Scum and Stavation

Unfortunately, Terri Schiavo didn't leave a living will or written instructions telling her family what her wishes would be should she ever become incapacitated. The decision made by Judge George Greer today to order the removal of Terri's feeding tube was based primarily on hearsay from her husband, Michael Schiavo.

Eight years after Terri collapsed, Michael suddenly said he remembered a private conversation he had with Terri in which she allegedly said she would not want to be kept alive by artificial means.

So what did Terri allegedly say? The following is an excerpt of Michael Schiavo's September 2004 interview with Larry King :

KING: How old was she [Terri] when this happened? SCHIAVO: Twenty-five. KING: A 25-year-old said that to you, if I die, if I'm in this state -- most 25-year-olds wouldn't think of something like that. SCHIAVO: It was a comment from watching certain programs. She said -- we were watching some programs, and she said, I don't want to -- I don't want anything artificial like that. I don't want any tubes. Don't let me live like that. I don't want to be a burden to anybody. She's also made comments to other people about different stories.

Am I missing something? I don't really believe this conversation ever took place, but when I hear 'tubes', I think respirator. I think braindead. I don't think of a tube that's used to provide me with food and water because I'm unable to swallow on my own as a result of a brain injury.

And I don't think "I don't want to be a burden to anyone" is equivalent to "I'd rather die."

Is this alleged statement from a 25-year-old woman, allegedly made while watching "some programs" (whatever that means), sufficient evidence to starve someone to death? Not in my opinion, but thanks to Michael Schiavo, his attorney George Felos and Judge George Greer, Terri Schiavo began the slow, painful process of dying of starvation this afternoon.

Kate Adamson knows what kind of pain and suffering Terri will experience. At 33, Kate suffered a stroke and was (mis)diagnosed as being in a persistent vegetative state (PVS). Rather than being unconscious with no chance of recovery as her doctors believed, she was actually awake and aware but unable to move any part of her body voluntarily. (This is known as a "locked-in state.") She eventually recovered, and wrote "Kate's Journey: Triumph Over Adversity."

This is an excerpt from an interview The Weekly Standard did in November, 2003 with Kate (H/T Common Sense Runs Wild):

In preparation for this article, I contacted Adamson for more details about the torture she experienced while being dehydrated. She told me about having been operated upon (to remove the bowel obstruction) with inadequate anesthesia when doctors believed she was unconscious: The agony of going without food was a constant pain that lasted not several hours like my operation did, but several days. You have to endure the physical pain and on top of that you have to endure the emotional pain. Your whole body cries out, "Feed me. I am alive and a person, don't let me die, for God's Sake! Somebody feed me." Unbelievably, she described being deprived of food and water as "far worse" than experiencing the pain of abdominal surgery. Despite having been on an on an IV saline solution, Adamson still had horrible thirst: I craved anything to drink. Anything. I obsessively visualized drinking from a huge bottle of orange Gatorade. And I hate orange Gatorade. I did receive lemon flavored mouth swabs to alleviate dryness but they did nothing to slack my desperate thirst.

How was Kate Adamson misdiagnosed as having PVS? According to Wittenberg Gate, PVS is misdiagnosed much more often than you might think. The Royal Hospital for Neurodisability in London studied 40 patients that had been diagnosed as PVS:

They were given therapy to promote communication. Seventeen of the patients (43%!) were found to be able to communicate. The conclusions? These patients were all originally misdiagnosed as PVS, and such a diagnosis cannot be easily made and requires a team of specialists. Perhaps this is an argument of semantics. Were they misdiagnosed or did they emerge from a PVS? It doesn't really matter. What matters is that in this sample 43% of people thought to be in a PVS were able to improve and learn to communicate. Another thing this study revealed is that a disproportionate number of those "misdiagnosed" were those that were visually impaired. The fact that Terri reacts to her mother's face when she gets very close to Terri may indicate that Terri does not see her well at a distance due to her brain damage. ... From the abstract of this study: The vegetative state needs considerable skill to diagnose, requiring assessment over a period of time; diagnosis cannot be made, even by the most experienced clinician, from a bedside assessment. Accurate diagnosis is possible but requires the skills of a multidisciplinary team experienced in the management of people with complex disabilities. Recognition of awareness is essential if an optimal quality of life is to be achieved and to avoid inappropriate approaches to the courts for a declaration for withdrawal of tube feeding.

