A. 6han* +$u. S$ this is sh$uld I
Mr. Kosko: can you hear all right/
Judge: can that #ove -ith hi#/
The clerk: yes.
A. the )ir$ph$ne is n$t <uite l$n. en$u.h.
Judge: -e0re going to try and #ove it.
A. than* +$u #er+ )uh. S$ I3) )a*in. a hart in 1hih the le&t $lu)n represents the
harateristis $& .enuine sleep! and the $ther $lu)n is %r$p$&$l anesthesia. S$ as I )enti$ned
earlier t$da+! .enuine sleep is A is ati#el+ .enerated
Judge: can ) stop every%ody or just one #inute/ ) it0s conditionally ad#itted, is there any
reason -hy -e can0t use the chart/ ) #ean, no- that in other -ords, it -ill #ake it easier,
it -ill go aster.
Mr. Kosko: yes. ) think that
Judge: )0# sorry. 3e0re changing things up as -e go along. The chart that you prepared,
-e0re going to actually use it.
Mr. Kosko: -e0re going to sho- it on the screen.
Judge: -e0re going to sho- it on the screen so you don0t have to -rite it out. Have a seat.

A. 6han* +$u.
Mr. Kosko: so there -ill %e no challenge to your artistic a%ilities today.
A. I 1as #er+ $nerned a0$ut that.
I. e#er+thin. else! 0ut n$t +$ur artisti a0ilities.
A. $*a+. S$ in preparin. this hart! $n the le&t side! I ha#e listed the harateristis $& .enuine
sleep4 and $n the ri.ht side! %r$p$&$l anesthesia. S$ +$u an see that .enuine sleep is ati#el+
.enerated 0+ the 0rain! 1here as %r$p$&$l anesthesia is a dru.5indued $)a. I )ean! the d$t$r
tells +$u 1hen +$u3re .$in. int$ the $perati$n that the d$t$r is .$in. t$ 0e puttin. +$u t$ sleep.
6hat3s 0eause the+ d$n3t 1ant t$ tell +$u that the+3re puttin. +$u int$ a dru.5indued $)a
0eause that s$unds a little sar+. /ut it is n$t sleep. S$ .enuine sleep &ul&ills 0i$l$.ial needs!
1hereas %r$p$&$l anesthesia d$es n$t &ul&ill th$se 0i$l$.ial needs. Genuine sleep is a readil+
re#ersi0le reduti$n in sensati$n4 and readil+ re#ersi0le! I e'plained earlier! )eans that i&
s$)e$ne .i#es +$u! +$u *n$1 sha*es +$u t$ 1a*e +$u up! $r .i#es +$u s$)e sti)ulus! +$u 1ill
1a*e up. %r$p$&$l anesthesia! +$u are pr$&$undl+ unresp$nsi#e. 6hat3s 1h+ the+ .i#e it t$ +$u4
0eause
Other1ise! 1hen the sur.e$n is $peratin. $n +$u! +$u 1$uld 1a*e up and +$u 1$uld &eel and
+$u 1$uld 0e upset. S$ +$u as l$n. as the %r$p$&$l is in +$ur s+ste)! it it is +$u 1ill n$t $)e
$ut +$u 1ill n$t 0e a0le t$ 0e ar$used $r it is n$t readil+ re#ersi0le. Genuine sleep is a readil+
re#ersi0le l$ss $& $nsi$us a1areness. In %r$p$&$l anesthesia! there3s n$ $nsi$usness at all!
and +$u ann$t 0e a1a*ened until the %r$p$&$l is $ut $& +$ur s+ste). And that happens
)eta0$lizin. the dru.! there is n$ HDA.5appr$#ed re#ersal a.ent &$r %r$p$&$l4 s$ i& the %r$p$&$l
is in +$ur 0l$$dstrea) at a ertain le#el! +$u are n$t .$in. t$ 0e $nsi$us and +$u 1ill n$t 0e
a0le t$ 0e a1a*ened n$ )atter +$u *n$1! e#en i& +$u an3t 0reathe! &$r e'a)ple. S$ i& +$u an3t
0reathe and +$u ha#e sleep apnea! e#er+ ti)e +$u an3t 0reathe! +$ur 0rain 1ill 1a*e +$u up s$
that +$u start t$ 0reathe. -$u )a+ sn$re! 1hate#er! and that essentiall+ sa#es +$ur li&e.
I. Is that in .enuine sleep,
A. 6hat3s in .enuine sleep.
I. O*a+.
A. 6hat 1$uld n$t happen 1ith %r$p$&$l anesthesia 0eause and that3s and that3s $ne $& the
hazards ass$iated 1ith %r$p$&$l! is that +$ur 0rain the n$r)al thin. that 1$uld 1a*e up +$ur
0rain! 1hether it3s pain $r a *ni&e $r n$t 0reathin.! the+ d$n3t the+3re n$t &unti$nin.. In .eneral
sleep! +$u an 0e easil+ a1a*ened4 as I said! +$u an3t 0e a1a*ened until it3s .$ne. In .enuine
sleep +les 0et1een the t1$ #er+ di&&erent 0eha#i$ral states! BEM sleep! the $ne ass$iated

1ith #i#id drea)in.! and n$n5BEM sleep A in %r$p$&$l5indued anesthesia! there is n$ BEM
sleep! and the n$n5BEM sleep is a0n$r)al.
I. Can +$u sa+ that a.ain,
A. 6here is n$ rapid e+e )$#e)ent sleep! n$ne! zer$.
I. In %r$p$&$l,
A. Bi.ht! %r$p$&$l! +$u d$n3t ha#e an+ BEM sleep.
I. And d$ +$u ha#e it in .enuine sleep,
A. -es.
I. O*a+. And then 1hat a0$ut the $ther t+pe $& sleep,
A. 6he n$n5BEM sleep is the arhiteture is a0n$r)al4 s$ instead $& .$in. thr$u.h th$se +les
that I sh$1ed +$u! it is 2ust +$u3re in $ne state the entire ti)e! and 1hate#er state +$u3re in
depends $n e'atl+ the $nentrati$n $& %r$p$&$l in +$ur 0l$$dstrea)! n$t $n an+ ph+si$l$.ial
pr$ess. S$ that 1h$le arhiteture $& sleep 1hih is ritial &$r the $ns$lidati$n $& )e)$r+ and
ritial &$r satis&+in. +$ur $ther 0i$l$.ial needs &$r sleep! that is n$t that is n$t happenin.! and
the and the inte.rati$n $& +$ur )e)$ries 1ith +$ur $ther )e)$ries! that3s n$t happenin.
0eause +$u3re n$t in rapid e+e )$#e)ent sleep.
And i& the %r$p$&$l le#els .et hi.h en$u.h in +$ur 0l$$dstrea)! +$u3re n$ l$n.er e#en e'hi0itin.
an+ sl$1 1a#es! 0ut +$u 2ust ha#e this relati#el+ &lat E.E.G. 6hat is si)ilar t$ that 1hih $urs
in pr$&$und $)a $r e#en in 0rain death. It3s 2ust s$rt $& and that is s$)eti)es that le#el $&
anesthesia is s$)eti)es indued i& i& pe$ple ha#e se#ere seizures $r s$)e $ther and +$u 2ust
need t$ st$p all 0rain ati#it+. In .enuine sleep! +$u3re sensiti#e t$ pain. I& s$)e0$d+ sti*s a
*ni&e in +$ur le.! +$u 1ill 1a*e up and +$u 1ill 0e sensiti#e t$ the pain. In the 1h$le purp$se $&
the anesthesia is that it indues 1hat is! in the )edial area! alled anal.esia! 1hih )eans +$u
are n$t sensiti#e t$ pain! 1hih I 1r$te $n the hart as 0ein. insensiti#e t$ pain. S$! in su))ar+!
%r$p$&$l anesthesia dissipates sleep dri#e! and that3s 1hat has )ade it $& suh .reat interest in the
&ield $& sleep )ediine.
I. 6hat3s a ne1 th$u.ht &$r us4 s$ 2ust tell us 1hat it )eans! it dissipates the sleep dri#e.
A. S$ n$r)all+ i& +$u3re n$t sleepin.! i& +$u3re n$t .ettin. an+ .enuine sleep let3s sa+ +$u didn3t
sleep last ni.ht. 6hen +$u 1$uld sleep )uh )$re deepl+ t$da+! and +$u 1$uld sleep &$r a
l$n.er ti)e. S$ and that3s als$ true $& the indi#idual sleep sta.es. S$ i& +$u didn3t .et BEM sleep
+esterda+ 0eause s$)e$ne 1$*e +$u up e#er+ ti)e +$u 1ere .$in. int$ BEM sleep! then +$u
1$uld ha#e 1hat 1e all a BEM re0$und. -$u 1$uld suddenl+ ha#e )uh )$re BEM sleep. -$u

