Florida Pilot

A compendium of random thoughts from a former Washington Beltway insider who is now having a lot more fun flying small airplanes in Central Florida.

Friday, March 18, 2005

amateur neurology

One would hardly consider neurology to be an appropriate do-it-yourself pursuit. The typical neurologist is highly educated and trained in evaluating and understanding conditions of the brain, certainly one of the body's most complex organs.

But the Terri Schiavo case has brought out hundreds if not thousands of amateur neurologists who believe their own observations, typically based solely on a review of a heavily edited videotape, are superior to those of the highly education neurologists who have actually examined Terri Schiavo and reviewed the medical evidence related to her condition.

One example of the silliness afoot here is Peggy Noonan, a Wall Street Journal writer. Ms. Noonan does not mention any credentials or previous experience she has in the area of medicine or neurology but evidently she doesn't feel that kind of credentials are of any value in assessing Terri Schiavo's medical condition.

"At the heart of the case at this point is a question: Is Terri Schiavo brain-dead? That is, is remedy, healing, physiologically impossible?

No. Oddly enough anyone who sees the film and tape of her can see that her brain tells her lungs to breathe, that she can open her eyes, that she seems to respond at times and to some degree to her family. She can laugh. (I heard it this morning on the news. It's a childlike chuckle.) In the language of computers she appears not to be a broken hard drive but a computer in deep hibernation. She looks like one of those coma cases that wind up in the news because the patient, for no clear reason, snaps to and returns to life and says, 'Is it 1983? Is there still McDonald's? Can I have a burger?'

Again, life is mysterious. Medicine is full of happenings and events that leave brilliant doctors scratching their heads."

So what is wrong here? The fact is that Terri Schiavo is not "brain dead" but is in a "persistent vegetative state". In the condition she is in, those parts of the brain that control higher functions (that make us human beings) have died and been replaced by fluid. This has been confirmed by diagnostic scanning. She does not have an injury to her brain -- there is something else in the space where her brain used to be. The fluid that has replaced her higher brain is no more likely to convert back to brain tissue than a person who has had a limb amputated is likely to grow another one to replace it. A chameleon can regrow a tail that is lost but a human being cannot grow back an arm or a leg and a human being cannot grow back a brain.

So, what about the video tape? As was brought out in some of the neverending court cases, the video tape found on the web site was extracted from many, many hours of tape in an attempt to show something that is not real. Terri Schiavo does not have the ability to track things with her eyes but her eyes do more randomly. Under the basic facts of probability, Terri's random eye movements will, given enough observations, track some other object completely by chance.


Post a Comment

<< Home