When certain right-to-life groups stated they were against letting Terri Schiavo die, they meant it, and they continue to attempt to breathe life into her (and more importantly, the issue), grasping at anything they can find to prove that yes, indeed, Terri Schiavo was but one more CAT scan from going for a walk. The latest attempt is spearheaded by Dean Esmay, and unlike past, more notable resurrections, this time it is those performing the resurrection coming out of the cave, and without the grand ideas.
To spare you the time of reading the whole post, Dean says the following:
1.) He was the victim in the Schiavo affair:
In the next day or two I got trackbacks from obscenity-shrieking asshats hurling nothing but epithets at me. Because the medical examiner had basically determined that Terry was blind and deaf at the moment of her death (after more than a week with no food or water, as I recall).
Those are just samples. I was then, and am now, simply stunned at the fierceness of absolute conviction from those who disagreed with me. For some (not all by any means) seemed to need to do more than disagree with me. Terry’s parents, siblings, and childhood friends needed to be denounced as 100% wrong, and Michael Schiavo had to be lauded as 100% right, period. To suggest anything to the contrary was simply evil. Or, at best, boneheaded: anti-science, anti-rational, anti-humanist, anti-everything-good.
To state that the medical examiner “basically determined that Terry was blind and deaf at the moment of her death” is, like it or not, anti-science, anti-rational, and, to boot, assinine. She wasn’t ‘basically’ blind. She was completely and totally blind. In fact, the term is ‘cortical blindness,’ and was discussed in detail in that tricksy autopsy with all those technical terms. Take it away, Will Saletan:
According to Terri Schiavo’s autopsy report, her “lateral geniculate nucleus (visual) demonstrated transneuronal degeneration with gliosis.” Or, as the medical examiner put it in plainer English, “Her vision centers of her brain were dead. Therefore, Mrs. Schiavo had what’s called cortical blindness. She was blind, could not see.”
That isn’t what Schiavo’s parents, pro-lifers, and congressional Republicans told us all these years. They said videos showed her eyes following people and objects. “In the video footage, which you can actually see on the Web site today, she certainly seems to respond to visual stimuli,” Senate Majority Leader Bill Frist declared three months ago as he spearheaded a congressional invasion of the case.
Using small words- Terri Schiavo could have had 32 eyeballs and she still would be blind. Not ‘bascially’ blind- full fledged, constant darkness, no sight, see no evil, blind.
2.) Terri Schiavo might have lived, had she been given a wafer thin mint or a zolpidem:
And you know, I wouldn’t have written about it again, except in the last week two stories in the news came to my attention. #1 is anecdotal but nonetheless powerful. #2 is more than anecdotal, and is in fact deeply disturbing in its implications. Here they are:
1) Mental Activity Seen in a Brain Gravely Injured
2) Reborn
I again say: #1 is anecdotal but somewhat disturbing.
#2, by comparison, is shattering. Give them some zolpidem, and some of them suddenly come alive? Even if it’s only a few?
But you were certain. You knew it all, didn’t you?
“But Dean, only a few respond to zolpidem treatment! So what?!?”
Yeah. Okay. So in the last year, how many people had their feeding tubes withdrawn when zolpidem therapy might have saved them? 2? 10? 100? Let’s say it was 100 worldwide at best.
The problem with Dean and others is that all coma patients = Terri Schiavo. But they don’t. Terri Schiavo was an extreme case in which her brain matter had essentially liquefied. Tossing up anecdotal evidence and medical breakthroughs in other unrelated and dissimilar cases does not change the fact that at the time of her death, her brain weighed less than half a normal human brain, and that it had been decimated by her tragedy to the point that she would have never recovered. That other individuals with less damage and different types of damage have recovered or might recover does not change Terri’s sad condition, and never will.
That will remain a truth no matter how many times you try to pretend her case is the same as other, more recent cases. The reason people were vehement about Terri Schiavo’s condition is because they were right, knew they were right, and the autopsy proved them absolutely right- not just ‘basically’ right.
So please quit pretending otherwise.
jg
Maybe they should have given her a shot of that stuff House wanted to give that cancer guy in the exciting season premiere on Fox. Funny how FOX tv characters are able to solve all the worldds problems simply by ignoring the beurocratic bullshit and following their gut. When will House and Jack Bauer team up with Chuck Norris and just save this fucking planet already?
Pb
John, you’ve done a great job following this issue, and I understand how abhorrent this is to conservatives, or indeed most Americans period, myself most definitely included, but I still have to say…
Not again.
John Cole
Buckley pretty much says what I have thought (and said) for a while- the GOP needs a time out and to spend a few years in the wilderness. It appears to me they now believe their bullshit.
Pb
You’ve probably seen them, but the other six essays are pretty good too.
stickler
The problem here is, the process by which the GOP gets to take a “time out” is likely to be very unpleasant for all of us. Because George W. Bush and his cronies are both deluded and singleminded. They do not respect the rule of law and they are not going to change course. Not in Iraq, not on tax cuts, not on privatizing Social Security. They are driving this country over a cliff. We’re all along for the ride.
Punchy
Mr. Cole! How can you be such an asshat with respect to the Olbermann debacle but so dead-on perfect with T-Shivvy? Your incredible range of complete asshattery all the other way to complete “you-da-man” is….well…stunning.