)i.ht &all diretl+ int$ BEM sleep! 1hih $rdinaril+ d$esn3t happen. Esuall+ +$u .$ thr$u.h the
sta.es. S$ the BEM pressure 0uilds up! the sleep pressure 0uilds up 1hen 1e ha#en3t .$tten
en$u.h sleep.
I. D$se that ause the desire t$ .$ t$ sleep,
A. -es.
I. -$u d$n3t .et a .$$d ni.ht3s sleep! +$u3re tired! +$u still 1ant t$ .$ t$ sleep,
A. Bi.ht. I& +$u 1ere up all ni.ht preparin. &$r an e'a)inati$n $r s$)ethin.
I. Aptl+ h$sen.
A. then +$ur sleep pressure 1$uld 0e hi.her and +$u 1$uld sleep )$re $n the &$ll$1in. ni.ht.
S$ ir$niall+! %r$p$&$l this 1as the &indin. that I )enti$ned. A0$ut nine +ears a.$! it 1as
dis$#ered that %r$p$&$l anesthesia! 1hen it3s s$ the+ an sleep depri#e ani)als4 and i& +$u
sleep depri#e an ani)al! and then +$u .i#e the) %r$p$&$l anesthesia! the+ d$n3t ha#e a re0$und!
s$ it3s s$)eti)es alled
A. S$)n$l+ti a.ent! )eans it l+ses $r destr$+s the dri#e &$r sleep
I. S$ 1hat happens i& the pers$n &irst $& all! h$1 d$es a pers$n &eel 1hen the+ 1a*e up &r$)
%r$p$&$l anesthesia &r$) the p$int $& #ie1 $& a sleep e'pert,
A. S$ &r$) the p$int $& #ie1 $& sleep! the+ 1a*e up &eelin. re&reshed 0eause it has dissipated
their sleep need e'use )e it has dissipated their sleep dri#e 1ith$ut &ul&illin. their sleep need.
I. D$ the+ thin* the+3#e had a .$$d ni.ht3s sleep,
A. 6he+ thin* the+3#e had a .$$d ni.ht3s sleep! +es.
I. "a#e the+,
A. N$.
I. "a#e the+ had an+ sleep at all,
A. 6he+ ha#en3t had an+ sleep at all.
I. S$ it dissipates the sleep! 0ut +et the+ d$n3t ha#e an ur.e t$ sleep,
A. N$. S$ that3s the that3s the that is the *e+ di&&erene 0et1een %r$p$&$l anesthesia and sleep!

is that +$u3re dissipatin. the sleep dri#e. S$ .enuine sleep dissipates the sleep dri#e! %r$p$&$l
anesthesia dissipates the sleep dri#e. Genuine sleep &ul&ills the 0i$l$.ial need &$r sleep!
%r$p$&$l d$es n$t &ul&ill the 0i$l$.ial need &$r sleep. S$ it is it 1$uld 0e li*e eatin. s$)e s$rt
$& ellul$se pellets instead $& dinner! and +$ur st$)ah )i.ht 0e &ull! +$u 1$uld n$ l$n.er 0e
"un.r+! 0ut +$u 1$uld ha#e had zer$ al$ries and it 1$uld n$t &ul&ill an+ $& nutriti$nal needs.
I. 6han* +$u. 6hat3s #er+ help&ul. N$1! earlier 1e tal*ed a0$ut s$)e $& the )ediati$ns that are
used t$ treat ins$)nia. And an +$u tell )e! d$t$r! 1hether there are an+ I #. intra#en$us
)ediati$ns that are appr$#ed &$r the treat)ent $& ins$)nia,
A. 6here are n$t.
I. N$1! ha#e +$u re#ie1ed! as a part $& this! +$ur preparati$n &$r this ase! the )edial re$rds
$nernin. Mihael Ja*s$n,
A. -es! I ha#e.
I. And I3) .$in. t$ partiularl+ all +$ur attenti$n t$ the last three )$nths $& his li&e. O*a+,
And d$ +$u *n$1 i& durin. that peri$d $& ti)e! he had 0een reei#in. De)er$l,
A. -es! he had.
I. O*a+. And 1hat a&&et d$es De)er$l ha#e $n sleep! i& an+,
A. De)er$l is an $pi$id! and it inreases sleep pr$pensit+. It is n$t the sa)e as an anestheti4 s$
alth$u.h it has e&&ets $n sleep and sleep sta.es! and dereases the a)$unt $& BEM sleep! &$r
e'a)ple 0ut it 0ut the e&&et that it has is n$t s$ pr$&$und that! &$r e'a)ple! +$u an3t 0e
a1a*ened &r$) the sleep! that that +$u d$n3t &ul&ill an+ $& the sleep need! and s$ $n. S$ 1hen
e#en 1hen +$u are A 1hen +$u ha#e had De)er$l! the sleep that +$u3re .ettin. is still ati#el+
0ein. .enerated 0+ the 0rain! it is n$t 0ein. the sl$1 1a#es are n$t a dru.5indued $)a.
I. And 1hat a0$ut
A. Ma+ I sa+ $ne )$re thin.,
I. Sure.
A. "$1e#er! i& +$u are reei#in. De)er$l durin. the da+ti)e and sleepin. &$r a nu)0er $& h$urs
a&ter +$u3#e reei#ed the De)er$l in2eti$n! &r$) the sedati#e s$ De)er$l is a sedati#e! n$t
anestheti! and it3s used usuall+ in $nneti$n 1ith a pr$edure $& s$)e s$rt &$r treat)ent $&
pain. 6hen it is .$in. t$ dissipate s$)e $& +$ur 0i$l$.ial dri#e &$r sleep4 and i& +$u 1ere
spendin. se#en h$urs asleep a&ter a De)er$l in2eti$n durin. the da+ti)e! it3s .$in. t$ 0e )$re
di&&iult then &$r +$u t$ sleep at ni.ht.