So nearly half of the patients in this study had been mistakenly diagnosed as being PVS. The neurologists who conducted this study say that an accurate diagnosis of PVS requires the skills of a multidisciplinary team experienced in the management of people with complex disabilities, But according to yesterday's article in NRO, Michael has never even had an MRI done on Terri.

Terri’s diagnosis was arrived at without the benefit of testing that most neurologists would consider standard for diagnosing PVS. One such test is MRI (Magnetic Resonance Imaging). MRI is widely used today, even for ailments as simple as knee injuries — but Terri has never had one. Michael has repeatedly refused to consent to one. The neurologists I have spoken to have reacted with shock upon learning this fact. One such neurologist is Dr. Peter Morin. He is a researcher specializing in degenerative brain diseases, and has both an M.D. and a Ph.D. in biochemistry from Boston University. In the course of my conversation with Dr. Morin, he made reference to the standard use of MRI and PET (Positron Emission Tomography) scans to diagnose the extent of brain injuries. He seemed to assume that these had been done for Terri. I stopped him and told him that these tests have never been done for her; that Michael had refused them. There was a moment of dead silence. “That’s criminal,” he said, and then asked, in a tone of utter incredulity: “How can he continue as guardian? People are deliberating over this woman’s life and death and there’s been no MRI or PET?” He drew a reasonable conclusion: “These people [Michael Schiavo, George Felos, and Judge Greer] don’t want the information.” Dr. Morin explained that he would feel obligated to obtain the information in these tests before making a diagnosis with life and death consequences. I told him that CT (Computer-Aided Tomography) scans had been done, and were partly the basis for the finding of PVS. The doctor retorted, “Spare no expense, eh?” I asked him to explain the comment; he said that a CT scan is a much less expensive test than an MRI, but it “only gives you a tenth of the information an MRI does.” He added, “A CT scan is useful only in pretty severe cases, such as trauma, and also during the few days after an anoxic (lack of oxygen) brain injury. It’s useful in an emergency-room setting. But if the question is ischemic injury [brain damage caused by lack of blood/oxygen to part of the brain] you want an MRI and PET.

If Michael Schiavo really cared about his wife, why wouldn't he have two simple, noninvasive tests done before asking the court to deny his wife food and water?

A few years ago I read some first-person accounts of people who underwent surgery without being sufficiently anesthetized. In other words, they had just enough anesthesia so that they couldn't speak or move, but they could feel every cut of the scalpel. It makes my skin crawl just thinking about it, even now.

Kate Adamson has experienced this firsthand. She also endured, while she was mistakenly thought to be in a vegetative state, eight days of being deprived of food and water. She says the pain she experienced as a result of thirst and starvation was worse than the pain she felt during surgery.

But Michael Schiavo and George Felos insist that starvation is "painless". When Schiavo and Felos appeared on the October 27, 2003 edition of "Larry King Live" the following exchange occurred: :

KING: When a feeding tube is removed, as it was planned [for Terri], is that a terrible death? SCHIAVO: No. It's painless and probably the most natural way to die. FELOS: When someone's terminally ill, let's say a cancer patient, they lose interest in eating. And literally, they--by choice--they stop eating. SCHIAVO: Cancer patients, they stop eating for two to three weeks. Do we force them to eat? No, we don't. That's their choice. Later in the interview, Schiavo reiterated the assertion in a response to a telephoned question: CALLER: Does it bother you that the death is so slow? SCHIAVO: Removing somebody's feeding tube is very painless. It is a very easy way to die. Probably the second best way to die, the first being an aneurysm.

So Michael Schiavo and George Felos use the example of a dying person refusing food to make the case that starvation is "painless", and "the most natural way to die". But Terri isn't dying. At least she wasn't until they started starving her to death today. And she didn't make that choice, they made it for her.