Great post. Glad you saw the applicable science where most Republicans only saw a right-to-shitty-life argument. Bravo.
Richard 23
Maybe scs can offer a reasoned and sensible rebuttal. I look forward to that.
Mike S
Newsweek
It’s a very interesting article.
scs
Yes Dr. Cole. You are very proficient is diagnosing Terri’s condition, considering the fact that medical science admits it has no good guidlines to determine yet what determines the “unrecoverableness” of PVS patients. Read any reputable university or medical reasearch article on the subject, (and please don’t get your medical info from Maureen Dowd).
Only after you inform yourself well on the subject, then you will be able to speak authoritatively on the subject. Not before.
Paul L.
Maybe if we had some of John Edward’s magic stem cells.
My reasons for being on Terri’s parents side.
1) Her husband was a prick. If you disagree, remember that he threw the parents out of the room as she was about to expire.
2) His lawyer gave me the creeps.
3) What is the harm in letting her parents take care of her?
Anyway, she is dead now so the point is mute.
However on the PVS (or VS) front.
Brain scan detects signs of awareness in brain-dead woman
Who are you calling “brain dead,” buddy?
DougJ
Dean, like JeffG, is mentally ill. Aside from that, he’s not a bad guy, truth be told.
The less said about him the better.
Pb
POTD!
kchiker
Ahhhhhhhhh…..I remember when we had Republicans like Danforth. The one Republican I’d actually vote for…for president.
Mary
Huge amounts of brain tissue going missing might be a good start for those guidelines.
Look, a video!
(Seriously, I read those stories about the sleeping pill bringing back PVS patients and was genuinely moved. But Terry Schiavo had moved beyond a shutdown brain to losing large amounts of brain tissue. She was gone.)
Pb
No. It’s ‘moot‘.
Andrew
Huzzah! Sane John Cole is back!
Pb
Dr. Cole and Mr. Darrell? The John Cole from the Mirror Universe?
Mike S
OTOH, Randal Terry was a peach.
Nikki
This is, of course, assuming that you have done the same and are equally medically informed and qualified to speak on this subject. Correct?
capelza
I honestly weep for the loss of Republicans like Wayne Morse, Mark Hatfield and even Bob Packwood.
Though honestly Hatfield might, and I say might, have voted on this in a way I would not have approved of. He was that extremely rare bird who walked the walk. He was anti-abortion, anti-death penalty and anti-war.
I am so glad that Terri Schiavo was cremated, they can no longer use her body at least. She is free of this.
KC
I think John just knocked a homer.
scs
John, even though you seem to consider yourself an expert on Terri Schiavo’s condition, a few basic medical facts for you to consider as you seem to still stubbornly pursue your mistaken ideas.
1. Terri’s brain was not all liquefied. She had about 30% of her cortex remaining. There is no medically defined limit on how little cortex must be left for any functionality to exist.
2. Areas lost in a brain does not defintely translate to skills lost. The brain is plastic and has overlap, stem cells are recuited and nerve cells are grown over time to reconnect areas, sometimes over decades. Different areas of the brain can take up different functions.
3. A brain autopsy is not conclusive in any way, it is just one piece of the puzzle, and a small, crude one at that. The best way to judge brain functionality is by a scan such as an MRI or a PET scan.
4. Medical experts have a very limited idea what PVS even is, let alone the recovery prospects for patients. The more they learn about it, the more they learn they know very little about the condition.
scs
Yes I have read many research articles on the subject- many of which I have linked to here in the past.
Zifnab
Via SCS
That’s right, John. We’re holding you to the “Dr. Frist” level of expertise.
How dare you report on another (non-Republican certified) doctor’s findings without also being a (Republican certified) doctor! I am shocked and disgusted with your gross and reprehensible treatment of the honored and respected field of medical science. If only we’d given Shavio a shot of zolpedim or something she’d be alive today and dancing.
Seriously, I want to see Democrats take this one to the bank. We need someone in the medical community to stand up and say stem cell research could have saved Terri Shavio’s life. Because, after that whooping 20% approval Congress got on their first Shavio run, I am all for them taking another dive down that road.
DougJ
Areas lost in a brain does not defintely translate to skills lost.
Though in your case it seems to, scs.
Pb
How long until scs reveals that she has an agenda and a personal stake in all of this–perhaps she’s in a coma, and has actually been posting all these years through a direct connection to the little that’s left of her brain, randomly firing to come up with her inane conclusions?
Paul L.
GEORGE FELOS: GHOUL
Yes, I know it is a Malkin link. Like a DeanM or JeffG link, it is like presenting a cross to a vampire with you guys.
Andrew
Yes, scs, because medical experts know so little about medicine, we must rely on the collective wisdom of right wing pundits.
Faux News
Obviously scs is speaking from her direct experience and detailed knowledge of Forensic Medicine as well as Neurology. I’m sure she can easily cite imperical data from Peer Reviewed articles from medical journals such as the New England Journal of Medicine or the Journal of the American Medical Association to back up her statements.
Such a dutiful RNC Sheep is scs.
Four legs good. Two legs BETTER!
scs
How about we start with the Science sections of your regular paper, not the Opinions section?