I. And 1hat a0$ut 1hat e&&et! i& an+! d$es a pers$n 1ithdra1in. &r$) De)er$l ha#e $n sleep
$r ins$)nia,
A. 6hat 1ill as I )enti$ned earlier! in the se$ndar+ t+pes $& ins$)nias! there3s a 1h$le lass $&
ins$)nias ass$iated 1ith dru. use! De)er$l 0ein. $ne $& th$se dru.s that 0$th inter&eres 1ith
sleep 1hen +$u3re ta*in. it! 1ith n$r)al sleep! as 1ell as ausin. ins$)nia 1hen +$u st$p ta*in.
it.
I. S$ that that an that inrease ins$)nia,
A. -es.
I. And 1hat e&&et! i& an+! d$es the 1ithdra1al $& %r$p$&$l ha#e $n &unti$nin.,
A. On 1hat,
Ms. "ahan: o%jection? vague as to B-ithdra-al.B
Judge: sustained.
Mr. Kosko: )0ll -ithdra- the Auestion. .kay.
I. (hat a0$ut i& a pers$n 1h$ has 0een .i#en %r$p$&$l $n a repeated 0asis 1hat e&&et! i& an+!
1$uld $ur &r$) the st$ppin. the .i#in. $& %r$p$&$l! essati$n $& .i#in. $& %r$p$&$l,
Ms. "ahan: o%jection, your honor. ) don0t think there0s any oundation. )t0s a ne- area.
Judge: sustained.
Mr. Kosko: it relates to -hether or not the Propool and sleep it -ould aect Propool
and sleep, -hich is part o his proposed opinion. )0ll go a%out it a dierent -ay. &octor, do
you, %ased on your revie- o the records in this case do you have an understanding as to
ho- #any nights in a ro- Michael Jackson received Propool prior to his death/
Ms. "ahan: o%jection? hearsay.
Judge: %ased on so#ething he read/
Mr. Kosko: %ased on -hat he0s read, %ut the kind o inor#ation that an e(pert -ould
nor#ally rely upon in rendering an opinion.

Ms. "ahan: your honor, this is the issue that -e discussed at the side%ar %eore. Just
%ecause it0s so#ething that an e(pert -ould rely upon doesn0t #ean that the doctor can
testiy to the speciics o -hat0s in that. ) they -ant to stipulate to it %eing ad#itted into
evidence, -e0d %e happy to do that.
Judge: -hy don0t you #ake it a hypothetical/
Mr. Kosko: okay.
I. I 1ant +$u t$ assu)e! d$t$r! that Mihael Ja*s$n reei#ed %r$p$&$l &$r C0 $nseuti#e
ni.hts in anesthesia pri$r t$ June 22nd! 200G. Can +$u )a*e that assu)pti$n,
A. -es.
I. And assu)e that it 1as ad)inistered 0+ a ?05)illi.ra) 0$lus! the usual in2eti$n! &$ll$1ed 0+
an intra#en$us drip &$r the re)ainder $& his sleep peri$d.
Ms. "ahan: o%jection? inco#plete hypothetical.
Mr. Panish: he hasn0t inished.
Judge: let hi# do his hypothetical. ) see there #ay %e a pro%le# -ith this so#e-here, %ut
#ay%e that0s not or no-.
Mr. Kosko: ) have a very long hypothetical, too.
Judge: all right. 3e0re listening to all your assu#ed acts.
Ms. "ahan: #ay ) have a running o%jection to the hypothetical/
Mr. Panish: he hasn0t even inished the Auestion.
Judge: yes. "ontinue.
I. I 1ant +$u t$ assu)e that a para)edi na)ed Bihard <uesti$n 1ithdra1n. I 1ant +$u t$
assu)e I 1ant +$u t$ assu)e that $n the 22nd $& June! Dr. Murra+ 0e.an t$ 1ean Mihael
Ja*s$n $&& $& %r$p$&$l4 and that $n the 22nd! rather than the that3s 1hen that 0e.an. And that
Dr. Murra+ .a#e! $n the 22
nd
)idaz$la) and L$razepa) in hi.her d$ses than he had 0een .i#in.
the pre#i$us C0 da+s! and a l$1er d$se $& %r$p$&$l 1ith a sl$1er drip! e'ept &$r s$)e A and that
e'ept &$r s$)e interrupti$ns in MihaelKs sleep! he re)ained under this %r$p$&$l &$r a
reas$na0le ti)e. And assu)e that that is M$nda+! June 22nd! I3) tal*in. a0$ut. 6hen I 1ant +$u
t$ assu)e $n 6uesda+! June 29rd! Dr. Murra+ did n$t .i#e an+ %r$p$&$l. Mihael 1as .i#en
)idaz$la) and L$razepa) $nl+.

A. Ma+ I as* &$r a lari&iati$n, (hen +$u sa+ 7June 29rd!7 1$uld this ha#e 0een the ni.ht $&
the 22nd int$ the 29rd,
I. It 1$uld 0e durin. the da+ ni.ht int$ the da+! +es,
A. O*a+. 6han* +$u. S$ )idaz$la) and
I. Midaz$la) and L$razepa) $nl+. 6hat Mihael see)ed t$ ha#e resp$nded )$re
ph+si$l$.iall+ t$ that4 he 1as n$t .r$..+ 1hen he 1$*e up4 and i& he .$t up in the )iddle $& the
ni.ht! he 1$*e up #er+ <ui*l+. N$1 I 1ant t$ 2u)p ahead. I 1ant +$u t$ assu)e that a
para)edi na)ed Bihard Sene&& &r$) the LA Hire depart)ent resp$nded t$ MihaelKs h$)e at
Car$l1$$d $n June 2?th! testi&ied that! 71hen I &irst 1al*ed in! I sa1 the )edial
E<uip)ent there! I sa1 the patient! and I th$u.ht perhaps this 1as a h$spie patient! the t+pe $&
patients 1h$ are at the end sta.e $& a l$n.5ter) illness 1h$ ha#e $)e h$)e t$ die. 6he patient
l$$*ed #er+ pale! #er+ under1ei.ht. I $uld see his ri0s. M+ &irst i)pressi$n 1as! +es! this is a
h$spie patient.7 assu)e that Karen Ha+e! Mr. Ja*s$n3s )a*eup and hair artist! testi&ied that
1hen she &irst sa1 Mihael in 200G! in the 0e.innin.! he 1as .reat! #er+ happ+! #er+ up0eat!
#er+ lear! 0ut he 1as $n the thin side4 0ut his $nditi$n han.ed drastiall+! he pr$.ressi#el+ .$t
thinner &r$) there. Assu)e that Ms. Ha+e testi&ied that $#er ti)e! MihaelKs s*in 0ea)e drier!
he 1as $nstantl+ puttin. e+e dr$ps in! he 1as .ettin. thinner and thinner! he 1as repeatin.
hi)sel& an a1&ul l$t! he 1as sa+in. the sa)e thin. $#er and $#er a.ain! and that it 1asn3t the
)an she *ne1. "e see)ed t$ 0e paran$id at ti)es. Assu)e that Ms. Ha+e testi&ied that there 1as
a Hrida+ 1here Mihael 1as s$ ill that his 0$d+ 1as s$ $ld it 1as li*e an ie u0e &reezin.! li*e
t$uhin. ie4 and at the end $& April 1hen she le&t MihaelKs h$use! he 1as str$n.! health+!
ati#e! interati#e. "e l$$*ed .$$d. /ut 1hen she returned $n June 2nd! he appeared #er+ 1ea*!
he l$$*ed thinner! undern$urished! there 1as an $0#i$us di&&erene 0et1een h$1 he l$$*ed in
April and in June. Assu)e that Ms. Ha+e testi&ied that $n June 8Gth! a&ter the &ittin.! Mihael
0ush t$ld her that he $uld see MihaelKs heart0eat thr$u.h the s*in in his hest! she had ne#er
seen hi) s$ e)aiated as this.
Assu)e that Ali& San*e+! AEG. Li#e3s ass$iate pr$duer &$r the 7this is it7 t$ur! testi&ied that
$#er the t1$ )$nths 1$r*in. $n the 7this is it7 pr$2et! she sa1 ph+sial han.es in Mihael
Ja*s$nKs 0$d+! e)$ti$nal state and 1ell0ein. that $nerned her4 and the &irst 1ee* in June! she
sent an e5)ail t$ Kenn+ Orte.a re.ardin. Mihael3s health. Assu)e that $n June 89th! Ms.
San*e+ 1as $nerned a0$ut Mihael3s $nditi$n 0eause he 1asn3t .ainin. an+ 1ei.ht! he
needed t$ .ain 1ei.ht! he needed )usle )ass! he 1as thin. And assu)e that Ali& San*e+
6esti&ied that Mr. Ja*s$n 1as 1earin. la+ers $&
Cl$thin. $n June 8?th and 8Cth! he 1as $ld! he 1$re
Gl$#es! he a)e t$ rehearsal 0ut sat and 1athed the run5thr$u.h. And it 1as e#en th$u.h the
li.htin. 1as $n! it 1as runnin.! and it 1as prett+ 1ar). Assu)e there is an e5)ail &r$) Kenn+
Orte.a t$ %aul G$n.a1are! 1hih is e'hi0it 2??4 and in the e5)ail! Mr. Orte.a sa+s 7I trul+
0elie#e he needs n$urish)ent! .uidane and ph+sial therap+! )assa.e &$r his &ati.ued )usles
and in2uries. "e is n$t in .reat ph+sial shape. I 0elie#e he is hurtin.. "e has 0een sl$1 at
.ra00in. h$ld $& the 1$r*. "e sa+s he )ust ta*e are $& hi)sel& s$ that he an )eet the shedule

