Diagnosing Terri Schiavo's brain damage

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With regard to this offer:

It is difficult,if not meaningless for a physician  to make a diagnosis, of  "persistent vegetative state"on the basis of  a head CT scan alone.  Physicians, in general, do not rely on a single test to make a diagnosis. In fact in medical school they are generally taught that approximately 60—70% of a diagnosis  relies on the patient's history, 10% on the physical/neurological exam,  10% on lab tests and 10% on radiological studies such as X—rays and CT scans. 

It is very rare that a specific diagnosis,let alone a diagnosis as vague as "persistent vegetative state"can be made on the basis of one of these criteria alone, and  physicians almost never do so.  Terri Schiavo's medical history was that 15 years ago she suffered an episode of loss of oxygen to the  brain that destroyed a significant number of her brain cells . She had  remained severely physically and mentally debilitated ( paralyzed, loss of bladder and bowel control, legally blind, unable to speak or understand the spoken word, incapable of rational thought, probable inability to voluntarily chew and swallow) since that time.  I

In general brain cells, unlike most other cells in the body, have a very difficult time regenerating. Her head CT scan which revealed a severe shrinkage of the portion of the brain controlling rational thought  speech,voluntary movements, and visual  interpretation was another (not the sole) indication of her severe brain damage. There  are indeed other medical conditions, particularly in the elderly, that can give rise to a similar appearing head CT scan, but such patients do not have Terri Schiavo's medical history or severe neurological debilitation. 

Taking all of this together a reasonable  conclusion is that Terri
Schiavo's brain damage was extensive and that she had no chance of
recovering from such severe brain damage.

Steve Collins, M.D.

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