CSI MEDBLOGS: ARAFAT PLUMBS YET NEW DEPTHS OF THE TERM "COMA" AS HOSPITAL OFFICALS PLUMB OBFUSCATION

If a coma were an ocean, Yasser Arafat would be seeing giant squids outside his bathyscape right now.

French hospital officials, a gang of Palestinian spokespersons, and uncountable unnamed sources are all agreeing on one concept as regards the condition of the ALID (Arab Leader In Demise): He is getting, at every announcement, deeper into a coma. Maybe they should stop making annoucements in order to halt this interminable descent before Arafat gets the "bends" to add to his problems.

Grunt Doc and Rangel both believe that Arafat has end-stage liver disease (ESLD)and a cerebral bleed secondary to low platelets. I have serious questions about that, however.

If he had end-stage cirrhosis, I think it would have been obvious to everyone earlier. You can't hide the protuberant belly, and the other sequelae of cirrhosis. In addition, almost always, these pateints require intervention before the last two weeks of life.

If he had portal hypertension (PH) the CT's scans could not possibly be reported as normal. He would have a large spleen. He would also have innumerable "extra" veins throughout the scan (varices) rerouting blood that is being obstructed in its flow through the liver due to the hepatic disorganization. These varices are quite obvious  (in the splenic hilum, the retroperitoneum, the bowel mesentery, et al) on CT's of patients with ESLD and PH. If the French radiologist who reported the CT as"normal" missed these findings, I have a few Torters who want to talk to him.

As for an intracerebral bleed due to low platelets: it would be extremely unusual to have a spontaneous bleed from thrombocytopenia alone. If one's platelets are low one has trouble clotting, but one doesn't usually spontaneously bleed unless there is a major cerebral infarct first, or trauma; i.e. someome dropped Arafat on his head or hit him over the head with something (all within the realm of posiibility!).

I stil think the explanation that fits all the disparate announcements so far is that the French experts did something bad -- probably by accident -- causing a cardiac or respiratory arrest leading to cerebral infarct +/- bleed.

Thus Yasser Arafat is less likely to have slipped into a coma than to have been PUSHED.

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