$r there are .$in. t$ 0e $nse<uenes. (e need a health+! rested and read+ MJ. At the &$ru) and
staples &$r all the re)ainin. rehearsals! as 1ell as the &e1 1e ha#e at the 02 in Jul+.7
Assu)e that Ali& San*e+ testi&ied she 0elie#ed that Mr. Ja*s$n 1as sl$1 at .raspin. h$ld $& the
1$r*! and she 1as $nerned. Assu)e that Kai Chase! the &a)il+ he& 1h$ 1$r*ed in April and
June! testi&ied that at a )eetin. in June 0et1een MJ.! Mr. %hillips and Mr. G$n.a1are! Dr.
Murra+ and Dr. Dile$ at MJ3s h$use4 that Mihael 1as #er+ $#ered up! he had a sur.ial )as*
$n in the h$use and la+ers $& l$thin.! s1eat pants! sh$rts $#er the s1eat pants! a t5shirt! and a
s1eatshirt $#er that! and that he l$$*ed sared and &ri.htened. Assu)e that at $ne p$int! his s$n
had t$ help hi) upstairs4 that $n the ni.ht $& June 8Gth! Ms. San*e+ and Mr. Orte.a 1ere r+in.
t$.ether 0eause Kenn+ sent Mihael h$)e a&ter the $stu)e &ittin.! Kenn+ t$ld her that 1hen
he 1as )assa.in. Mihael3s &eet! Mihael 1as tal*in. a0$ut 1as tal*in. a0$ut .$d spea*in. t$
hi)! he didn3t understand 1h+ .$d 1as spea*in. t$ hi). Assu)e that Kenn+ and San*e+ 1ere
0$th r+in. 0eause Mihael 1as n$t spea*in. n$r)all+. Assu)e there3s an e5)ail! e'hi0it DC8!
&r$) /u.zee that sa+s 7%aul and %aul! rand+! I3) n$t 0ein. a dra)a <ueen here. Kenn+ as*ed
)e t$ n$ti&+ +$u 0$th. M.J. (as sent h$)e 1ith$ut steppin. &$$t $nsta.e. "e 1as a 0as*et ase!
and Kenn+ 1as $nerned he 1$uld e)0arrass hi)sel& $nsta.e $r! 1$rse +et! .et hurt.7
Assu)e e'hi0it 928 is an e5)ail &r$) /u.zee "$u.dahl t$ %hillips. 7)+ la+)en3s de.ree tells
)e he needs a shrin* t$ .et hi) )entall+ prepared t$ .et $nsta.e and a trainer t$ .et hi) int$
ph+sial shape.7 and assu)e /u.zee then sa+s 7I ha#e 1athed hi) deteri$rate in &r$nt $& )+
e+es $#er the last ei.ht 1ee*s. "e 1as a0le t$ d$ )ultiple 9C0 spins 0a* in April. "e3d &all $n
his ass i& he tried it n$1.7 assu)e e'hi0it 2GD is an e )ail &r$) Orte.a t$ %hillips! a 7tr$u0le at
the &r$nt7 e5)ail! in 1hih Orte.a sa+s 7)+ $nern 7
A. I3) s$rr+. Hr$) 1h$) t$ 1h$),
I. I3) s$rr+! sir,
A. 6he last $ne 1as &r$) 1h$) t$ 1h$),
Mr. Kosko: this is ro# Kenny .rtega to Mr. Phillips, and it0s dated June CDth.
Mr. Putna#: do -e need to -ait until the end to o%ject that this is an i#proper
hypothetical, your honor/
Judge: keep going.
Mr. K$s*$&&@ this e5)ail sa+s 7I 1ill d$ 1hate#er I an t$ help 1ith the situati$n. I& +$u need )e
t$ $)e t$ the h$use! 2ust .i#e )e a all in the )$rnin.. M+ $nern is that n$1 that 1e3#e
0r$u.ht the d$t$r int$ the &$ld and ha#e pla+ed the t$u.h l$#e n$15$r5ne#er ard is that the
artist )a+ 0e una0le t$ rise t$ the $asi$n due t$ real e)$ti$nal stu&&. "e appeared <uite 1ea*