Personally, I don't know if there is a hell, but if there is, I'm sure there's a special place there reserved for scum (sorry, I mean alleged scum) like Michael Schiavo and George Felos.

At Felos' press conference today, he said that congress "Cannot walk over the dying body of Terri Schiavo for their political deals." Maybe he meant that they'd have a hard time walking over her dying body because he's blocking their path as he steps over her to pick up his check.

He also said that members of congress should "be ashamed, and wear their shame." I don't think George Felos should be talking to anyone about shame - I don't think he knows anything about it.

Comments

[Man of Substance]

John, nothing to say but thank you.

[Zelda]

John, this is terrible. What kind of societ are we that decent people would allow this to happen. A woman just commented on my blog that President Bush could send in the U.S. Marshalls to rescue Terri. Do you know anything about that? She also said something about a suspicious relationship with that bimbo mistress and the Pinellas county government. I'll have to check into that. I also read on a web site that people can go to Florida. What do you think they can do there besides holding up signs? Thanks for listening.

[John from WuzzaDem]

Hey Zelda,

I hadn't heard about any connection with Schiavo's mistress, and I really don't know what marshalls could do, or what else anyone could do in FL aside from protest.

I saw on the news this morning that a few people were arrested, looked like it was for some kind of civil disobedience.

[HubcapDave]

I know the NRO article says that no MRI was ever taken of her brain, but the notes from her medical records indicate one was taken. Here's the link:

http://www.theempirejournal.com/02230551_medical_observations_sh.htm

"7/24/1990
MRI Report Dr. Pinkston
Profound atrophy w/ very atrophic appearing cortex. Mild white matter disease, anoxic/hpoxic injury
"

[Pile On®]

What could the Marshalls do????

The could insist she be fed. If the judge doesn't like it let him come take the feeding tube away himself.

I know it is a stretch but it is not completely without precedent.

[John from WuzzaDem]

Hey Pile,

I really wish we could see something dramatic like that happen. That's what's needed.

[bambi]

The reason that Terri Schiavo hasn't had an MRI, or at least a recent one, is because of an experiemental therapy/treatment she had in the mid-90s where she had to have implants put inside her skull. There is plenty of evidence that she has had many CTs and other tests, otherwise her 30,000 pages of medical records must be a lot of blank pages. But it turns out they can't do an MRI unless they remove the implants first. Her court-appointed guardian sheds a lot of light on this case, as he is very sympathetic to both sides and non-partisan. I highly suggest one of the many interviews circulating with Dr. Jay Wolfson.

So the fact that she han't had an MRI undermines the very thing that people are implying, that Michael Schiavo hasn't tried to do anything to help her. It's because Michael Shiavo did try to help her that they can't do an MRI-- not without performing cranial surgery on her first. (Any records of an MRI might be from before the experimental treatment.)

Sadly, Terri Schiavo's case doesn't have a lot of the medical ambiguities that a lot of cases like this have-- 15 years really is enough to prove PVS. She's had enough tests to show that her cerebral cortex is almost entirely gone. The woman who talked about being misdiagnosed with PVS had had an accident a few months prior, not 15 years.

I wouldn't be so quick to judge the people in this situation-- I think everyone involved is doing what they believe Terri would have wanted. Also, there's lots of cherrypicking going on about the facts in this case. If you only get your facts from National Review and other places that are trying to find facts to support their forgone conclusions, then you're really not getting a complete picture.

[John from WuzzaDem]

Bambi (or is it ZoeKentucky? That's the name you used in your comment on the "Tom Delay on Michael Schiavo" post),

I'm aware of the implant. I'm not sure why your "medical records" link leads to an online conversation with Jay Wolfson, but I've read the Wolfson report as well. I hope your life never hinges on the report of someone appointed by a probate judge, who oversees civil matters.

If Terri was able to undergo cranial surgery to have the implant inserted, I don't see why it couldn't be removed.

I'm not sure how you've reached the conclusion that there are not a lot of medical ambiguities in this case. Since you keep changing your name in the comments I'm assuming that you aren't a neurologist willing to share your credentials.

As for cherry-picking, if you're getting your information on someone's medical records from the Washington Post, I don't think you're getting a complete picture.