Talking about Terry:

Here’s an excellent analysis about Mrs. Schiavo’s condition by one of my favorite bloggers, a PhD psychologist who calls herself Rivka. Her blog is Respectful of Otters. Here are some excerpts from her commentary:

I have a doctorate in clinical psychology. I have completed a year-long practicum in clinical neuropsychology. I'm not qualified to evaluate Terri Schiavo myself - that would take a board-certified neurologist or neuropsychologist - but I am certainly qualified to evaluate the adequacy or inadequacy of someone else's evaluation. And so I have read every one of the 17 affidavits, plus the report of the examining physician on whose findings Schiavo's parents are basing their case, plus the rulings from the trial court and the court of appeals.

None of the 17 affidavits are by providers who examined Schiavo. Only one of the 17 providers claims to have reviewed her medical records. The remaining 16 providers apparently based their statements primarily on six snippets of videotape, totaling 4 minutes and 20 seconds, which have been posted on Schiavo's parents' website and broadcast repeatedly on the news. Several of them explicitly say that they viewed these clips on the net, and the others all refer to the same short samples of behavior (e.g., Schiavo's eyes tracking a balloon). Many of them say they read news stories about Schiavo. One admits to only seeing news stories and photographs. They all reference their experience with "similar patients," but without qualifying what they mean by "similar.” For example, one doctor draws comparisons to catatonic patients - but catatonia simply refers to an absence of voluntary motion or interaction, and can be caused by any number of things. Another references stroke patients, and two more talk about patients with Alzheimer's.

[none of the affidavit providers] mention the specific degree and type of brain damage that Schiavo has, as documented by her CAT scans: Theresa's brain has deteriorated because of the lack of oxygen it suffered at the time of the heart attack. By mid 1996, the CAT scans of her brain showed a severely abnormal structure. At this point, much of her cerebral cortex is simply gone and has been replaced by cerebral spinal fluid. Medicine cannot cure this condition

Although the physicians are not in complete agreement concerning the extent of Mrs. Schiavo's brain damage, they all agree that the brain scans show extensive permanent damage to her brain. The only debate between the doctors is whether she has a small amount of isolated living tissue in her cerebral cortex or whether she has no living tissue in her cerebral cortex. [emphasis added]

[snip] The 17 affidavits all put considerable weight on the fact that, in the video snippets on Schiavo's parents' website, she appears to be responding to stimulation. Her eyes track a balloon. She smiles in response to her mother's voice. The affidavits therefore conclude that Schiavo is appropriately responsive to external stimuli, and that she is at least minimally conscious - not in a persistent vegetative state (PVS) at all. Yet none of the exhibited behaviors are, in themselves, unusual for patients with PVS. According to the National Institute of Neurological Disorders and Stroke:

“Individuals in such a state have lost their thinking abilities and awareness of their surroundings, but retain non-cognitive function and normal sleep patterns. Even though those in a persistent vegetative state lose their higher brain functions, other key functions such as breathing and circulation remain relatively intact. Spontaneous movements may occur, and the eyes may open in response to external stimuli. They may even occasionally grimace, cry, or laugh. Although individuals in a persistent vegetative state may appear somewhat normal, they do not speak and they are unable to respond to commands.”

So the presence of smiles, grimaces, vocalizations, and eye movements alone is not relevant to the question of whether Schiavo has retained any degree of consciousness or may benefit from therapy. They may be in part reflexive - as when she "smiles" when her cheek is stroked - and they may be completely random. The key to the 4 minutes and 20 seconds of video is that Schiavo seems to be responding in a meaningful way to specific stimuli. All 17 experts who reference the videos take for granted that they demonstrate meaningful emotional or communicative responses. Could they really all be wrong?

Oh, yes. All you need to know to illuminate the question is that the six snippets of video were selected from 4 1/2 hours of tape. As do most people with PVS, Schiavo emits random behaviors and noises. If a person gives enough commands or makes enough interaction attempts over the course of several hours, by sheer coincidence some of Schiavo's random behaviors will appear to coincide with their commands. Both the trial court and the appeals court viewed the entire 4 1/2 hour tape, and both concluded that her responses were indeed random. [snip]

So what we have, in Mrs. Schiavo, is a living, breathing automaton. She's not home any longer. Her brainstem is hale and healthy and keeps her breathing and responsive to some stimuli. Her brain is a liquid. She told her husband she didn’t want to live like that. Her parents dispute that - and it turns out that in a deposition that they alleged that when she was 11 or 12 she said something that might have disputed what she told her husband - when she was 11 or 12! Her parent’s medical “experts” and the medical “experts” in congress, having viewed the four minutes and 20 seconds of video excerpted from four and one half hours of tape have concluded that she’s just slow and merely needs a little therapy to come up to speed and become a useful member of society - despite the fact that her cerebral cortex is a liquid. Right!

Meanwhile, the malpractice settlement that her husband got has apparently been keeping her alive - Bush wants to cap malpractice settlements, so that wouldn’t work in the future, and off course he’s all for gutting Medicare and Medicaid. He also apparently signed a bill in Texas when he was governor that would pull the plug on indigent patients if their money ran out.

In Texas, whether you like it or not, after 10 days, there is no obligation to provide life-sustaining treatment - unless of course you’ve got the money. Here’s the link: http://thinkprogress.org/index.php?p=480. Scott McClellan, the White House spinner-in-chief tried to explain it and failed - and Jeff Gannon/Guckert wasn’t there to save him. Pity.