and &ati.ued this e#enin.! he had a terri0le ase $& the hills! 1as tre)0lin.! ra)0lin.! and
$0sessin.. E#er+thin. in )e sa+s he sh$uld 0e ps+h$l$.iall+ e#aluated.7 and he sa+s 7I 1as
t$ld 0+ $ur h$re$.rapher that durin. the artist $stu)e &ittin. 1ith his desi.ner t$ni.ht! the+
n$tied he3d l$st )$re 1ei.ht.7
Assu)e e'hi0it 2GD is an e5)ail $n the 20
th
&r$) Orte.a t$ %hillips. It3s at 8@20 p.). "e sa+s 7I3)
h$)e a1aitin. +$ur all and instruti$ns. I h$nestl+ d$n3t thin* he is read+ &$r this 0ased $n the
$ntinued ph+sial 1ea*enin. and deepenin. e)$ti$nal state. 6here are str$n. si.ns $& paran$ia!
an'iet+ and $0sessi#e5li*e 0eha#i$r. It3s li*e there are t1$ pe$ple there4 $ne deep inside tr+in. t$
h$ld $n t$ 1hat he 1as and still an 0e! and n$t 1antin. us t$ <uit $n hi)! the $ther in this
1ea*ened and tr$u0led state. I h$nestl+ &eel i& I had en$ura.ed hi) $r all$1ed hi) $nsta.e last
ni.ht! he $uld ha#e hurt hi)sel&. I 0elie#e 1e need pr$&essi$nal .uidane in this )atter.7
Assu)e that in )id June! 6ra#is %a+ne testi&ied that Mihael Ja*s$n 1as ha#in. a hard ti)e
pi*in. up s$)e $& the )aterial. Assu)e that Mr. %a+ne testi&ied that $ne ni.ht durin. the last
1ee*! Mr. Ja*s$n $uldn3t ta*e the sta.e 0eause he 1as n$t all the 1a+ $herent. Assu)e that
Mr. %a+ne testi&ied that Mihael as*ed &$r a telepr$)pter &$r the l+ris &$r his s$n.s 1hih he
had sun. )an+ ti)es! and &$r the patter 0et1een s$n.s! and that he had ne#er d$ne that 0e&$re!
s$n.s that he had 0een sin.in. &$r +ears. Assu)e that Ali& San*e+ testi&ied that she 1ent t$
rehearsal $n June 29rd! and that Mihael had a .$$d rehearsal.
Assu)e he still 1asn3t in &ull pr$duti$n5read+ a)era )$de! 0ut he 1as de&initel+ d$in. the
1$r* and d$in. a little )$re &ull $ut than usual. Assu)e &urther that Karen Ha+e testi&ied that
durin. the last t1$ da+s $& MihaelKs li&e! she &elt he 1as d$in. 0etter! and she 1as a little 0it
relie#ed that his rehearsals 1ere 0etter $n the 29
rd
and 2;th! and that $n June 29rd! he 1as still
reall+! reall+ $ld and tre)end$usl+ thin.
Assu)e that $n June 2;th! Mihael 1as 1rapped in 0lan*ets 1hile n$ $ne else 1as. In the last
t1$ da+s! a$rdin. t$ Karen Ha+e! I3d li*e +$u t$ assu)e that Mihael l$$*ed s*eletal and si*4
his e+es! his 2a1! his ears t$$* l$$*ed i))ense $)pared t$
"is s*ull and ne*. Assu)e that 6ra#is %a+ne testi&ied that Mihael per&$r)ed parts $& the sh$1
th$se ni.hts! 0ut he 1as a0le t$ d$ s$)e hun*s $& the sh$1! that he had n$t d$ne a &ull run $&
the sh$1 0ut had still n$t d$ne a &ull run $& the sh$1. Assu)e that $n the 29rd! 6ra#is %a+ne
th$u.ht MihaelKs per&$r)ane 1as n$t at sh$1 standards! 0ut he 1as rehearsin.. "e 1as
pr$.ressin.. Mr. %a+ne! assu)e he said he didn3t e'pet Mihael t$ 0e as i& he 1ere in &r$nt $& a
r$1d 0eause he 1asn3t. /ut Mr. %a+ne said he sa1 there 1as an i)pr$#e)ent in .ettin. l$ser
t$ the .$als. MJ. (as i)pr$#ed $#er his past per&$r)anes! 0ut MJ. (asn3t 1here he needed t$
0e +et. Assu)e that %a+ne testi&ied he sa1 Dr. Murra+ at the staples enter that ni.ht! and
assu)e that %a+ne testi&ied that he 1as there t$ assist MJ. (hen a ra)p li&ted hi) up s$ that he
1$uldn3t &all. D$t$r! d$ +$u ha#e an $pini$n 0ased $n reas$na0le )edial pr$0a0ilit+ as t$
1hether $r n$t there 1as a ausal $nneti$n 0et1een the %r$p$&$l that 1as .i#en 0+ Dr. Murra+
and the s+)pt$)s )ani&ested 0+ Mihael durin. that peri$d $& ti)e, Just +es $r n$ at this p$int.

Ms. "ahan: o%jection, your honor. )t0s going to take #e a little -hile to go through all the
o%jections. )t0s a long Auestion. )t0s an i#proper hypothetical
Mr. Kosko: can -e do this in the a%sence o the jury/
Mr. Putna#: not -ith a Auestion posed.
Ms. "ahan: i#proper hypothetical, inco#plete hypothetical, outside the scope o this
-itness0s e(pertise, #isstates evidence, #isstates testi#ony, assu#es acts not in evidence,
counsel -as testiying, it -as leading, an i#proper conclusion %y counsel, and -e -ould
#ove to strike, your honor.
Judge: -ell, assu#es acts not in evidence, so#e, perhaps, so ) think -e0re going to have to
e(cuse the jury or the night so -e can discuss this. +et #e ind out -hen you co#e %ack.
9:<E to#orro-.
(the ollo-ing proceedings -ere heard in open court, outside the presence o the jury:)
Mr. Putna#: Ms. Haye has %een pro#ised to us yet again or to#orro-. )t -as discussed, i
you recall, t-ice over the last t-o days the idea that i -e didn0t inish -ith hi#, Haye
-ould still go to#orro-. )t has no- %een si( -eeks since she -as last here. ) #oved
everything the 3ednesday to the Hriday or the hal day %ecause they said Haye -ould %e
a%le to go.
Ms. "ahan: your honor, given the a#ount o %rieing that -e0ve already agreed to and
-hat ) e(pect #ay %e #ore, -e pro%a%ly could use the couple days to -ork through these
re#aining issues %eore the testi#ony is co#pleted.
Judge: are you talking a%out this -itness/
Ms. "ahan: this -itness.
Judge: okay. $o %asically, in a rounda%out -ay, you -ant to interrupt this -itness0s
testi#ony to take on Haye. .kay. 3hat0s the deal -ith Haye/
Mr. Kosko: -ell, they -ant to interrupt t-o -itnesses rather than one, -hich already has
%een interrupted, and they -ant to interrupt this -itness -ho has co#e here ro# !oston
to take a -itness ro# "aliornia. 4nd it see#s to #e that just ro# a kind o a airness
point o vie-, it -ould %e %etter to inish this -itness and allo- hi# to go %ack ho#e rather
than have hi# have to co#e cross country t-ice.

Mr. Panish: -hat date is this/ )s it a ull day on the C@th/


Mr. !oyle: it is, %ecause that0s the day -e -ere going to try to get &r. Hinkelstein, %ut he0s
out o that0s perect.
Mr. Panish: ) understand Mr. Putna#0s issue. ) hate to say this, %ut ) sy#pathi'e -ith -hat
he0s saying, %ecause it0s %een a -hile or Ms. Haye. ) also let0s just assu#e hypothetically
that Ms. Haye this -itness and ) haven0t even discussed it -ith the#, so ) don0t #ay%e you
should go outside. ) don0t -ant you to hear -hat )0# going to say.
Judge: -ell, co#e %ack at 9:<E.
Mr. Panish: don0t go any-here yet. 3e0ll talk in the hall.
Judge: okay. 3ould you -ait outside in the hall, doctor.
A. +es.
Judge: thank you.
(the -itness and Mr. Panish coner sotto voce.)
(the -itness let the courtroo#.)
Mr. Panish: he said it0s going to %e diicult or hi# to co#e %ack. $o let0s assu#e,
hypothetically, -e try to like %eg hi# to stay until Monday. Monday is a hal day. .kay/ $o
) understand -hat Mr. Putna# is saying. .kay/ )0# not disregarding that. ) understand
that Ms. "ahan -ould have several hours, ) assu#e, o cross2e(a#ination.
Judge: okay.
Mr. Panish: )0# not in any -ay trying to #ini#i'e her. ) assu#e Mr. Kosko is getting
to-ards the end.
Mr. Kosko: very close.
Mr. Panish: ) -ould have Ms. Haye here -aiting the #inute this -itness is done to take the
stand, %ecause ) kno- Mr. Putna# #ade arrange#ents to do this, and ) appreciate it, and )
thanked hi# or that. !ut she you kno-, )0ll try to get her to co#e i he 7 ) kno- he
pro%a%ly -ouldn0t inish in a hal a day. 8ou kno-, #ay%e you could order her to co#e on
Monday.
Mr. Putna#: Monday is a hal day.

