“Soft despotism is a term coined by Alexis de Tocqueville describing the state into which a country overrun by "a network of small complicated rules" might degrade. Soft despotism is different from despotism (also called 'hard despotism') in the sense that it is not obvious to the people."

Thursday, February 04, 2010

Too Bad for Terry Schiavo

Terry Schiavo was an inconvenience, brain injured, damaged, alive but in a strange place, slowly, inexorably, incrementally responding to those that loved and cared for her, still human yet strange to those that judged her from a plane of ignorance.

The best of people wanted only the best for Terry. They knew better than those who spent hours and days and months watching and praying for a piece of Terry to return. The best people mocked the vulnerable pitiful Terry. They mocked the family that invested their lives to help Terry return to life in tiny slivers.

The best of people wanted Terry Schiavo dead.

Terry's family prayed to God. They begged God. They plead for anything and when they got a little they bargained for more. Their prayers were answered and helped Terry return in small subtle joyful and hopeful ways. That offended the good people, the law, the putrid beautiful people.

Terry Schiavo had to go.

The little patch cleared for her, that sliver of hope refined by her parents and family of blood, those shallow roots carefully nurtured had to be cut.

Terry was deprived of the basic needs of all living things, water and nourishment, by men in black robes and herds of American sheep that are offended by fur coats and people that starve dogs.

Now the truth is exposed, a truth known all along to ordinary people that love and care for brain injured people. The brain injured, still human, still alive and still loving to those that take the time and have the intelligence to notice. God bless them.

Goddamn the bastards that killed Terry Schiavo.

Brains of vegetative patients show life

Five of 54 unresponsive subjects in a new study demonstrate brain activity indicating awareness, with one able to respond to simple questions.

By Melissa Healy LA Times
February 4, 2010

In a study certain to rekindle debate over life-sustaining care for those with grievous brain injuries, researchers report that five patients thought to be in a persistent vegetative state showed brain activity indicating awareness, intent and, in at least one case, a wish to communicate.

Of 54 unresponsive patients whose brains were scanned at medical centers in England and Belgium, those five appeared able, when prompted by researchers, to imagine themselves playing tennis, and four of them demonstrated the ability to imagine themselves walking through the rooms of their homes.

One of those patients -- a 22-year-old man who had been unresponsive for five years after an automobile crash -- went on to respond to a series of simple questions with brain activity that clearly indicated yes or no answers, researchers said.

Their work is the first to give physicians and families the prospect of a biological test to determine whether a patient who shows no response to his or her surroundings is conscious and aware of them.

That information, in turn, could bring comfort to families and better care to patients who are able to demonstrate their awareness and communicate their needs. For those consistently unable to respond, such tests may bring a measure of comfort to families inclined to end life support.

The research was published online Wednesday in the New England Journal of Medicine.

But some neurologists cautioned that such a new diagnostic technique might further confound families.

In an accompanying editorial, Harvard University neurologist Allan H. Ropper wrote: "It will now be difficult for physicians to tell families confidently that their unresponsive loved ones are not 'in there somewhere.' " Even when a patient has shown purposeful brain response, "we cannot be certain whether we are interacting with a sentient, much less competent, person."

Regardless, the study demonstrates that a form of brain scanning called functional magnetic resonance imaging might be used to discern the extent of a patient's consciousness. It is the latest in a growing body of research suggesting that the medical profession's methods of classifying unresponsive patients are crude, imprecise and often fail to predict the possibility of recovery.

That imprecision became a touchstone for impassioned political debate in the months leading up to the 2005 death of Terri Schiavo, a 41-year-old heart attack victim who languished, unresponsive, for 15 years before a Florida judge allowed the removal of the feeding tubes that had kept her alive.

Unlike Schiavo, whose brain was deprived of oxygen for five crucial minutes, all of the subjects whose brains showed signs of awareness and intent in the study had suffered traumatic brain injury -- most commonly sustained in falls, motor vehicle accidents, collisions and assaults. Of the 49 patients who failed to respond, 29 had sustained brain trauma and the rest had been subject to illness or injury that deprived them of oxygen.

An estimated 9,000 to 37,000 people in the United States are in a persistently vegetative or minimally conscious state; the number ranges widely because diagnostic definitions are vague.

