Spinal Reflexes and Brain Dead People

In a recent post, I mentioned having learned that “There’s an area of your brain that handles a reflex to turn your head and look before you even form the question ‘What was that streak of orange and roaring noise?'” While this is true, it’s a relatively complicated reflex. There are some reflexes so important that they are completed before any message is sent to the brain at all! A good example of this is pulling back from something that hurts you. You’ve already reacted to the hot pan in your hand or the LEGO you stepped on in the dark before you ever think “Ow!”

One way this was demonstrated in lab was with a short film of a frog that had been “pithed.” It used to be done commonly in some science classes but by watching the film, it didn’t have to be repeated in every lab, every semester. The college saves money, fewer frogs die, we still learn. This procedure does render the frog brain dead: the parts of the frog that say “Heart, beat!” or “Lungs, breathe!” still work; the parts that say “I’m hungry” or “I like lily pads” or “Ow!” are gone. Over the course of this short film, we watched the frog react to painful stimuli using nothing more than spinal reflexes (regrettably, I can’t find a Youtube clip in English that demonstrates well). We were reminded by the narrator several times that the frog is not feeling anything, is not “trying” to do anything. The parts of the brain that feel or try were gone. It’s just reflexes.

At the end, the lab instructor — an older lady who had initially trained as a nurse in Brittain’s Army — told us that we needed to remember this film because those of us going into patient care were likely to someday encounter brain dead patients and their families, and their families would be desperate to attribute reflex movements to improvement in their condition. In fact, she remembers that the first time she saw these reflexes in person, “It scared the bejabbers out of me!”

And this brings me to the sad story of Jahi McMath. Last month, tonsil surgery went wrong for Jahi. She experienced severe bleeding, cardiac arrest, and brain death. She is currently on a ventilator — the part of her brain that would say “Lungs, breathe!” doesn’t work anymore either. The brain death was confirmed by no fewer than 5 licensed physicians, 3 of whom were selected by the girl’s family. She’s actually been declared dead. Nevertheless, the family has hopes that she will get better and wants her transferred to another facility. One doctor says he thinks the girl is not brain dead because “he visited Jahi’s bedside and observed her responding to her grandmother’s voice and touch with a squirming movement.”

Now, I’m not a neurologist, but I think I’ll take the word of multiple neurologists and other doctors over the word of one pediatrician who thinks he saw something that can be explained by simple spinal reflexes.

Talks to allow transfer this unfortunate young lady to another facility are ongoing at this moment. In the highly emotional words of the hospital’s lawyer: “It’s horrible that this child has died. It’s also horrible that it’s so difficult for her family to accept that death.”

In Closing: pre-employment credit checks; college education; sequestration; “reality” TV; deliberately hard maybe?; “Hi guys!”; Bill!; and doge.

 

What IS the Matter with Kansas?

So Kansas wants to make it perfectly legal for a doctor to lie to a dumb bitch pregnant woman. Let me provide my own commentary on the ACLU’s points:

It would provide legal protection to a doctor who discovers that a baby will be born with a devastating condition and deliberately withholds that information from his patient because he doesn’t want her to seek an abortion. That means a doctor could decide to lie about the results of a woman’s prenatal test so that she won’t have information that she needs to make the best decision for her circumstances.

In other words, a doctor can make a woman give birth to a baby with birth defects that she can’t provide for financially or emotionally. Sorry, the days of “put the abomination in an institution” are long over. I’ve already discussed that this is fraud.

The bill attempts to scare women by forcing doctors to tell patients about a supposed link between abortion and breast cancer — a risk that the National Cancer Institute, the American Cancer Society, and other medical experts roundly reject .

Doctors are not only allowed to lie to patients, they are forced to lie to patients.

This bill would also require public hospitals to turn away a woman who desperately needs an abortion to prevent serious harm to her health. The extremists pushing this bill would have a hospital tell a very sick woman that she should come back when her pregnancy is about to kill her, even if that risks her future fertility or causes organ failure.

I’m not sure what the definition of “public hospital”  is here: hospitals owned by government entities (rather than corporations or charitable organizations) or just hospitals open to the public. Nevertheless, this is like telling someone with chest pains to come back when they are sure it’s a heart attack.

Now here’s the thing. Where are the doctors on this? Why aren’t doctors screaming that this law puts women in danger? Why aren’t doctors pointing out that this bill requires them to lie to patients? Why am I the one pointing out that even with this fig leaf of a bill it’s going to bite doctors on the ass to tell a patient that everything is fine when it isn’t?

AMA? AOA? ACOG? This is the second state that wants to say it’s acceptable to conceal important medical information. I don’t even know how many states require doctors to lie about breast cancer. At least one state requires expensive, medically unnecessary procedures before an abortion, and more states are considering it. Where’s your statement on this? How does this square with your legal and ethical requirements to do the right thing for patients?

How long before employers decide they just can’t do business in a state where their female employees face obstacles to sometimes (regrettably) medically necessary care, and where a routine pregnancy can mean losing employees who must become full time caregivers for a baby with severe birth defects?

In Closing: Ninja; that resume can go in the trash; on J.P. Morgan; how did we get to a lunch revolution?; and NAFTA vs. China.