Pb
You know, besides the fact that the science isn’t there yet, and may never be there, the most optimistic made-for-tv science fiction result of that would probably be a fortysomething infant.
scs
Well most of my information comes from University research, (ie CalTech, Oxford) articles I found online. I don’t know if NEJM has this info as I don’t have access to that. I would theorize not so much, as this information is still in the research stage, and as far as I am aware, little large scale, controlled, in other words medically standard studies have been been done on this. If you read the article linked to above, apparently very little medical dollars have been spent on this subject, but hopefully that will change.
Pb
Come on, Paul L., you can do better than that. Ghoul? Creepy? Weak.
Of Maturity and Murder: George Felos, Adolf Hitler, and an American Majority
jaime
Well they pretty much admitted that they would have every limb severed as long as there was a heartbeat. They were’nt fighting for Mrs. Schiavo (I didn’t know her to call her Terri), they were fighting letting go.
That’s why they aligned themselves with psychotics, liars, charlatans and mongrel idiots.
Paul L.
Wow, An excuse to post my favorite link about medical experts.
chopper
scs is still pissed about being proven dead wrong in this whole affair. the autopsy is crystal clear – terri was never coming back. scs and frist’s attempts to diagnose by video and cherry-picked evidence nonwithstanding.
Zifnab
Oh. My. God! Did you see what George Felos was wearing? I mean, ga-ag! And his hair was all mussy. And he had that old man smell. I was just there to check out some designer shoes, but I stopped to check out like this cute younger lawyer standing like next to him and before I knew it, I was totally listening to his speech. And he was totally offensive and stuff. Someone should have him arrested or something. Like totally.
~ Michelle Malkin, raising the punditry discourse to like totally fabulous 11th grade valley girl rhetoric since forever.
DougJ
What is the harm in letting her parents take care of her?
The same thing that’s wrong with child services letting parents keep their kids locked up in the basement.
jaime
I demand, to Sean Hannity’s chagrin, that scs give back his “Nobel Peace Prize for medicine”.
scs
Brain autospies are never crystal clear. Get it straight for god’s sake.
Zifnab
Yeah. It’s a true reach. At best it would be no better than suggesting a few shots and a little physical therapy would have her up and running again.
It’s just nice to see I-hate-science Republicans get legislation they just voted down thrown back in their faces.
Zifnab
Now that we know what NOT to trust, scs, what exactly are we allowed to trust? You’ve ruled out doctors and autopsies.
Punchy
First of all, yes, areas lost in the brain DO translate to skills lost. Go slice your corpus callosum and tell me your right hemisphere will just have “overlap”.
Secondly, nerve cells do not divide. They’re in G-0 resting stage. They may expand their dendrites, but they do not divide. I’m quite sure the remaining 30% of her neurons were not going to reestablish the necessary 70% of the connections, and that’s obvious.
You’re speaking about a field about which you’ve only read the bullet points. You have no substance beyond your talking points. Typical Republican.
Andrew
Thanks, Paul, for showing us how little you understand about the scientific process.
Since the medical experts are so wrong, so often, I suppose you don’t bother with modern medicine.
scs
That’s the point. There is nothing to trust at this point as the reasearch is ongoing. There are no definites here. The best way we have at the moment to figure out what is going on in someone’s brain is a scan, MRI or PET or any of the new ones they are coming up with. Even those are not very accurate but it’s the best thing we have for now. Those scans can pick up activity that cannot be found any other way.
Paul L.
Or
GodGaia-forbid homeschool them.Mr Furious
What did yours reveal?
scs
Wrong. The brain has ‘hidden’ areas of overlap for functions. Case in point, the hippocampus- previously thought to be the site of processing all short term memory. Turns out the brain has other areas for that as well.
Nerves cell grow and reconnect, even in the brain. That is basic.
They might have not established enough for what she was before obviously, but it might have been enough to establish something. If you disagree, please tell me the minimun cortex weight or percent left to have any funtion. I’d love to hear the answer.
Mr Furious
Yeah, he should have just kissed and made up after all they put him through. And I’m sure they all would have jus held hands together…
Mr Furious
Oh, nice follow-up John. Hope for a post like this is what keeps me coming ’round.
Paul L.
Just showing that “medical experts” are not infallible.
canuckistani
Why, Jesus of course. He’s coming back any week now, and was going to miracle Terri’s ass out of bed and into the local baptist choir.
Pb
That’s the best religious argument I’ve heard yet in this case–if only they had kept Terri alive long enough for Jesus Christ to return and heal her! Why, he was just about to cut his vacation short!
p.lukasiak
We all know how busy John is…so I thought I’d save him some time….
Pb
That sounds about right. But for the record, I will point out that ‘pissing off both sides’ does not equal ‘balance’.
fwiffo
John*, I don’t think it’s really appropriate for you to use corpse of Terri Schiavo as a political football in order to criticise those who use the corpse of Terri Schiavo as a politcal football.
* I sincerly apologize for the above comment. But is it possible that some folks might have good reason for thinking your Olberman posts were sorta lame?
fwiffo
(Sorry, Didn’t intend to be redundant or pile-on, my post being after p.lukasiak’s is because of the race-condition nature of commenting)
Larry
Well, there you are. Henceforth, every patient will be kept alive forever. That’s the only policy that properly respects life.
Allowing anyone to die is just playing God.