Dr. Jamshid Ghajar, president of the Brain Trauma Foundation and a neurosurgeon at Weill Cornell Medical College, called the study "very innovative." Ghajar -- who was not involved in the research -- said it was "remarkable" that a patient considered vegetative for five years could follow complex instructions.

The study's lead author, Martin M. Monti, said in an interview that he and his colleagues were "absolutely stunned" when, watching the shadowy images of Subject No. 23's ostensibly vegetative brain, they detected clear responses to yes or no questions.

A staff neuroscientist with the British government's Medical Research Council, Monti said the possibility of unlocking the wishes of previously mute patients "certainly contributes to the debate" over a patient's right -- and ability -- to express his or her desire to die. But that was not among the questions asked of Subject No. 23, he said.

Several times when Subject 23 was asked to imagine playing tennis, Monti said, the region of the brain most closely associated with complex motor planning became highly active, and stayed active for 30 seconds after researchers prompted such imagery by saying "tennis."

Similarly, when researchers asked the patient to imagine walking through the house where he grew up and then said the word "navigate," Subject No. 23 responded with bursts of activity in the region of the brain involved in constructing and navigating a mental map.

The young, French-speaking man was the only subject who was then trained to answer simple yes or no questions -- whether his father's name was Paul (yes) or Alexander (no), whether he had siblings and how many -- using the imagery technique he had already learned.

Checking the patient's responses for accuracy and comparing them to the yes-no brain responses of a group of healthy volunteers, researchers discerned that Subject No. 23 was not only still "in there," but capable of purposeful thought and communication.

Ghajar cautioned that the failure of some patients to show responses could have a wide range of meanings: that they were temporarily asleep or unconscious; that they could hear and understand, but not sustain their focus long enough to answer; or that they had no conscious awareness at all.

Bioethicist Arthur Caplan said the study would complicate decisions about sustaining life in the netherworld between alertness and unresponsiveness.

"The more these measures of consciousness get complex and fine-tuned, the harder it is to write a recipe about them" in advanced directives, said Caplan, director of the University of Pennsylvania's Center for Bioethics.


  1. ..." Terri Schiavo, a 41-year-old heart attack victim who languished, unresponsive, for 15 years before a Florida judge allowed the removal of the feeding tubes that had kept her alive."

    Says who? Not those that loved her and stayed with her and worked with her, sustained by the first hand observation and knowledge that Terry was still there, different, altered and able to find joy in their company.

  2. Shiavo was in a persistent vegetative state due to a heart attack. The findings of this most recent study would mostly help victims of things like traumatic brain injury, not people who experienced a lot of time with no oxygen to the brain resulting from things like stroke or cardiac arrest, like Terri.

    But in addition, the doctors performing her autopsy found that all areas of her brain were severely damaged, and especially since her pyramidal neurons were lost. Not dead, not damaged, not even damaged and *maybe* healing. Gone. Those are core components of the nervous system, and there is no way that Terri was conscious or communicating with those around her. In the words of Chief Medical Examiner Thogmartin in Largo, FL, the damage was so extensive it was "irreversible, and no amount of therapy or treatment would have regenerated the massive loss of neurons." While I sympathize with those who loved her, I cannot help but believe they were overly influenced by their familial love of Terri and took the vocalizations and eye movements as signs of her consciousness--when really they were just reflexive movements caused by nerves that still worked but had no functioning brain to control them.

    I knew when I heard that story over the radio earlier today that people would dredge up the Shiavo case again. It's amazing that the Shiavo case's true believers still exist--especially after the damning autopsy report. But what's even more sickening is that even after five years those same true believers are still trying to put blinders on themselves--whether it's ignoring the Chief Medical Examiner's report, or bending scientific studies which they have little to no scientific knowledge of in the first place.

  3. To bad she had to starve to death, a fate that is considered cruel and inhumane, if done to criminals or prisoners of war.

    When the Judge decided that her life should be terminated, he should have had the courage of his convictions and had her lethally injected.

    Not starved.

  4. And who should have funded the continued, life long, hospital stay that Ms Schiavo would have required if her life had been prolonged?

    And after her parents died, who would be there, to provide emotional care?

