Make no mistake that even a "routine" tonsillectomy is no walk in the park. I had one in 1978 at the age of 31, after repeated bouts of tonsillitis going back to my childhood. 'Enough was enough' as they say. I was fortunate to have one of the best ENT surgeons in Barbados, but even so the blood loss after I emerged from anesthesia was significant. As I came to in the ICU I saw and heard nurses screaming at me "No! No! Don't spit up the blood!" They were referring to how it was collecting in my mouth and my instinctive reaction to spit. The alternative was to swallow it and block my breathing passages. However, spitting wasn't the solution as it risked bursting the sutures. (Bear in mind I was still under the influence of the anesthesia).
After some hours the bleeding stopped and I was able to eat a small cup of vanilla ice cream, but could only make hand signals and write on note paper to communicate to my smiling wife. I wrote:
"HURTS! Like HELL!"
But let us understand that despite over one hundred media reports, Jahi McMath did not have an ordinary tonsillectomy. In this case, we have yet another instance in which our corporate media dropped the ball and either believed the actual operation was too complex for the public to grasp (disrespecting the intelligence of their readership) or they deliberately misrepresented it as a "routine tonsillectomy"- for whatever reasons.
According to Brandon Peters, M.D. at About.com
“There is a paucity of known facts in this situation. The family and their lawyer have released few specific details. Oakland Children’s Hospital, bound by the privacy restrictions of the Health Insurance Portability and Accountability Act (HIPAA), has offered even less. Jahi underwent three surgical procedures for the treatment of her sleep apnea. This included a tonsillectomy, uvulopalatopharyngoplasty (UPPP), and removal of nasal turbinates. Though initially described as a “routine tonsillectomy,” this degree of surgery in children is not routine. It is extensive. When performed on a child, the risk is high. “
Readers can see more here and on uvulopalatopharyngoplasty (or “UP3″) and its indications and further information on the associated risks here. It should be apparent that with the paucity of facts available it is too early to begin speculating what went wrong in Jahi’s case and what kind of medical negligence - if any- might have been involved.
What does seem clear is that brain death has occurred and according to California law this qualifies as actual expiration. The technical term used is known as a permanent vegetative state, or PVS. It means basically that when the patient is hooked up to an electro-encephalograph (EEG) no brain activity is registered, or recorded. The person, for all practical purposes, is a vegetable and there is no going back to any normal state. The only way the person can be kept alive is by extreme life support systems, e.g. respirators.
The PVS state is not to be confused with being in a coma. A statistically significant number of people have come out of prolonged comas, but no human in recorded medical literature has ever returned to functional consciousness after being in the PVS state. It is right here where the debate over Jahi's future care resides, especially after a
Jahi's parents are fighting to keep her sustained as they believe she is still alive on account of sporadic motions when they're with her. But as medical specialists have pointed out such nerve responses don't prove functional consciousness. Despite that, the family has its staunch defenders.
Wendy Patrick, a prosecutor and a working minister who is versed in the theological and legal arguments of the debate, has said the issue is particularly pointed because of the number of cases over time in which individuals have "revived after being declared dead". But let us again bear in mind those were medical errors since no one can return after being literally dead or brain dead. In those cases then, the "declarations of death" were premature and the person wasn't really in PVS.
Patrick went on to cite a 2007 case in which an
But again, this is nonsense. No one comes back to life after being genuinely dead, and we know the Lazarus story, like most biblical accounts, was a myth - designed for spiritual inspiration not factual ingestion. Can a person in a coma return to consciousness? Of course! But this is not the same as "returning from the dead".
What is needed then, is a final determination of Jahi's condition by medical professionals in the field of neurology, neurological function and PVS.
Interestingly, even the more educated religionists believe this case is closed. According to the Rev. John Paris, a professor of bioethics at
Indeed. But PVS is certainly a pretty clear condition once the EEG is properly interpreted and there is confirmation.
The last hope for Jahi McMath to be kept on a ventilator (past Jan. 7th) may come from a former Long Island hairdresser who runs a brain-injury treatment center dedicated to Terri Schiavo, the Florida woman whose case sparked a fierce nationwide end-of-life debate lasting almost 15 years and which was final resolved nearly a decade ago. (On Tuesday, the Terri Schiavo Life & Hope Network said publicly for the first time that it has been helping Jahi's family for weeks to find a place to transfer her.)
Meanwhile, the news of Jahi's possible transfer came as the California Department of Public Health confirmed Tuesday it is investigating Children's Hospital Oakland and its handling of the Oakland 13-year-old after her tonsil surgery and two other procedures to remove throat and nasal tissue, complications from which left her brain dead.
Let's hope that no other family has to endure such a medical and ethical morass engendered by assorted advances in medical technology, i.e. in maintaining life while pushing our boundaries – moral, legal, and practically – of the concept of death.