Cyrus
Now that a full-on flamewar has started I realize a valid, new rhetorical point has little chance of being noticed, but call me a glutton for punishment…
scs, you and Paul keep bringing your editorial page science into the discussion, while demonstrating little knowledge of or even interest in the legal side of it. Fine, let’s say you’re right and she might have recovered, or at least that they didn’t know otherwise at the time. So what? All this is a jackalope, if you’ll pardon the overused reference; on the legal side of things, it’s a testament to the callous dishonesty of so-called pro-life side that the Schiavo case went on for even a matter of months, let alone years.
A person or whoever is his or her legal guardian gets to make choices like this. Michael Schiavo was his wife’s legal guardian and I never saw reason to dispute that, other than unsupported wild accusations or ridiculously dumb arguments. So under the law, no matter how sad or tough the choice is, it’s pretty obviously his. Or to use a counterfactual: all your arguments could apply equally well if there had been a living will. This would make them completely unenforceable, or at least mostly.
Current law on durable power of attorney, living wills and do not resuscitate orders do not depend on likelihood of recovery. Why do you think they should? Maybe that sounds like a leading question, but if you say you don’t think that way, then either you haven’t thought through the consequences of your argument one bit or you’re just throwing out bullshit.
Faux News
Whom are we allowed to trust? RNC talking points of course.
Mike S
Here are a few quotes from Randall Terry.
\
That’s your boy, Paul L. And since you come from the Malkin wing of the GOP I’m sure you have no problem with what he says.
Punchy
Nice false argument. I didn’t say the brain doesn’t have overlap–I said that you DO lose abilities if you lose brain lobes or material. Of course more than one part of the brain can process memory–but tell me, Ms. Neuroscience, what overlaps with the hippocampus?
What overlaps with the cerebellum? Hmm?
RSA
Conservative response to the Schiavo case is pure ad hockery, as far as I can tell. After all the uproar in Congress, was there any movement to revisit laws governing guardianship, end of life care, financial support for destitute PVS patients, etc? I seem to recall that it all just faded away.
Um. . .the bell part?
Thomas More
Dean Esmay is probably the most intellectually dishonest person I’ve read on the web, and that’s saying a lot. I love how he casts himself as some sort of victim, when he was in the thick of smearing Michael Schiavo, including passing along the lie that Schiavo never allowed therapy for his wife. In his own inimitable fashion, Dean also called people who supported Michael Schiavo “deranged, death-loving fuckheads.” Let’s hear it for reasoned debate!
Thomas More
Dean Esmay, today:
“I also never, at all, appreciated those who tried to demonize Micheal Schiavo, claiming he somehow murdered her. I never saw any serious evidence of that.”
Dean Esmay, June 2005:
In a post entitled “How Much More Like O.J. Can You Get?” (!) Esmay called Michael Schiavo “a lowlife piece of human excrement” and “the scum of the earth.” He also said he was “fairly certain that [Michael Schiavo] murdered this girl.”
Dean Esmay, check your archives.
Tsulagi
On this issue today’s Republican leadership were every bit as disgusting and contemptible as that Phelps asshole who pickets soldier’s funerals with his “God hates fags” good Christian message. Phelps knows he’s absolutely right, and so do the Save Terri crowd. Both about as moral.
The Other Steve
Oh man, now I’ve lost the link. But this morning while I was looking for something else I came across a Powerlineblog entry complaining about how the Democrats were trying to turn Teri Schiavo into a political issue.
I don’t know who the hell Dean Esmay is, but there are just as bad out there.
And oddly, they’re all Republicans.
jaime
That’s odd. Weren’t Republicans attacking Democrats for NOT taking a stand on the Schiavo affair?
The Other Steve
Nothing beats Neal Horsley and the mule story though!
The Other Steve
God, now I can’t find it.
It was a picture of 4 people protesting Jeb Bush, calling him brain dead or something. And the whole paragraph was about how Democrats are haters.
I mean it’s so fucking pathetic, this whole hater thing has become a joke and they’re too stupid to understand it.
Kimmitt
Well, now I know — if my wife gets into an accident, and I go to nursing school to learn to care for her for years, I’m apparently a prick. Thanks for the heads up.
chopper
you’re the neuroscientist.
chopper
jesus, you sound like tom cruise regarding psychology. ‘i’ve read articles, have you?’
The Asshole Formerly Known as GOP4Me
scs, this thread is golden.
I’m telling you, any time you want it, you’ve got a posting slot on Scrutator. You can have total creative freedom, plus the scattered remnants of Scrutator’s old audience. Trackback to some other sites, and the audience is resuscitated for you.
Any time, scs. Just send me an email at [email protected]. We’ll hook you up in a heartbeat.
scs
First of all, the point was not ‘recovering’ anyway- we are using the wrong term. I never said she would recover to the point of anywhere near normal, as that would be very unlikely, impossible. What is not so unlikely, is that she MAY have have some consciousness and awareness left. We know this is not impossible and in fact even happens in a significant chunk of patients studied who are presumed to be PVS. I believe in one study I read about that they did in a nursing home, it was up to 40% mistakenly identified as PVS as found on brain scans. In other studies, they have found signs of awareness even in the most severely brain damaged PVS patients, I would guess on par with Terri’s damage.
Now John Cole, with his advanced medical degree, has decided on his own and unilaterally declared, without any brain scans, that Terri’s injuries were WAY beyond any of those conducted in any of the previous research studies, even though they were also performed on some of the worst cases of PVS, hence making these findings applicable to all severe PVS patients – EXCEPT Terri Schiavo.
