Terri was aware, says brain doc

Refuting the findings of the county medical examiner, a neurosurgeon who examined Terri Schiavo before her death says the autopsy report confirms she was aware of what was going on around her.

Dr. William Hammesfahr, nominated for a Nobel Prize for his work in medicine and known as a pioneer in approaches to helping the brain injured, said to ignore the facts would "allow future Terri Schiavos to die needlessly."

"The record must be set straight," he said. "As we noted in the press, there was no heart attack, or evident reason for this to have happened (and certainly not of Terri's making). Unlike the constant drumbeat from the husband, his attorneys, and his doctors, the brain tissue was not dissolved, with a head of just spinal fluid. In fact, large areas were 'relatively preserved.'"

He said the autopsy results confirmed his opinion that the frontal areas of the brains, the areas that deal with awareness and cognition were relatively intact.

"In fact, the relay areas from the frontal and front temporal regions of the brain, to the spinal cord and the brain stem, by way of the basal ganglia, were preserved, thus the evident responses which she was able to express to her family and to the clinicians seeing her or viewing her videotape," he said. "The Spect scan confirmed these areas were functional and not scar tissue, and that was apparently also confirmed on Dr. (Stephen) Nelson's review of the slides."

Dr. Hammesfahr describes Terri as "a woman trapped in her body, similar to a child with cerebral palsy, and that was born out by the autopsy, showing greater injury in the motor and visual centers of the brain. Obviously, the pathologists comments that she could not see were not borne out by reality, and thus his assessment must represent sampling error. The videotapes clearly showed her seeing."

He was critical of the findings that she was not capable of swallowing on her own. He cited her ability to swallow up to about 1.5 liters per day of liquid, confirmed, he said, by two other physicians.

"With respect to the issue of trauma, that certainly does not appear to be answered adequately," he added. "Some of the types of trauma that are suspected were not adequately evaluated in this assessment. Interestingly, both myself and at least one neurologist for the husband testified to the presence of neck injuries."

Hammesfahr concluded: "Ultimately, based on the clinical evidence and the autopsy results, an aware woman was killed."

His statements concur with others who have conducted analyses of the autopsy results. Last week, an attorney specializing in medical ethics cases, Jerri Lynn Ward of Austin, Texas, made similar observations. She particularly took note of this autopsy finding: "The frontal temporal and temporal poles and insular-cortex demonstrated relative preservation."

"What this tells us is that her cortex retained function and that her brain was more normal in the area that controls higher-level thinking," said Ward, who has weighed in on the case in her weblog and in an interview with "Joseph Farah's WorldNetDaily RadioActive" show.

Schiavo died March 31, nearly two weeks after the feeding tube that had kept her alive was removed under a court order obtained by her husband, Michael Schiavo. Her parents, Bob and Mary Schindler, said they were willing to care for their daughter, insisting she had a strong will to live.

Experts supporting Michael Schiavo – contending Terri Schiavo's brain cortex essentially was missing and filled with fluid – concluded she was in a persistent vegetative state. The Schindlers, arguing that their daughter recognized and responded to family members, produced neurologists who diagnosed her as "minimally conscious."

Pinellas-Pasco medical examiner Jon Thogmartin, speaking at a news conference Wednesday, said the damage to Terri Schiavo's brain was "irreversible, and no amount of therapy or treatment would have regenerated the massive loss of neurons."

But Ward, pointing to the autopsy report, noted the brain's frontal lobe plays a part in impulse control, judgment, language, memory, motor function, problem solving, sexual behavior, socialization and spontaneity.

"It is very possible that she remained cognizant of sounds and other things without being able to communicate," Ward said. "It's possible Terri was aware of everything being done to her – yet could do little to make people aware that she was there."

Ward pointed out that major damage to Schiavo's brain was shown to be toward the back – the areas that affect motor skills.

So the question remains, says Ward, was Terri Schiavo still a thinking, aware human being?

In fact, neuropathologist Nelson, whose assessment is included in the report, conceded there is no way of determining through an autopsy whether a person was in a persistent vegetative state.

LOL, you're whacky. "Convenience of the nurses"? You just make it up as you go. You have no credibility with me. Try somebody else who is easily browbeaten by and susceptible to straw dogs.

I don't know, I'm not a doctor. But removing a feeding tube is legal under Florida law specifically because it is established and approved.

You cannot seriously dispute that fact, can you? Has Florida made a move to make it illegal in all cases? Why not? Perhaps because it is a established medical procedure?

I thank the Lord I don't live in Florida - and won't be going anywhere near the place anytime soon!

The forcible starving of anyone is murder. If it was done to a convicted felon, the civil libertarians would go into fits of apoplexy.

That was in quotes for a reason. And testified to at trial, by nurses. But keep it up. With your every post you are showing how little you actually know about this case.

Caffeine probably wasn't screened for. In fact, I think I remember the ME saying it wasn't but that's neither here nor there, I should not have even mentioned it.

The fact of the matter is that the etiology of her arrest is unknown. The claims that she was bulemic is based on no evidence but an abnormal K level after epinephrine and 1200 cc's of fluid during the emergent care phase by the techs at the scene. Little noted is that lots of her electrolytes and enzymes were out of whack as one would expect them to be in a cardiac arrest patient treated repeatedly with epi and fluid.

IOW's like I've said before. Nobody knows why she arrested and nobody knows what her state of consciousness was, Peach not withstanding.

"It's also not an absolute that she was or wasn't the victim of foul play but to assert it without evidence is wrong, just as asserting she was bulemic and that her arrest was due to systemic low K level is wrong."

What the cononer wrote about was based on a preponderance of evidence. Just as he wrote Bulemia wasn't likely so to does he write about the foul play aspects...not likely.

I would further note that the coroner left the case/door open pending any additional information that comes to light. Hardly someone who speaks in absolutes.

So, because there is no absolute proof that she wasn't bulemic, it is OK to assert that she was? Nice logic, You and Peach deserve each other.

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