Terri Sciavo – the Post-Mortem

Dr. Boyle, at Code Blue, gives his summary of the questions he had (and still has) about the Terri Sciavo case. After sounding off in his blog, he has attracted a lot of attention, and many have questioned his qualifications – and right – to opine as he has.

None of this changes the observations I have made on the Schiavo case and I stand by every single one of them. I have been grilled -- live -- on the radio twice by neurologists, neuroradiologists, and sundry experts concerning everything I have said, and I have not been knocked off any point.

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His questions deal with a number of topics, including:

Life support

"My original issue was the feeding tube. I did not -- and still do not --understand how food and water came under the rubric of life support in the same category as intubation, forced breathing, and cardiac pacing."

Brain atrophy, brain death

"Upon seeing the CT slice I was shocked that, yes there was severe atrophy, yes, there was severe damage, and yes the cortex was markedly thinned, but the CT itself did not reflect the descriptions I'd heard; and worse, I have seen many old and debilitated nursing home/assisted living patients as well as younger patients with chronic brain damage, with similar or worse atrophy. And not all of these patients were nonfunctioning. <snip> "I've been heavily criticized as unethically interpreting Terri's CT from this single slice, and speculating from the limited data. Let's get something straight. First, this was the only slice available. Second, it was the same and only slice everyone other expert was commenting upon. <snip> "I also felt strongly that it was disingenuous for experts to put Terri's CT slice side-by-side with a normal 25 year-old female's CT. To the nontrained eye, the striking disparity nailed the case shut. To me that was unfair journalism and tendentious in the worst way. It would have been far more appropriate to put up the CT of a patient with severe cerebral palsy or chronic atherosclerosis. But this would not have made their case so strong, and one must question why these experts were given a pass for passing judgment on a single slice of a CT and for a deceptive comparison."

Bone scans and the nature of injuries

"Following-up a reader's link, I found the report of a bone scan done on Terri Schiavo in 4/91. This gave me the second real "jolt" in as many days looking at some of the medical details of the TS case. <snip> "One pattern of bone scan uptake radiology residents are taught to recognize is that associated with child abuse. <snip> "Reading the radiologist's report on the combination of the three findings on the bone scan (ribs, L1, femur), my very first thought was that this would be a typical pattern for abuse..."