The point is, a brain scan is sometimes the only way we have to pick up any signs of awareness. Without a brain scan, we cannot say with total certainty that Terri did not have any awareness. If we have the tools available, and they are often helpful, and they are not used, then that is a legal travesty in my opinion, whether the husband wants it or not. And let me remind you, that if the scans had pciked up any signs of awareness, that would by definition make her minimally conscious, and thus illegal to allow her to die, no matter how much Michael wanted that.
It would be like in a death penaty case, with a whole bunch of witnesses, and all kinds of other evidence, we refuse a death row inmate a DNA test his family wants to clear him. We would say, “sorry, the case has already been decided and we already have enough evidence, we don’t need a DNA test too. That would just be overkill, plus the judge and the victim’s family don’t want it.” I mean would that ever happen? No. YEt we are okay to let medical patients die without giving them all our best tools.
I don’t mean literal overlap of the brain parts dummy, I mean overlap in functionality. You obviously do lose abilities with brain damage, but sometimes a percentage of those abilities recover. Ask any stroke patient.
scs
Thanks. You know maybe I’ll take you up on that. And you know, I feel like posting like a Leftie all of a sudden. I wouldn’t call it spoofing, just a change of heart. I know your readers will love that.
Hyperion
i’d prefer a change of brains.
could you make that happen?
The Asshole Formerly Known as GOP4Me
As I said, you’ll have total creative freedom. You can post as a radical Islamic fundamentalist if you want, I won’t stop you. (I’d post other posts calling you names, but if you wanted to post Osama Bin Laden talking points I wouldn’t stop you.)
TOTAL creative freedom, scs. Think about it. Get back to me whenever.
The Asshole Formerly Known as GOP4Me
The real question, of course, is whether lefty talking points are really distinguishable from those of Osama. Moonbats claim that there are subtle differences; I tend to disagree.
Both sides hate America, and both Osama AND Tipper Gore want to ban video games and offensive music lyrics. If the liberals aren’t card-carrying members of the Axis of Evil, I don’t know who is.
Par R
I note that Pb, the Andalusian hermaphrodite, has weighed in on this issue and, as always, has proven itself to be hopelessly lost at sea. I suppose this should not be surprising given Pb’s track record; but as ppGaz once said, “Pb defines stupidity down to a level that even moles can’t find.”
Pb
Par R,
Cite?
JWeidner
Hmmm…I note that Par R has weighed in on this thread….but not really on the issue at hand. As always, (s)he has proven to be a hopeless lover of pie. I suppose this should not be surprising, given Par R’s track record when it comes to pie, but as many people have said, “Par R DOES like pie.”
The Asshole Formerly Known as GOP4Me
Well, he’s in good company on this blog. “Balloon Juice” should be changed to “Piefights”.
Or, alternatively, “Pie; Fights”.
Cyrus
449 words later… like I said, I’m a glutton for punishment. scs, you still have not explained exactly what changes you want to see to the relevant laws, or how you would justify them. You also have not shown that you know anything at all about the legal issue. Forget that – you haven’t even demonstrated any awareness that the legal issue and the medical issue are separate. The closest you come is this argument by assertion:
Cite? Anything? Bueller? Apparently the closest you have come to reason is swapping “recover” out for “minimally conscious”.
Again to use my counterfactual, I assume you agree with the legality of living wills in general, and just haven’t thought through the contradiction here. Well, start thinking it through, please. What have you said here that would not be true if Mrs. Schiavo’s wishes had been known?
rachel
I think this board might have one of the Shiavo family’s lawyers on it:
scs
Fine, I’ll shorten the legal arguments for you Cyrus. Legally, you can only stop treating a person who is dead. You also have to take all reasonable steps to make sure that person is not alive. A person who has awareness is considered alive and legally you can’t stop treating them. Get it?
Pb
Or poor. But you’re fine with that.
Beej
scs,
Are you saying that in the 15+ years that she was in a PVS, Terri Schiavo was NEVER given a PET scan or an MRI? Somehow, I find that very hard to believe. Can you cite a source for that?
By the way, you are wrong about not being able to “pull the plug” if there are signs of awareness. If there is a Living Will or a do-not-resuscitate the fact that there may be “awareness” is not legally relevant. Do you want to contend that it should be? That’s opening a whole different can of worms. After all, what’s the point of either a Living Will or a do-not-resuscitate if they are not going to be honored so long as the tiniest bit of “awareness” (whatever that is) can be detected?
scs
That’s correct.
scs
Only in the event of imminent and assured death – such as a terminal cancer patient in a very advanced stage. Terri was actually physically healthy and could have lived years longer in her condition.
scs
This is some more info to show you that John Cole and his fellow bloggers are not medical experts, and they should stop turning to each other each for medical education, even though they find each other fun and easy to read. I was browsing around in John’s post and this is an excerpt from John Cole’s links above, if you click on ‘vision centers’. and then click of some visual sections of the brain.
As you can see the visual areas are spread throughout the brain, some of which are still mysterious, some of which may not yet be charted. Which brings me back to my conclusion that John just can’t seem to get through his head, that the brain is still mysterious to all. If he started reading the info in his own posts, it may be a start for him.
scs
A little more tech info for you all thanks to John’s links.
