<p>She was… undaunted. I liked that very much about her. </p>
<p>"I told my mother-in-law that my house was her house, and she said, “Get the hell off my property.”</p>
<p>She was so genuinely honest and funny and had fans from teenagers to her own peers. One of a kind.</p>
<p>While I find any person’s death sad, I’m still shuddering at the horrifically racist things she said only a few weeks ago. </p>
<p>Oh right, those horribly racist comments about Justin Bieber’s fashion choices. Good grief. </p>
<p>That was part of her humor - nothing was off-limits - not her husband’s suicide - not Princess Dana’s death, etc. I think there were times when she went too far - and when her audience froze - she would ask something like, “what? too soon?” and break the ice. </p>
<p>I feel like I grew up laughing at Joan Rivers’ jokes. I remember her when I was a little girl, watching her on TV. She’s always been there. Very sad that she’s gone. </p>
<p>Found this list of lines:</p>
<ol>
<li><p>“I knew I was an unwanted baby when I saw that my bath toys were a toaster and a radio.”</p></li>
<li><p>“All I ever heard when I was a kid was, ‘Why can’t you be more like your cousin Sheila?’ And Sheila had died at birth.”</p></li>
<li><p>“I have no sex appeal; if my husband didn’t toss and turn, we’d never have had the kid.”</p></li>
<li><p>“You know you’re getting old when you buy a sexy sheer nightgown and don’t know anyone who can see through it.”</p></li>
<li><p>“At my age an affair of the heart is a bypass!”</p></li>
<li><p>“I wish I had a twin, so I could know what I’d look like without plastic surgery.”</p></li>
<li><p>“My face has been tucked in more times than a bedsheet at the Holiday Inn.”</p></li>
<li><p>“People say that money is not the key to happiness, but I always figured if you have enough money, you can have a key made.”</p></li>
<li><p>“My love life is like a piece of Swiss cheese; most of it’s missing, and what’s there stinks.”</p></li>
<li><p>“Grandchildren can be so ■■■■■■■ annoying. How many times can you go, ‘And the cow goes moo and the pig goes oink’? It’s like talking to a supermodel.”</p></li>
<li><p>“You know why I feel older? I went to buy sexy underwear and they automatically gift wrapped it.”</p></li>
<li><p>“I can’t wear yellow anymore. It’s too matchy-matchy with my catheter.”</p></li>
<li><p>“My best birth control now is just to leave the lights on.”</p></li>
<li><p>“I must admit I am nervous about getting Alzheimer’s. Once it hits, I might tell my best joke and never know it.”</p></li>
<li><p>“I love Israel for its blue and white flag as it matches my legs.”</p></li>
</ol>
<p>Interesting speculation from a local NYC morning show host; if it is indeed rather unusual for this type of procedure to be conducted in a clinic rather than an hospital room, it may have been because Joan insisted on it and the doctor’s agreed because she was a V.I.P. If there were no inordinate risks, doctors may have allowed Joan to avoid all the hulabaloo that could happen at a hospital, with the press, public and curious staff.</p>
<p>Being 81 does not automatically disqualify one from availing oneself of services offered at ambulatory surgery centers. Depending on her medical history, the procedure performed, the inherent risks, etc., this may have indeed been a relatively low risk procedure which unfortunately had a bad outcome in spite of her good health and past ability to tolerate anesthesia and various other procedures.</p>
<p>From what I understand, this was an endoscopy center. I don’t know this center specifically, but I work at one, and there are always multiple qualified doctors and anesthesia providers in house at all times. We have access to all currently mandated emergency equipment, all anesthesia providers are proficient in intubation and emergency management, all health care providers are ACLS certified, many have experience in critical care, surgery, etc. </p>
<p>If this was indeed a surgery center (rather than a “clinic” or “doctor’s office” as I have also seen it referred to), it seems really unlikely that this particular procedure should not have been performed there or that there were not providers there capable of handling a respiratory arrest.</p>
<p>She may have had a severe laryngospasm, which can make intubation very difficult. Otherwise, you have to wonder if this was indeed as “state of the art” a facility as has been implied. If malpractice occurred, this will be obvious pretty quickly.</p>
<p>
</p>
<p>If the staff deviated from current standards of practice, it won’t matter what Joan insisted on. We are supposed to be patient advocates and adhere to medical standards and ethics no matter what the patient wants. She is not the person who is supposed to understand the implications of medical practice; that is the duty and responsibility of the medical professionals. In a nutshell, if SOP was not followed, the docs will be liable, all claims of patient pressure notwithstanding.</p>
<p>Problems under anesthesia can occur anywhere, especially with an 81 year old. And the outcome from such an event can be lousy at any facility. It may not have decreased her risk of the event and of the outcome to have had the work done elsewhere.</p>
<p>Lergnom, thanks for posting the list of lines. </p>
<p>Does anyone know whether she kept her smooth skin by surgeries or by non-surgical procedures like Botox? She really had smooth skin, no sagging or wrinkling. It’s amazing when you think about it. If she did this through surgeries, she must have been really motivated to undergo the procedures/anesthesia. They would have been risky at her age, I would think. Much riskier than an endoscopy, if that’s all she had last week. </p>
<p>I don’t think she ever hid having plastic surgery, so I doubt that was what she was having done. </p>
<p>A friend who is a speech pathologist said her voices seemed raspier lately, and wondered if she had developed a vocal polyp that was being evaluated.</p>
<p>Yes, I heard that she was having her vocal chords operated on.</p>
<p>Anesthesia always has complications; doesn’t mean there was malpractice.
But I’m glad she went as she did - working and living a vital life to the very end. I think that’s how she would have wanted it. </p>
<p>I didn’t really realize until I thought about it how much of a true pioneer she was in her day.</p>
<p>Joan understood very well that anesthesia comes with risk for even fatal complications. She said it in a recent interview when asked about her willingness to undergo so many “procedures.”</p>
<p>Consolation, I was not suggesting that she was having plastic surgery last week. I know that she was completely open about having it. I was just thinking that if she had a fatal complication from light surgery for an endoscopy, how much more dangerous it would have been to have plastic surgery. I was wondering whether she was doing that in her 70’s, or if she was only having more minimal procedures like Botox.</p>
<p>She has had multiple face lifts and other procedures which go way beyond botox even in the last decade, iirc. She had cheek implants and a chin implant, and possibly something added to her brows as well, I think. Quite frankly I thought she was a case of plastic surgeries gone way too far; she had begun to look scary. </p>
<p>We do facelifts, a full 8 hour surgery, with local anesthetic and propofol in the plastic surgery center where I work. That’s much easier on the patient than the heavy duty stuff you would receive in a conventional surgery. But the patient has to be monitored very closely. I don’t see how a respiratory arrest occurs in that scenario, because their oxygen saturations are monitored constantly, as well as their heart and blood pressure. If breathing slows down, proprofol administration ceases, and they wake up very quickly due to the short duration of the drug. </p>
<p>I’m wondering if either she experienced a laryngospasm that closed off her airway, or a stroke or heart arrhythmia that led to a cardiac arrest/subsequent respiratory arrest. </p>
<p>I read that her book sales are up 60,000 percent. That is not a typo. </p>
<p>edited to say that I post this as a compliment to her popularity. </p>