Jahi McMath: Follow-up

After I posted my thoughts on the Jahi McMath case a good friend of mine (Hi, K.S!!) e-mailed me this article that posits Jahi can regulate her own body temperature, therefore her hypothalamus is working, and therefore she is not brain dead.

I'm always fascinated in what people think of these issues and instead of just waving things to the side as nonsense, I try to look at things in a logical sense to see if they have merit. I think all people on BOTH sides need to do this.

Now, it is an interesting point that if she can do this-- is part of her brain functioning?

The first thing to note is the post is authored by Dr. Byrne whose bio states is a certified neonatologist and pediatrician. I mean, to be honest, his bio is impressive. It seems he should be quite knowledgeable in this area.

The first issue I have with his article as that the medical information he has is not sourced. So, how did he get this information? He doesn't state in his own piece that he examined the child though this article states he did. But if you read through Dr. Byrne's piece-- it seems as though he has collected facts from elsewhere. I mean, why not say, "I examined Jahi and these were my findings."

At one point, the doctor states:

"The 'poor care' I am referring to here is the prolonged starvation; the protracted and unnecessarily repeated apnea testing conducted in a potentially deleterious manner; the deprivation of needed thyroid medication; refusing to treat an adrenal gland problem that arose; et cetera."

From the hospital stand-point, they were waiting for her family to come to terms with the brain death issue-- which is likely why they weren't feeding her. My guess is they were providing IV fluids to keep her hydrated. The apnea test he refers to is a test for brain death and he doesn't expand on what he thinks was deleterious. The deprivation of thyroid medication actually supports the theory of brain death because her brain was not signaling to produce these hormones-- and same with the adrenal gland issue.  

The only other instance I found that mentions her self-regulation of body temperature is this article where her attorney, Christopher Dolan, states this. Well, one, he's not exactly unbiased. And two, I'm always wary of medical information coming from a non-medical person. BEWARE. I mean, don't come to me for advice if you're in jail. What makes me more suspicious is that Christopher Dolan, according to this article, is trying to change state law from using brain death as legal death. He sates it should always be the family's decision to terminate life support--- not the state's.

This is my personal opinion but the more he keeps this case in the forefront-- the more he is paid. I may be cynical but he has reasons other than family advocacy to keep this case going ($$$ and notoriety to name a few.) I pray he is doing this for the right reason.

This is just a big can of worms. Again, I am pro-life. I believe in the value of life but there does come a point that because we can doesn't mean we should and, for me, prolonging a death is just that.

What about you? What should be considered legal death: the heart stopping or loss of brain function? Who should decide to withdraw care when there is no hope of recovery?

Do Nurses Ever Stop Caring? End of Life Issues...

There is nothing that distresses me more than watching a television show, seeing a movie or reading a book that says something akin to the following..."He's going into hospice. They're not going to care for him anymore."

Honestly, boils my blood.

When I was in nursing school, I spent six weeks caring for a hospice patient. Our community health instructor first asked for volunteers. I remember her saying, "It's for six weeks but he is expected to live several more months."-- implying that we wouldn't have to deal with his death.

Let me first say no human can put an expiration date on you.

It came down to a lottery and my name was drawn.

He was in his mid 60s and was diagnosed with multiple myeloma-- which is a type of bone cancer. I would visit he and his wife at their mobile home to make sure his needs were met. They had a feisty, young golden retriever that was one huge, butterball of energy that greeted me at the door every visit.

My non-care (yes-- that is dripping with sarcasm) included pain management (helping the family choose a PCA pump, instructing them in how to use it, etc) and discussion of end of life issues. This includes a lot of talk about where you think you're going to end up. Heavy, spiritual issues.

I was just twenty-one.

As we were talking one day, he said he'd really like to go up to the mountains. Unfortunately, he was bedridden. The previous summer, I spent a camping trip in Rocky Mountain National Forest and had some pictures.

I brought him this huge pile of photos. I said, "I'm really sorry you can't go to the mountains but perhaps you could pick one of these photos and put it by your bed to help you visualize being there."

And that's just what he did. Took a red, push-pin and shoved one of those photos right into the wall.

A visit shortly after that and the normally exuberant golden retriever was inconsolable. He would not leave this gentleman's side and in my heart I knew that was the last time I would ever see my patient alive. He died within a few days.

I went to the funeral, with some other members of my nursing class, and I still can hear the bagpipes play in that church and how my soul just ripped apart at the grief of his widow. He truly touched my life in those short few weeks I was with him.

After the funeral, my class went to a Chinese restaurant for lunch. My fortune cookie said, "Your kindness to another will not be forgotten."

I don't know... call it what you will, but I think that was a God wink.

His wife gave me that picture back and told me how often she would find her husband just staring at it. I still have that photo and that fortune in a frame some twenty years later.

Please, do not make the mistake of EVER saying that medical personnel stop caring for patients when they have made the choice to forgo further lifesaving measures.

There is much care that is done, very humbling, straight-at-the-heart moments and hospice nurses are truly angels on this earth.