Wednesday, March 23, 2005

I Swear This Is My Last Schiavo Post

I've given my opinion about the Terri Schiavo case at length, and I don't necessarily want to keep contributing to the media frenzy. (As of this morning, Respectful of Otters is the number one hit on Google for "Terri Schiavo CAT scan." The next few links are to Alas, A Blog and Abstract Appeal. Fortunately.)

Through my referrer logs, I found a link to some additional information which does seem worthy of Yet Another Schiavo Post. The blogger who writes Pekin Prattles wrote to Ronald Cranford, one of the examining neurologists from the original Schiavo trial, inviting him to respond to the National Review article condemning the medical handling of Schiavo's case. Among other things, Dr. Cranford's reply addresses the questions about additional scan techniques:
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.
Pekin Prattles also reproduces a lengthy journal article by Dr. Cranford (it's mislabeled "Dr. Cranford's complete Terri Schiavo report," but it's obviously a summary article, not a medical report). It's well worth reading. He discusses the series of CAT scans taken between 1990 and 2002 (not just the 1996 one which has been widely reproduced on the net), the EEG evidence over the same time period, and Schiavo's clinical records from her attending physicians - correcting the widespread misapprehension that Schiavo's neurological condition has not been re-evaluated since the 1998 trial. The article also provides this searing dismissal of the parents' "experts" who testified that there were treatments which could restore Terri Schiavo's brain function:
The following is a sample of the completely fallacious opinions rendered about Terri’s medical condition by Drs. Maxfield and Hammesfahr. Twelve years after an hypoxic-ischemic insult, and serial CT scans showing extremely severe atrophy of the cerebral hemispheres, both doctors said there was a “chance for recovery,” with the potential for response to treatment. Dr. Maxfield testified that “abnormal brain dissolves, so what’s left [as seen in the CT scans] is “normal, functioning brain.” He further stated that the most recent CT scan shows “improvement.” They gave no published data to support their opinions on their proposed treatments of HBO and vasodilator therapy but instead presented an infomercial style approach of anecdotal cases of dramatic responses to their therapies. There are no credible articles in the peer-reviewed medical literature on HBO or vasodilator therapies as effective treatment for patients with chronic brain damage. The articles on the internet on vasodilator therapy, including those by Dr. Hammesfahr, are extremely poorly written, and only a cursory examination of these articles would tell any medical professional that they could not have possibly been peer-reviewed.
"Abnormal brain dissolves, so what's left is normal, functioning brain." Well, no problem, then. She didn't need her cerebral cortex, it was abnormal. If this is the best the Schindlers' experts could do, it's no wonder the trial and appeals courts have found so consistently for Michael Schiavo.