Mr. Panish: right. !ut i you go on Hriday and Monday, #ay%e she -ould %e done. ) not,
she can co#e on the ne(t Hriday. ) understand )0# certainly sy#pathetic to Mr. Putna#0s
position.
Judge: the pro%le# is i -e go -ith your suggestion, then they have to disrupt their entire
-itness presentation.
Mr. Panish: -hy is that/
Judge: they just e(plained to #e that they have other -itnesses that they have lined up.
Mr. Panish: the#/ 3e0re still in our case. )t0s our case.
Judge: -eren0t you calling other -itnesses/
Mr. Putna#: it0s cross o Haye.
Judge: all right.
Mr. Panish: )0# not trying i they had a -itness that they told us, that0s no. This is just
HayeFs cross. !ut ) sy#pathi'e -ith Mr. Putna#. )t0s %een a -hile, there0s no Auestion? and
that0s -hy ) -as intending on this no-, ) -asn0t intending on an hour side%ar issue.
Judge: so -hat is the necessity o Ms. Haye right no-/ ) that0s the just %ecause they said
they could. ) #ean 7 ) thought it -as so#e -itness arrange#ent issue.
Mr. Putna#: not at all, your honor. They0ve told us three ti#es %eore.
Judge: okay. $o they0ve told you three or
Hour ti#es.
Mr. Putna#: i they -ant to #ove it again, -e0ll #ove it again.
Judge: -hat is the necessity o doing it no-/
Mr. Putna#: none.
Judge: okay.
Mr. Panish: thank you.
Judge: so -hy is this an issue/
Mr. !oyle: it0s not.

Mr. Panish: ) thought Mr. Putna# -as #aking it an issue. )0# sorry. May%e ) apologi'e
or sy#pathi'ing too #uch. ) -as trying to ) -as trying to -ork -ith Mr. Putna#
so#eho-.
Judge: ) thought it -as %ecause o so#e -itness
Mr. Panish: )0ve told hi# one ti#e -e had Phillips -hen Ms. Haye -as supposed to co#e,
and -e agreed -e -ould inish her. 4nother ti#e, another -itness. $o, ) #ean, it0s not like
-e0ve intentionally said she0s co#ing and she can0t co#e, you kno-. $o she0ll co#e ne(t
Hriday. +et0s don0t let any -itness go past =:DD o0clock on Thursday and, you kno-, Ms.
Haye %ut )0# saying i this -itness gets done early, she 7 %ecause she %locked out the day,
she could co#e and they could get a e- hours in, unless they -ant to -ait until a ull day.
)0# not trying to stall it at all. ) #ean, ) %elieve #e, ) -ant to get it done #ysel. ) -ould
like to inish this -itness irst.
Ms. $te%%ins: rather than have Ms. Haye co#e %ack t-ice, ) think, given ho- long it0s
taken today -ith Ms. "ahan0s cross e(a#ination and the likely redirect, and the act that
to#orro- aternoon is only C::D to =:DD, it0s pro%a%ly %etter to just %ring Ms. Haye in ne(t
-eek. Ho-ever, ) -ould ask that plaintis not call an out2o2to-n e(pert on Thursday that
can0t %e inished in a day ne(t -eek.
Mr. Panish: that sounds like a reasona%le reAuest.
Ms. $te%%ins: just so -e can %e sure to have her all day.

Mr. Panish: is it really only C::D to =:DD to#orro-/ Ms. $te%%ins #entioned and ) kno-
the court so#eti#es does #otions on Hriday. )s that happening to#orro-/
The clerk: there0s no #otions to#orro-.
Mr. Panish: good. ) hate to %ring this up, %ut ) -ould ask i ) could leave ten #inutes early,
appro(i#ately, %eore noon, %ecause )0ve %een ordered to appear in judge "'uleger0s
depart#ent to#orro-. 4nd ) tried to schedule it later, and ) couldn0t, and they told #e )
have to %e there. 4nd it0s an i#portant #atter on a trial, so i ) could just leave at ten
#inutes to noon. ) #ean, ) tried to tell hi#, and he -as not any-ay, that0s -hat they told
#e ) have to do. ) tried to get it %eore court at @::D, and counsel ro# out o the state
couldn0t %e there then.
Judge: oh, you have an out2o2state counsel in that
Mr. Panish: they0re on the other side.

Judge: yes, on the "'uleger case/


Mr. Panish: yeah. That0s -hy he #ade it later, so they could %e here. They0re ro# three
states. ) asked to do it at @::D %ecause ) kno- -e -ould start later. )t0s only ten #inutes,
and ) apologi'e.
Judge: so you -ant to leave at ten to <C:DD.
Mr. Panish: yeah. ) guess ) could just leave
Mr. !oyle: ) think -e can handle it.
Mr. Panish: in ront o everyone. ) don0t -ant to stop, %ut you0ve got to tell the jury )0#
not just %olting, that you0ve given #e per#ission to leave ten #inutes early. ) don0t -ant to
delay the proceedings, ) -ant to inish the -itness. $o as long as you tell the jury )0#
leaving ten #inutes early, they don0t think )0# leaving that0s all.
Judge: that0s ine.
Ms. "ahan: did you -ant to discuss, your honor, the hypothetical/ 3e can talk a%out it
to#orro- #orning %eore the jury co#es in.
Judge: -hy don0t you give #e your 7 your argu#ent. $tart it.
Ms. "ahan: sure.
Judge: -hy don0t ) tell you -hy ) think it -as a pro%le#. $o#e o the assu#ed acts are not
in evidence, like &r. Murray -eaning Michael Jackson o o Propool on June CCnd. )s
there any evidence o that/ 4re you going to put any evidence in/
Mr. Kosko: it0s actually the Auestion that -e actually started the -hole aternoon -ith
-here ) think ) asked, you kno-, a%out that, and ) think your honor suggested that ) just
say assu#e it. *o-, ) #ay %e #istaken. 4nd that0s -hat ) did.
Judge: ) did.
Ms. "ahan: that0s ro# the police state#ent, your honor, as -ell as the
Mr. Putna#: all o it is ro# the police state#ent.
Judge: ho- are you going to get that 7 ) suppose -e can let i -e let the opinion in, the
pro%le# is that your opinion is vulnera%le %ecause you haven0t proven so#e o the assu#ed
acts.

Mr. Panish: let0s talk a%out that.


