Posted on 03/23/2005 5:31:11 AM PST by conservativecorner
Jim,
Your analysis will be ignored here, I'm afraid.
Anyone who has debated the pros and cons of this case has taken the same abuse in this Forum Doc, We are EEEEEvil. didnt you know? One debater had no qualms at killing me but wanted to save Terri. Volunteered to shut MY machine off.
Yeah no sense in beating your head against a wall,nothing you could say hasnt been said before and it didnt matter then either.
I suppose any medical case has two sides, but where were these quacks who are coming out of the woodwork now 15 years ago?
Terri was in a coma for approximately one month, and then evolved into a vegetative state. Four board-certified neurologists in Florida consulting on her care (James H. Barnhill, Garcia J. Desousa, Thomas H. Harrison, and Jeffrey M. Karp) had repeatedly made a diagnosis of PVS over the years. The initial CT scan on the day of admission, February 25, 1990, was normal but further CT scans documented a progression of widespread cerebral hemisphere atrophy, eventually resulting in CT scans of 1996 and 2002 showing extreme atrophy (CT scans-1996, 2002: "diffuse encephalomalacia and infarction consistent with anoxia, hydrocephalus ex vacuo, neural stimulator present); prior to these most recent two CT scans, CT scans had been performed on February 25, 1990, February 27, 1990, and March 30, 1990, with an MRI scan on July 24, 1990.The two most recent EEG's have demonstrated no electrical activity-on July 8, 2002: "no evidence of cerebral activity;" and October 4, 2002-"does not have any definite brain activity. However, most of the tracing is obscured by artifact from muscle and eye movement." The clinical exams over the years were entirely consistent with diagnosis of permanent vegetative state secondary to hypoxic-ischemic encephalopathy. From the initial hospitalization in February, 1990, until the present time, there have been no significant changes in Terri's neurological findings, and nothing in the medical records to suggest any disagreement whatsoever among Terri's attending and consulting physicians about the underlying diagnosis and prognosis for recovery. A deep brain stimulator was placed in Terri's brain on December 12, 1990 at request of the husband who flew with his wife to San Francisco for the procedure. This highly experimental form of medical treatment did not result in any clinical improvement in Terri's condition. (14)
hydrocephalus ex-vacuo defined
encephalomalacia defined
Well I'm not a physician, BUT I have heard the eminent Dr. Hammesfahr and several other highly respected neurologists say that CT scans are too "fuzzy" to be used for a definitive diagnosis of this condition.
MRIs and PET scans, according to these experts, are much clearer and are state-of-the-art.
Michael Schiavo has refused to let Terri have either an MRI or a PET scan.
I always expect Freepers to turn on me when I offer legal interpretation, since I am an evil lawyer....but now a doc as well?
This is my last comment until after the funeral.
Suppose that you got what you refer to as a "definitive diagnosis" of encephalomalacia, hydrocephalus ex vacuo, and persistent vegetative state?
I mean, just suppose.
Would you say it was all right for TS to be killed?
If not, what do you care about what scans have been done, or not done?
I also know enough to know that there are elderly people walking and talking whose scans would show up similar to this.
Am I wrong?
Even though many people would love to pin this on the evil Mr. Schiavo, it's not quite as simple as that.
An MRI was never recommended because, in this case and other patients in a permanent vegetative state, the CT scans were more than adequate to demonstrate the extremely severe atrophy of the cerebral hemispheres, and an MRI would add nothing of significance to what we see on the CT scans. Plus the MRI is contraindicated because of the intrathalamic stimulators implanted in Terri's brain. A PET scan was never done in this case because it was never needed. The classic clinical signs on examination, the CT scans, and the flat EEG's were more than adequate to diagnose PVS to the highest degree of medical certainty, along with the credible testimony of the three neurologists at the longest evidentiary hearing in American law, whose opinions were strongly affirmed by the trial court judge and three appeal court judges. Please see Judge Greer's opinions on the credibility of the experts testifying on behalf of the Schindler family.
In addition, the only PET scan center in the country I would trust right now for doing the PET scan for the determination of PVS is New York-Cornell Medical Center with Niko Schiff. There are other PET scan centers in the US (such as in Miami and Atlanta which I contacted in 2002 as to the feasibility of doing a PET scan at these centers), but the only one doing top quality work with the precision necessary for PVS is the one in New York.
I do not believe there are "a number of other prominent members of your field" who feel these other tests should be done, because these "other prominent members" are physicians with strong conservative credentials who obviously don't know the facts of the case, and some of these physicians have "credentials" similar to Dr. Maxfield and Dr. Hammesfahr (the "HBO and vasodilator experts"). Where were these physicians earlier in the case when they could have examined Terri and testified at trial on behalf of the Schindler family, instead of the two doctors whom Judge Greer found not very credible?
The calls for new tests on Terri are nothing more than one of several last minute desperation moves by the Schindlers and their supporters to delay the withdrawal of the feeding tube from Terri. There has never been a more extensively litigated case in the history of right to die cases in terms of the length of the entire litigation itself, and the extensive medical testimony during the elaborate evidentiary hearing of 2002, and the thorough review of this medical tesimony by the appeals court.
No one is turning on anyone, but when you make statements it's a given that you will be challanged by some or all if you differ. The discourse has been civil, and this is a forum where many views can be expressed. Just don't make a statement and suppose that we will take it as fact.
I'm a neurologist and have read hundreds of CT scans. Two problems with this scan are that there is no name on it and it is only a single image of the multiple image complete CT scan.
That being said, I don't see any cortex on this CT image. There is white matter but the normal "cortical ribbon" that surrounds the white matter is missing.
Look pal, I called you on this crap already. For the record, you declined to answer.
You are arguing with people who think that 19 (now 20) courts as well as all the doctors and nurses that don't support their viewpoint are all in a conspiracy to cover up either Michael beating her.
Good luck to you!
Some of these posts really reminds me of a bunch of little kids throwing a fit and being ruled by emotion rather than rational adults looking at the issue and making decisions based in logic.
You are incorrect. The only working part of Terri's brain is the brain-stem.
She is brain-dead.
No need to spread propaganda. You can still get the fanatics riled-up with the truth.
Nobody says Terri is brain dead. Not even the opponents of keeping her alive say that. Please provide your source for this statement.
Thaks for the insight. Unfortunately, you will be ignored and/or be called a "Death Cultist".
Her frontal cortex seems to be in pretty decent shape.. there is definately damage to the back areas... but anyone that says she has no cognitive ability based on this scan, I think is a liar... I've seen scans of children with "water on the brain" who had far far less total brain matter that were perfectly normal.
This entire thing smells!
I understand that the very doctor who implanted those stimulators urged Michael Schiavo to have them removed. Michael Schiavo never did so.
The classic clinical signs on examination, the CT scans, and the flat EEG's were more than adequate to diagnose PVS to the highest degree of medical certainty
It is absolutely false to claim that there is "the highest degree of medical certainty" in that diagnosis.
Dr. William Hammesfahr, who spent by far the most hours with Terri in making his diagnosis, disagrees strongly.
So do dozens of other respected neurologists who haven't been able to examine Terri in person, because Schiavo hasn't permitted it.
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