THE FEEDING TUBE MUST BE REINSERTED IN ORDER TO GET A NEW CT OF THE BRAIN
I have offered the following proposition to Terri Schiavo's legal team today:
The single CT image I was able to access at the U of Miami's web sight raises the following ESSENTIAL questions/issues:
Issue: There is something in Terri's right ventricle (the image is reversed). I know she had thalamic implants, but on this one slice the "thing" in Terri's ventricle is not projected to the thalamus, it is projected within the ventricle. She needs a follow-up scan to see what this is and where it is
Issue: If the "thing" in Terri's ventricle is a "shunt tip" -- who put it there and why is it there and was it removed? If she was shunted to relieve hydrocephalus then she must have follow-up exams and someone needs to postulate the most common mechanisms for hydrocephalus (which, I believe, is blood in the cranial vault)
Issue: Given this ONE image, NO ONE can exclude the possibility that Terri, at that time, had hydrocephalus.
I see all the classic signs:
1. Enlarged ventricles
2. Rounded, bulbous front and back ventricle horns
3. "Pressure" effect on the occipital lobes of the brain (which, by the way, do not -- on this image -- demonstrate the atrophy seen everywhere else)
*People with untreated hydrocephalus OFTEN SHOW IMPROVED MENTATION WHEN THE OBSTRUCTION IS RELIEVED.*
So, if the other images bear out my impression from this one slice, then Terri MUST have a follow up CT or MRI or BOTH and if she is hydrocephalic she needs to be shunted, because there are possible positive therapeutic implications that no one can deny.
What if The State and Terri's Tube-Remover Ignore This ?
If she is NOT shunted it is my contention that there is no physician ANYWHERE who could say, in the future, definitively, that Terri did not have hydrocephalus at the time of that particular CT slice.
What does this mean? Everything.
As I said, nonshunted hydrocephalics can experience improved mental functioning after shunting. I am not saying this would be the case with Terri (because of how long this has gone on); however, what I AM saying is that if they DON'T do a repeat CT scan NOW BEFORE TERRI DIES, the evidence will be on that scan forever. They will never be able to say it wasn't so.
Do they want to face their own carnivorous legal system when the dogs of war are let loose after Terri dies? I WILL BE THE FIRST TO TESTIFY. I will say that one cannot exclude hydrocephalus on that image. ONE MUST REPEAT THE SCAN. Basically, given THAT image the onus is on them to prove she is NOT hydrocephalic -- meaning she needs a repeat CT, and to do that they need to reinsert the feeding tube.
If they proceed as is, with that image out there on the internet, the person(s) who pulled that tube had better be aware that they are in jeopardy of actuating a death when there were standard medical procedural methods that had yet to be deployed.Here's what they can look forward to at the trial:
Dr. Boyle: ONE MUST REPEAT THE CT SCAN
Dr. Boyle: BECAUSE SHE MAY HAVE HYDROCEPHALUS.
Tube-Puller: O come on, that's ridiculous.
Dr. Boyle: MAYBE. BUT SHE MAY HAVE HYROCEPHALUS.
Tube-Puller: O come on. So what?
Dr. Boyle: HYDROCEPHALICS CAN IMPROVE WITH SHUNTING.
Tube-Puller: But she was brain dead. You're insane
Dr. Boyle: MAYBE. JUST REPEAT THE CT SCAN AND PROVE ME CRAZY.
Tube-Puller: we can't do that
Dr. Boyle: WHY?
Tube-Puller: She's dead. I pulled out her feeding tube.
Dr. Boyle: DEAD? HOW DID SHE DIE?
Tube-Puller: Dehydration. Starvation.
Dr. Boyle: I'M SORRY FOR HER. I PITY YOU.
Dr. Boyle: I CANNOT CHANGE WHAT IS ON THAT FILM. SHE MAY HAVE HAD HYDROCEPHALUS. IF SHE DID, SHE MAY HAVE EXPERIENCED IMPROVEMENT WITH SHUNTING.
Tube-Puller: That's a lot of maybes.
Dr. Boyle: THAT'S ALL TERRI HAD.
YOU SHOULD NOT HAVE PULLED THAT TUBE. YOU ARE CULPABLE. I'M AFRAID IT'S MURDER.
Tube-Puller: that's idiotic. I only did what I was ordered by the courts to do.
I'VE HEARD THAT BEFORE.
IT DOESN'T FLY.
ONE MUST REPEAT THE SCAN. PUT THE TUBE BACK AND REPEAT THE CT SCAN.