Judge: ) suppose does it #ean the -hole opinion goes out, or is it just a -eak opinion
%ecause so#e o the acts haven0t %een proven/
Mr. Panish: irst o all, under the "aci, the jury is instructed on hypothetical Auestions, and
they0re to, you kno-, e(a#ine each act. !ut %ack to -hat Ms. "ahan has %een saying in
ront o the jury. "ertain o these acts are in the police state#ent. .kay/
Judge: -hich is not in evidence, %ut yes.
Mr. Panish: no. Ho-ever and ) kno- you #ade one ruling already regarding a speciic
state#ent that the deendants tried to use.
Judge: right.
Mr. Panish: okay. !ut other parts o the state#ent, i there are e(ceptions to the hearsay
rule, they could %e ad#issi%le and relied upon %y an e(pert. $o, you kno-, it just doesn0t
say one or t-o sentences, then everything is in. That0s not the ruling. $o the Auestion is, are
there any state#ents contained -ithin &r. Murray0s police intervie- that -ould %e
e(ceptions to the hearsay rule/ !ecause the o%jection %y is that -hatever &r. Murray said
out o court -ould %e hearsay. $o the issue then %eco#es are there any state#ents
contained -ithin that that #eet the relevancy reAuire#ent irst, and that are e(ceptions to
the hearsay rule/ 4nd ) %elieve that there are several state#ents %y &r. Murray that #eet
recogni'a%le e(ceptions to the hearsay rule. 4nd Mr. Putna# has #arked, ) %elieve, the
transcript and the tape. )0# not sure a%out the tape.
&id you #ark the tape, also/
Mr. Putna#: ) did.
Mr. Panish: o &r. Murray0s intervie-. $o there0s one layer o hearsay that has to %e
Judge: -ho is going to testiy/ &id the police oicer/
Mr. Panish: yes, he did. He identiied and authenticated that the transcript truly and
accurately depicts the state#ent. $o there0s one layer o hearsay that has to %e addressed
or anything additional o &r. Murray. 4nd ) %elieve at least t-o o those state#ents that
-ere #ade are recogni'a%le e(ceptions to the hearsay rule.
Judge: -hat are the state#ents/
Mr. Kosko: the only ones the only assu#ption that are assu#ptions not %ased in evidence
right no- are, in act, e(ceptions to the hearsay rule.

Judge: and those state#ents that are e(ceptions, that you -ant to pull out -hat are they/
Mr. Kosko: they0re the ones that ) think you pro%a%ly you picked up on it right a-ay.
)t0s the putting hi# on or ;D days, and -eaning hi# on the last several days ro# that.
Ms. "ahan: your honor, -e tried to elicit that ro# detective Martine' and you disallo-ed
it %ecause detective Martine' said he didn0t %elieve that -as credi%le.
Judge: ) don0t think that0s the reason ) disallo-ed it. ) think ) just disallo-ed it altogether
as hearsay. 3hat0s the e(ception/
Mr. Kosko: the e(ception is
Mr. Panish: declaration against interest %y &r. Murray.
Mr. Kosko: against penal interest. )t -as a cri#e, and it turned out he -as convicted o
the cri#e.
Mr. Panish: so i you #ake an ad#ission out o court to so#ething that0s against your penal
interest, that is an e(ception to the hearsay rule.
Judge: -eaning Michael Jackson o the Propool/
Mr. Kosko: ad#inistering it ;D days straight in a ho#e setting.
Judge: )0# not %uying it.
Mr. !oyle: that -as the lead evidence in the cri#inal trial that convicted hi#.
Judge: that doesn0t #atter.
Mr. Putna#: in addition, your honor, that0s not the only %it o evidence
Judge: that ca#e in through
Mr. Putna#: that0s not the only hypothetical that0s not %eore the court. There -as several
e(hi%its he cited to. .ne in particular he cited to as i it -as ad#itted, it -asn0t.
Mr. Panish: -hich one/
Mr. Putna#: he indicated that those three 7 the three %eginnings o the hypothetical -ere
the only things in the hypothetical that -eren0t %eore the court.
Judge: that0s -hat ) ocused on.

Mr. Putna#: that0s -hat ) ocused on initially. There -ere several -e -ent to see ) think
it0s @;<. )n addition, your honor, as you kno-, or a nu#%er o these ite#s, a nu#%er o
these ite#s, the reason it0s an inco#plete hypothetical
Mr. Panish: actually
Mr. Putna#: can ) inish or once/
Judge: )0# listening. )0# sorry. )s that chatter distracting. Please keep it do-n.
Mr. Putna#: your honor, or a nu#%er o these, as you kno- )0ll give you one perect
e(a#ple. There -as instances -here he talks a%out the idea that Karen Haye had testiied
to so#ething that actually Karen Haye had not testiied to %ut, rather, Kai "hase had
testiied to. Hor e(a#ple, the idea o -ho ca#e in 4pril, -ho ca#e in June.
Mr. Panish: -e agree -ith that. He #ade a #istake on that.
Mr. Putna#: in addition, the other things -hich occurred in that -hich #akes it
inco#plete is the idea that -hile Kai "hase said he -as carried upstairs, -e then sho-ed
that the person -ho supposedly carried Mr. Jackson upstairs said he never did that.
Judge: that0s just a credi%ility ) #ean, the jury can decide -hether or not they %elieve that.
That doesn0t #ake it inco#plete.
Ms. "ahan: or e(a#ple, Mr. $ene0s testi#ony, they reerred to the act that he said he
thought he -as a hospice patient? %ut on cross, ) elicited ro# hi# that that -as ro# the
totality o the circu#stances, the ).>. Pole, the o(ygen tanks, the
Judge: that0s okay.
Mr. Panish: e(hi%it @;< is in evidence as another e(hi%it. )t0s an e2#ail that is in evidence.
Judge: the only things )0ve heard so ar that0s a pro%le# is -hat0s taken ro# &r. Murray0s
testi#ony. That0s a pro%le#. .ther than that, ) don0t think there #ay %e conlicting
evidence concerning the jury can decide -hether or not they -ant to %elieve one version or
the other.
Ms. "ahan: the ulti#ate Auestion that -as asked, your honor, ) %elieve and ) don0t have it
7 ) didn0t get a chance to jot it do-n, %ut it -as a%out -hether, %ased on his #edical
e(pertise, he %elieved there -as a reasona%le pro%a%ility that the Propool interered -ith
Mr. Jackson0s sleep and a%ility to
Ms. $te%%ins: caused the sy#pto#s, ) think.

Ms. "ahan: caused the sy#pto#s that -ere seen. 4nd ) don0t think he has the oundation
to rule out the causes or those non2speciic sy#pto#s. 3e have other people -ho said they
thought that -as a drug2related issue. )t0s not )0# concerned a%out the oundation or the
ulti#ate opinion, also that he0s %eing asked to give %ecause it0s not so#ething he testiied to
at his deposition.
Judge: let0s ind out -hat it is. 3hy don0t you proer -hat is his ans-er going to %e to that
Auestion/
Mr. Kosko: he0s going to say all o these things -ere caused %ecause o MichaelFs
deterioration over the si( -eeks the t-o #onths, his co#plete deterioration -as caused %y
the ad#inistration o Propool, and the cessation o the Propool is -hat -ill account or
the act that in the last t-o days, he -as doing %etter. This is it0s a perect #atch, and he
-ill say it0s a perect #atch, and there is 7 you kno-, and -hat they say is right. They have
an e(pert, a drug addiction e(pert, -ho they can ask a%out this, and they can %ring in a
dierent opinion, %ut -hen it co#es to sleep, ) think he0s Aualiied to give that opinion.
Ms. "ahan: that0s a%solutely not an opinion he oered at his deposition, it -asn0t one o his
nine opinions, and it0s not appropriate or hi# to %e oering this ne- su##ary opinion
su##ing up all the evidence in the case that they think supports the point no- or the irst
ti#e in trial.
Judge: ) think the hypothetical is okay e(cept or those acts, %ut those are crucial acts.
Mr. Putna#: they are the crucial acts, your honor. They say that everything ste#s ro#
ater-ards, %ecause they say he had that or ;D days and hadn0t slept? and thereore, -hen
they started to -ithdra-, the ollo-ing occurred. The very thing that -e sat in cha#%ers
and talked a%out, that -e talked a%out #ore than once in cha#%ers, a%out their ina%ility to
use this as the %asis or an opinion, they nonetheless have used or the %asis o their
hypothetical.
Ms. "ahan: your honor, it #eans that their e(pert -itness and plaintis are vouching or
everything that "onrad Murray told the police %ecause there0s no evidence in the record
-hatsoever that he ever had Propool in his syste# e(cept or the day that he died.
Mr. Kosko: -e0re not vouching or everything "onrad Murray said, %ut he did say in his
deposition that part o his %asis or his opinion -as that Murray gave hi# Propool or ;D
nights. )t0s on page
Mr. !oyle: page =I, line
Judge: let #e ask you this. ) the other acts are all proven