From Wiki –
In other words, even though Terri’s LGN was damaged, there are some visual nerves that travel directly to the midbrain, where they are involved in tracking objects.
Hmmm. LIKE MAYBE A BALLOON?????
The Asshole Formerly Known as GOP4Me
Email me, scs. This thread gets better and better.
I think with you helming it, Scrutator could become one of the premier right-wing/left-wing/Islamist/Communist/Nazi/ChristoTaliban/Terri Schiavo-related blogs on the Internet.
The Asshole Formerly Known as GOP4Me
In the wake of the Schiavo incident, several of my friends enacted living wills explicitly stating that, in the event they enter a PVS, that all life support be cut off.
In the event that this should happen to one of them, do you feel that such a will should be enforced?
Nikki
Uh…someone asked for a cite as to whether or Terri had a PET scan or MRI in the 15+ years. I noticed you affirmed that statement, but provided no cite. Do you have valid proof that Terri Schiavo was never given a PET scan or MRI from the time of her collapse to the time of her death? If so, please provide it. If not, please shut up.
Edmund Dantes
She wasn’t given them after about 4 or 5 years into her treatment for one simple reason. The cunning bastard of a husband Michael decided that to try and revive his wife (and to through off future litigation further down the road) using an experimental treatment out in California where they inserted metal electrodes into her brain. This was a chance this would have an effect on her brain that would wake her up from the vegetative state. It didn’t work. It did however leave her with two metal electrodes in her brain so that no MRI or PET scan could be done since Metal and very large powerful magnets don’t mix.
It was a very clever ploy, and I applaud the unthinking, uncaring bastard that was only looking out for himself for traveling to California with her for the time it took to have the procedure performed and recovery. It was like 6 months if I remember correctly.
I salute you Michael Schiavo for having the foresight to plan for this very eventuality. This is the guy we should have tracking Bin Laden and planning our War on Terror. He truly is a cunning mental genius with no moral qualms.
spoosmith
The reason she was not given a PET scan is that it would not have shown the doctors any more information than they already had to make their diagnosis – PVS is a clinical diagnosis and is not dependant on multiple scanning techniques. The CAT scan images showed such massive trauma, that it was decided that further scans were unnecessary. As for her sight returning because of the “evidence” scs lists – it would be quite the miracle, since she didn’t have a mid-brain left.
I would be interested to know how MRI and PET scans can detect awareness. Really I would.
Cyrus
Legally you can’t stop treating them? Since when? Are you making this up as you go? What have you said here that would not be true if Mrs. Schiavo’s wishes had been known? And I agree with Beej:
VidaLoca
Nikki, Beej
Well, wikipedia has her CT images from 2002.
If I were scs I wouldn’t be braying about them either.
John D.
Sigh.
No magnets are used in a PET scan. Please stop getting your ignorance all over my monitor.
scs
Okay more myths to clear up. A CAT scan does not show different areas of the brain working, it just shows the architecture, so it does not count as a scan that may show awareness. A PET scan could have been given to Terri, even with the implants but never was at Michael’s request. The thinking is changing in the last 5 years that a “clinical” diagnosis is enough to decide PVS, based on the fact that scans are showing the clinical diagnosises often don’t match at all to what they are seeing in scans, even in patients with severe damage like Terri.
And where does it say Terri’s midbrain was non-existent? I know Terri had about 30% of her cortex left, and most of the damage was at the top. I will have to look it up to see if any midbrain was spared.
scs
Okay looked it up. Some info on the midbrain-
And on the brainstem:
Since we know that Terri had all those functions of breathing, etc, her brainstem and midbrain were probably not damaged.
Since we know some visual nerves travel directly to the midbrain, and those nerves travel to areas that can process object movement, it seems to me not only possible but highly probable that Terri tracked that ballon with her eyes. Man, all it took was a little googling to prove you ignoramuses wrong.
The Other Steve
Everybody should stop giving scs a hard time.
Clearly, she’s a modern miracle. It’s very amazing that she’s able to function as well as she does with 70% of her brain missing.
spoosmith
Again, can you please explain how a scan can show awareness? An EEG was performed on her cerbral cortex which showed no activity. What would the benefits be to having a PET scan?
scs
Click on John’s link above (Mental Activity Seen in a Brain Gravely Injured) for starters.
John D.
Scs,
You can make these unsupported claims all you want, but in this specific case, the doctors were *right*. The autopsy showed that everything they said was correct.
You keep attempting to throw out fMRI (not MRI, BTW) and PET as “awareness” detectors. They aren’t. PET detects glucose uptake, so it would show what areas of the brain were active — and we have no idea where the seat of conciousness is in the brain. fMRI detects blood flow through the oxygenation of hemoglobin, so it shows where the blood is flowing, after a delay that ranges from 1-5 seconds. Hard to correlate stimulus response with that wide of a margin. Since you like to claim that research is on your side, I’d like you to point me to the research that has mapped brain functionality to awareness.
The macroscopic and microscopic degeneration of Terri’s brain shown by the autopsy supports the finding of PVS, yet even *it* says that PVS is a purely clinical diagnosis. As in, there *is no test we are capable of performing* to discern whether a patient is in a PVS or not. CT, PET, fMRI, EEGs — all of these can be used to help with the diagnosis, but none of them are definitive. And when the CT and EEG scans show the massive damage that they did, it’s hard to say that the doctors were wrong. The autopsy removed even THAT quibble.
scs
I repeat – Click on John’s link above (Mental Activity Seen in a Brain Gravely Injured) for starters.