    Exorbitant and extraordinary medical efforts to sustain lives that are not recoverable, or efforts that are not cost effective should not foisted upon the public as necessary or moral.

    Where's the justice in that?

  5. Judges do not judge based on their convictions, they hand down decisions based on current law--and thank god for that. The current law says that as her husband, he is her primary guardian. Her parents were not. Some may say that is unfortunate, but that's the way it is (was). You know full well that the judge was not ordering her death, it was the decision of her husband, who she signed a legal agreement with at the time of their marriage giving each other the right to make these tough decisions in end-of-life matters. The judge was merely upholding the law, and the law stated that Michael Shiavo--again for clarity, as her legal guardian--had the right to remove the artificial means keeping her "alive."

    Also, Terri "starved" to death in the same sense that my petunias "starve" during a long dry stretch in the summer. If you read my previous comment, no reasonable person would believe that someone whose brain was missing as much matter as this ( would be conscious at all, let alone be aware of thirst, hunger, or even a runny nose. In that image, the dark parts in the scan of her brain (which is even only from one angle...) are actually spinal fluid, with the lighter parts being what grey matter had remained that basically floated around. The woman was nothing but physical body and nerves. As such, this "emotional care" you wish for Terri would have been for naught, and I think her parents would have benefited from that more than she ever would have responded to.

  6. Yes, damn the bastards.

    Her parents wanted to keep her alive and would care for her. Terry Schiavo became a poster child for the Death with Dignity crowd.

  7. Death by starvation not only effects the one that is dying, by that method, but those in the immediate vicinity.

    It is a barbaric practice, when a lethal dose of barbiturate would better end the torment, for the living.

    When the practice of starvation is ordered by a Court, it is all the more immoral, staining us all with the inhumanity of prolonging a life already lost.

  8. So here's the thing: It's supposed to start snowing early tomorrow in DC and continue, becoming progressively heavier, for two days. Total accumulation may be up to 24 inches.

    Sunday is the Superbowl.

    Given the panic-buying that goes into effect when three or more inches are forecast in the Metro area, combined with the need to stock up for Superbowl Sunday, all the beer, chips, and chicken wings - along with the usual bread, milk, and (mysteriously) toilet paper - in MD, VA, and the District will be gone by noon tomorrow.

    Two such gloriously silly, time-honored traditions rarely coincide. This may be one for the history books.

    The Washington Post, Federal paper of record in a charmingly (YMMV) self-obsessed town, has dispatched entire teams accordingly.

    Note: Those without sleds may want to procure same from already slim stocks during today's lunch hour(s), lest you you find yourself stuck with merely a sodden piece of cardboard as was the case on the last Federal Sledding Holiday. And remember, drunk sledding (please WALK to your nearest hill) is rarely prosecuted in either state or the District.

    Now back to the grave discussion at hand.

  9. Bwahahahaha....drunk sledding. I live one block from a golf course.

  10. Eli Lake, Washington Times.

    The five senior leaders of the U.S. intelligence community told a Senate panel Tuesday they are "certain" that terrorists will attempt another attack on the United States in the next three to six months.

    The warning came during the annual threat briefing to Congress in response to questions from Sen. Dianne Feinstein, California Democrat and chairman of the Senate Select Committee on Intelligence, who asked, "What is the likelihood of another terrorist-attempted attack on the U.S. homeland in the next three to six months? High or low?"

    "An attempted attack, the priority is certain, I would say," Director of National Intelligence Dennis C. Blair, a retired admiral, said in response. Four other intelligence agency leaders who appeared at the hearing with Mr. Blair said they agreed with the assessment...

  11. Cartel v. Cartel:
    Mexico’s Criminal Insurgency

    by John P. Sullivan and Adam Elkus

    As the decade ends, Mexico’s criminal insurgency continues. Yet the narco-war in 2010 is not identical to the violence that began three years ago. Mexico’s criminal insurgency at the beginning of 2010 is distinguished by three main trends: continuing (though increasingly diffused) violence against the state, increasing militarization of the Mexican state’s response, and a growing feeling of defeat among some within Mexican policy circles. Additionally, the conflict has assumed broader transnational dimensions.