Mr. Panish: they0re transcripts.


Judge: then perhaps it0s really the deense0s ) guess your counter attack or your
i#peach#ent o the opinion is that these acts haven0t %een proven, and they have no -ay
o proving it up. )n other -ords, ) guess -hat )0# asking is does it #ake it a deective do )
have to thro- out the entire opinion, or is it you can co#e %ack and say, Bladies and
gentle#en, there0s %een no you should disregard his opinion %ecause he hasn0t proved
these three crucial acts, so disregard it.B there0s a dierence in thro-ing it out altogether
versus allo-ing you to argue that it should %e thro-n out %ecause the acts underlying the
opinion haven0t %een proven.
Ms. "ahan: your honor, they have to have a good2aith %asis that i it0s not in evidence,
so#ething this speciic, i it0s not in evidence, it0s going to co#e into evidence, and they0re
ighting it co#ing into evidence, as ) said repeatedly.
Judge: -ell, it0s not going to co#e into evidence. *one o MurrayFs state#ents have co#e
in, and ) don0t see any e(ception.
Ms. "ahan: so the oundation or this entire hypothetical alls co#pletely apart, and it0s o
no value -hatsoever, and it0s going to conuse the jury i he0s allo-ed to oer it as a
theoretical thing -ith all these details and pieces o e2#ails that they0ve heard and
testi#ony they0ve heard. )t0s going to %e hugely prejudicial, and it0s o no evidentiary
-eight -hatsoever, so under :EC, it0s co#pletely inappropriate.
Mr. Putna#: there0s a reason you have an e(pert like this, your honor. 3e sat here and
heard his credentials this #orning. They0re incredi%le, the -hole Harvard thing, *5$4
")4. ) could go through the list.
Mr. Kosko: it0s *5$4, not *4$4.
Mr. Putna#: )0# sorry i you don0t like #y accent. .kay/
Mr. Panish: -e love your accent.
Mr. Putna#: as you go throughout, your honor, all o that is incredi%ly i#pressive and it0s
-hy it0s so prejudicial -hen you have an e(pert -ho opines on so#ething that has
a%solutely no oundation. )t0s not enough or us to get up and say those three parts, they
didn0t prove that, did they/ )t #akes it so prejudicial, your honor. ) think the only re#otely
curative ele#ent that -e can do at this #o#ent is strike it and not allo- it.
Judge: -ell, the instruction does say the opinion is only as good as the acts that are relied
on, and it0s up to you to deter#ine -hat acts have %een proven. !ut they0re so#e o the
#ost crucial acts in his opinion.

Ms. "ahan: your honor, there0s no good2aith %asis it0s one thing i he -ere oering, or
e(a#ple, all the stu he did -ith Propool, it0s conditional on &r. !ro-n co#ing and
shoring it up. That0s one thing. !ut there0s no good2aith %asis. 4nd you0ve told us <E ti#es
this is not co#ing into evidence, so it0s not as though he0s oering it and the evidence -ill
co#e in later. 3e kno- it0s not co#ing in %ased on your honor0s rulings, so anything he0s
going to say a%out this is going to %e entirely o no evidentiary -eight -hatsoever and
incredi%ly prejudicial. They just gave their closing argu#ent.
Mr. Putna#: and it already is prejudicial, your honor. That0s -hy you have to have a good2
aith %asis or doing -hat they just did, and they didn0t have a good2aith %asis. This is
so#ething -e0ve %een arguing a%out or seven -eeks, and -e highlighted this point -ith
your honor #ore than once or this very -itness, and they did it any-ay, and you0re not
allo-ed to do that.
Mr. Panish: no, -e didn0t. 4nd nu#%er C, the jury is going to %e instructed Bin e(a#ining
an e(pert -itness, counsel #ay ask a hypothetical Auestion. This is a Auestion that is asked
to assu#e a certain set o acts and give an opinion %ased on that assu#ption. Bin
per#itting this type o Auestion, the court does not rule and does not necessarily ind that
all assu#ed acts have %een proved. )t is or you to decide ro# all the evidence -hether or
not the acts assu#ed have %een proved. Bi you should decide that any assu#ption in the
Auestion has not %een proved, you are to deter#ine the eect o the ailure o that proo on
the value and -eight o the e(pert opinion %ased on the assu#ed acts.B and that0s ho- a
lot o e(perts testiy a%out hypothetical Auestions. The deendant has %een saying all along
that it -as their intention to call &r. Murray, so ho- -ould that not co#e in -hen they call
&r. Murray/ They0ve %een saying they0re going to call &r. Murray, so there0s one -ay that
it could co#e in.
Ms. "ahan has said that she -ill stipulate that the -hole police state#ent can co#e into
evidence. $he said that in ront o the jury, she said that 7
Judge: you o%jected to that portion o the state#ent, and ) sustained it.
Mr. Panish: ) did, to that one portion.
Judge: it0s the sa#e grounds to e(clude the -hole thing. )t0s not as though a portion o it
can co#e in and the other portion
Mr. Panish: ) don0t necessarily agree -ith that. There -as a speciic reason on that portion,
not just hearsay, there -as another reason that you gave or it %eing inad#issi%le -hen you
did. 8ou took the %rieing and you #ade your ruling on that. 4nd just %ecause one speciic
state#ent #ay not %e ad#issi%le doesn0t #ean the rest o it #ay %e ad#issi%le. ) think she0s
saying

Judge: i you -ant to agree the -hole thing can co#e in, perhaps this opinion can stand?
%ut ) don0t see it i you -ant to retract that and MurrayFs state#ent can co#e in a%out he
-as the personal doctor or Michael Jackson, and that0s -ho he understood -as his
e#ployer i you0re -illing to allo- that into evidence, then -e can let the rest o this in. !ut
) think to parse it out that -ay is unair.
Mr. Panish: ) understand -hat you0re saying in the police state#ent. 3e0ll go %ack tonight
and -e0ll, you kno-, assess the situation and igure out ho- -e -ant to ask the Auestions.
Judge: okay. )0ll take argu#ent in the #orning i you -ant to co#e %ack.
Ms. "ahan: thank you, your honor.
Mr. Putna#: thank you, your honor.
(proceedings adjourned to Hriday)

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