I don’t know why you all (john) persist in this idea that Terri’s brain damage was beyond the scope of all other PVS patients. Do you think that if a person is in PVS, they all have beautifully intact brains, and Terri was the only one with severe brain damage? No many other PVS patients probably have severe damage as well, probably just as bad as Terri’s. I’m sure it’s a range, and granted Terri was probably on the more severe side, but I doubt she was that unusual, like one of a kind in severity for PVS.
So although the EEG and CT scan did show massive brain damage, I would guess that that is pretty normal for a PVS patient, because if they didn’t have it, then they wouldn’t be in PVS, would they? SO where is the proof that although past research studies have been successful in picking up activity in some of the most severe patients, they would have had NO chance with Terri.
The Asshole Formerly Known as GOP4Me
So, living wills for people who become PVS: should we listen to their wishes prior to the PVS onset, or ignore those wishes?
John D.
Go learn about the specifics, then we can talk.
RSA
Are you saying that “areas that can process object movement” were still active in Schiavo’s brain, outside the visual cortex, which was destroyed? I don’t know enough about visual processing to know if this is possible, but I’m skeptical based on what I do know.
Faux News
BAAAAAA! BAAAAA!
Four Legs Good, Two Legs BETTER!!!
TM Lutas
Zolpidem seems to be having positive effects in about 60% of PVS patients. This is not a small deal but a big deal and no matter where you stand on Schiavo’s case *this should be celebrated*. Coma patients will be coming out of their comas and have something of an interactive life with their families. Nobody knows how far this is going to go but it’s certainly more progress than embryonic stem cells have produced.
The action of zolpidem seems to take brain cells that the best medical knowledge at the time of Schiavo’s death would have called “dead” cells and reactivates them so that they function. Nobody knows how this works or whether Terri Schiavo would have benefitted from this treatment. It is a mystery we will never be able to solve because Schiavo’s dead.
The more interesting question is whether Schiavo’s husband would have permitted the administration of zolpidem had its effects been discovered a year or two earlier. That *is* a question that can be resolved by simply asking the man though I’m not so sure it would be in good taste to do it. Follow up questions depending on whether he says yes or no would include why not (for the no response) and what makes zolpidem different from the treatments Terri’s parents advocated (for the yes response).
BIRDZILLA
I hear that animal right extremists PETER SINGER is all in favor of euthinasia and so are the eco-freaks
jaime
If he REALLY loved her, like the Schindlers and the snake handlers and objectively pro-abortion clinic bomber crowd did, he should have kept her alive by any means necessary, including sawing off every piece of decaying flesh on her body until every muscle stopped twichting.
Richard 23
Welcome back, BIRDZILLA!
scs
Just read my prior quote above- but here is most of it again for you.
There is no one actual visual cortex. There are areas that specialize in vision, but areas dealing with vision are also spread through the brain, including the midbrain. Read my above quotes to learn.
scs
I think guardians should legally be required to give the best modern diagnostic tools that we have before we let someone die, even if the husband doesn’t want to let his wife have them. In addition all wishes should be put in writing, or have abundant, neutral witnesses (not your brother) to back it up. Especially in a situation where the cause of collapse is not expected, unlike say a terminal illness. There are too many conflicting monetary incentives (insurance money, assets) to trust families, especially spouses, to make these decisions otherwise and too many divorces to trust that at the time of the unexpected collapse, the spouse was the best spokesperson. It should be decided by a panel of doctors otherwise, and more than just three of them, based on chances of recovery or possibility of awareness left. But those doctors should be free to give any tests they want, not just give whatever tests the husband wants. Those are my legal issues.
RSA
scs wrote:
Sorry, I missed that. My bad. I did follow the link to find that the optical processing described on that web page deals with the pupillary light reflex. Do you have any information about midbrain processing to support visual tracking of movement? (That’s what a lot of the controversy was about.)
jaime
It’s over, scs. Mrs. Schiavo legally passed away last year (never mind she really died 15 years prior). Take your goal posts move them somewhere else…probably to the next poor unconscious person. Hopefully the next time you wingnuts decide to use him or her to prove how pro-life YOU all are, the sane people will ignore you.
scs
Again, see above, 11:09.
scs
Actually that and 3:49 AM.
jg
Scs,
I bet your parents had a bitch of a time convincing you Santa Claus wasn’t real.
rachel
Wow. Talk about flogging a dead vegetable horse.
Proud Liberal
Great post John. It worries me that so many in this country have such a poor understanding of science or are in fact anti-science. I understand we are pretty much next to last in the world as far a countries go in the belief of evolution. Strong support still for another “theory” gravity, but we’ll see if we have a few more years of Republican leadership where that will end up.
The Asshole Formerly Known as GOP4Me
It sounds like we need to revamp the whole concept of legal guardianship. Every decision undertaken in the course of a guardianship has financial implications, after all.
Should guardianships even exist? I’m thinking we could have a court system decide every non-medical issue that would otherwise be decided by a guardian, and every medical decision could be decided by a panel of medical experts. I realize that this will have far-reaching economic implications as hundreds of ad hoc panels spring up to adjudicate every aspect of every legal guardianship in America; but the moral ramifications are too important for a bout of price-taggery to stop us now.