    On the surface, the conflict has entered into a period of seeming stasis. But it is a bloody stalemate—and the war promises to continue simmering well into this year and beyond. According to the Mexican press, 2009 may have been the bloodiest year of the war, with 7,600 Mexicans perishing in the drug war. Whatever the nature of the conflict, the danger still remains to American interests. As we have noted before, loose talk of a Mexican “failed state” obscures the real problem of a subtler breakdown of government authority and bolstering of the parallel authorities that cartels have already created.

  12. We're back in western Pee-Ay, where rather modest accumulation is anticipated, til Sunday and so will miss much of the happy, anticipatory chaos.

    Our driveway in McLean, however, will make a fine sledding hill all on its own and bonus: The beer fridge graciously left by the owners in the garage is but steps away.

  13. "When the practice of starvation is ordered by a Court, it is all the more immoral, staining us all with the inhumanity of prolonging a life already lost." --desert rat

    Wow, you really can't read, can you? I suppose I should give up arguing on a political blog where discussion gets derailed by one comment about the weather (a sign in and of itself), but I'm a sucker for pain. desert rat you didn't address one of my points, you just kept posting the same kind of things I'd expect from a SarahPAC newsletter. 100% emotional appeal, no evidence, no facts.

    I already told you the judge didn't order her execution, and her "death by 'starvation'" was not ordered by a court. You're resorting to histrionics because you're losing the debate. It was a LEGAL decision by her LEGAL GUARDIAN, yet you went right on equating the judge with a murderer. Christ man, you don't even have the excuse of there being a ton of replies in between, it was literally one post after mine. I suppose you have to protect your indefensible positions by reflexively denying everything contrary to your patently false opinion. Why let something like facts get in the way of your beliefs? Go ahead, keep on blaming "judicial activism".... (judicial activism meaning federal judicial decisions that don't match up with whatever you happen to believe)

    Furthermore you went on talking about how poor little Terri was starving. I told you previously about her neurons being completely broken down and replaced by spinal fluid. Even your illiteracy is still no excuse, because I even linked to a picture. She was straight-up brain dead, and only "alive" in the sense that machines kept her physical processes working.

    Actually, you know what, if I was as demonstrably wrong as you are, I'd probably ignore facts to the contrary to my misguided opinions, too...

  14. "Her parents wanted to keep her alive and would care for her. Terry Schiavo became a poster child for the Death with Dignity crowd." --trish

    And you're exactly right, because this case was so clear-cut that it's when the Bush administration really began to lose a lot of people's support due them waking up and realizing social conservatism is completely out of line with the direction of our country. Name me one highly contentious socially conservative position that withstood the test of time. Social conservatives lost the struggle over civil rights for both blacks women, abortion (yes, it's over, you lost. RvW is never getting overturned), prohibition, battles over what constitutes obscenity of all types, and many, many, more. When will you learn?

  15. Whoops, forgot to say that very soon you'll be losing the fights over gay marriage (and things like DADT) and marijuana too! :)

  16. Interesting that you would gleefully think those topics were related: brain injury, euthanasia, gay marriage and hallucinogens.

    Find another blog DADT is more to your taste.

  17. Ostriches that keep their heads in the sand eventually get eaten by lions.

    And euthanasia, gay marriage, and the prohibition of drugs or "hallucinogens" (THC is not hallucinogenic but what the hell, you guys wouldn't expand your minds if a gun was to your head) certainly are related in the context of social liberalism, which has over time prevailed over every conservative force acting against it in the course of American history. I defy you to find a social issue in which it hasn't, or a current social issue in which the trajectory does not lean that way.

    Just a note, you talked about euthanasia. Terri Shiavo was not euthanized. She was brain dead. I swear to god, I've addressed this in every reply here over and over and you guys Just. Don't. Get. It. I'm really hoping deep down you actually do, and are just pretending you don't, because holy cow.

    Give it up and let it go, there was no one there for you to save.

  18. Hey axle, there's the door. Beat it!

  19. That's right. You cannot argue your points in a fashion that will convince others, nor can you refrain from using hysterical emotional appeals (which would have no basis in reality). Just tell me to leave. Yeah, that's the ticket! Well, I'm convinced!