My $.02.
RSA
Thanks again, scs.
The Other Steve
I don’t see the point.
I do find it absolutely fascinating that flat earthers who don’t believe in science are now hailing this as a miracle.
Research is always important, and if this helps us to better understand brain function to one day reverse course on dead brain tissue, that’s wonderful.
But, this seems to ignore that the miracle drug doesn’t actually do that much. It doesn’t bring people back to a normal sense of living. The effects are temporary.
The fact is, if a person has chosen that they don’t want to live their life like that. That they’d rather die, than spend the rest of their life unable to communicate in a meaningful way. Then we should allow them to die with dignity and honor.
scs
You know, I guess my problem IS guardianship. Any decision allowing a person to die where the guardian stands to gain financially from it should be suspect, unless that agreement is in an ironclad written contract.
This goes for child to parent and for spouses, siblings. I don’t really think parent to child counts, because it is the rare situation where the parent would gain financially from a child. But maybe even that, for child stars, wills etc.
I guess my point is that even though we have these ‘guardian’ relationships presumed, this is not a perfect world and all families are not always Ozzie and Harriet. I think there shoud be more room in the law for other parties to challenge the nature of the relationship between guardian and spouse, just like parent and child relationships can be challenged for custody battles.
scs
Well that’s ironic isn’t it? Remember the whole ridiculing about Terri’s eye movements? Did anyone even bother to read up anything about the eyes and nerves and the brain before they did that? Anti-science my ass. Look in the mirror.
The Other Steve
Where exactly did you get your medical degree?
I though Cracker Jack stopped putting those in their boxes years ago.
The Asshole Formerly Known as GOP4Me
Exactly. Not to mention that it might be in a parent’s best interest to send a child to a crappier school than a child’s abilities or interests might otherwise get him/her into, largely for the parents’ financial interest. This could also apply when the parents uproot a child’s whole life just because Daddy got a job somewhere else. So a child’s school, social network, neighborhood, and universal framework all have to get uprooted so that the parents can find work in California or wherever. The parents gain financially at the expense of the child, who is forced to tag along. (Can courts stop this, though? Put the kids in orphanages, or pay for them to get hotel rooms, or use eminent domain to seize their homes so that they can still live there until 18 as wards of the state, at which time the homes will be sold at auction to finance the child’s upbringing? I don’t know, but I’m very sure it would require some huge legal overhauls.)
Including non-relatives? I’m just wondering how far we can go with this. Suppose I’m a wealthy Christian (for argument’s sake- NOT Islamic fundamentalist although we could just as easily use them) zealot who decides to challenge the custody rights of every parent in town who don’t take their kids to church. Say I have $200 million to squander on these lawsuits, and I end up winning every kid from some poor neighborhood. If I can buy their homes, kick the parents out, let the kids live there rent-free until they’re 18, and then kick them out and turn the whole neighborhood into some kind of theme park or casino, is there anything wrong with that?
Maybe it would just be easier to assign every child a judge at birth. Abolish the whole concept of parent-child relations, and bring all children up in state-run facilities. I don’t know. Maybe not. We’re just brainstorming here, anyway.
Dan Collins
DougJ Says:
Dean, like JeffG, is mentally ill. Aside from that, he’s not a bad guy, truth be told.
The less said about him the better.
September 13th, 2006 at 1:41 pm
I must firmly object to this vicious and unwarranted attack on Mr Jeffrey Todd Goldstein, Abd. of Denver Colorado. This sort of cheap anti-Semitism, directed at a patriot, a father, and a homeowner, is beyond the pale.
scs
I’d say, yes. When it comes to time to pull the kid off the respirator, I’d say even that person would have a right to challenge the guardianship. Then of course the judge would promptly throw it out as frivolous. But if it had merit, such as a teacher who had inside knowledge of abuse, then it should go forward.
So according to your logic, we should throw out all civil suits because there is the constant danger frivolous lawsuits will be filed. Of course not my friend. This would be the same like any legal action.
The Asshole Formerly Known as GOP4Me
.
I wasn’t talking about respirators, I was talking about custody. I guess it still applies, but I was talking about the broader implications.
.
I haven’t really displayed any logic yet, I thought. :) I was just asking questions and posing hypotheticals. Although I do remember a judge telling me one time, “Look, I know the system is slow. If the taxpayers are willing to chip in another $10,000 each in taxes, we can get a second courthouse and lots of new judges to speed it up. But somehow, I don’t see that happening.” (I was doing volunteer work in Camden, NJ, where a typical docket was 50-60 cases a day, and a person called in to court at 8:30 AM could reasonably expect to be there until at least 3 PM.)
It’s all about the money. Time is money, effort is money. That’s why so much abuse (of every form) occurs- the police don’t have time to thoroughly investigate every allegation, and the courts don’t have time to adjudicate it. If we all chip in another $10k a year, that might change, but it seems unlikely in the current economic climate.
The Asshole Formerly Known as GOP4Me
Good God, why can’t I do a simple smiley face without it turning into a Walmartized, mutant version of itself?
I hate the new smileys.
Tim F.
So now criticizing a Jewish person is automatically anti-semitic. If true, that would make nearly every rightwing commenter on this blog an anti-semite. You, sir, are an idiot.