Friday, January 1, 2016

Really most sincerely brain dead?


On Christmas day, a friend posted a link on my Facebook timeline to an article about a tabloid-ready story of a father, George Pickering II, who held a three-hour stand-off with the police, initially at gunpoint, to prevent a hospital in Texas from putting his son on a "terminal wean," after they proclaimed him brain dead. That means they were slowly withdrawing his life support. Another son disarmed their distraught father.

The doctors had convince that son and their mother--the father's ex-wife--to allow the supposedly brain dead George Pickering III to die. I guess a terminal wean is supposed to be gentler than yanking the plug, slowly easing him into his grave. The hospital contacted an organ donation center that a death was imminent.

The hospital had appointed his ex-wife and other son as guardians of George, Jr. The father admitted that he was drunk when he pulled out his gun, but his desperation was real. “I felt hopeless," he said. "They were moving too fast. The hospital, the nurses, the doctors.” His son had suffered a stroke, but he was convinced that his son wasn't brain dead. And indeed, during the siege, his son squeezed his hand on command three or four times. That reassured him that he would be able to convince the hospital that the junior Pickering wasn't in fact brain dead, and he eventually surrendered.

Was he fooling himself? Out of his mind with denial? Or just drunk? No, no, and no. The standoff occurred in January of 2015, Today, George Pickering III is fully recovered. This is what he has said about his dad's actions, "There was a law broken, but it was broken for all the right reasons. I’m here now because of it."

There are so many things about this that are disturbing that I hardly know where to start. When I recounted the story to Keith and Joella, I was surprised at the level of anger I felt welling up. First, how could they so confidently proclaim the son brain dead? If they had performed a simple EEG on him, they would've seen that he still had brain activity, as mine showed. My doctors never said I was brain dead, only that I had "profound brain damage."

Next, there was the rush to "harvest" George III's organs. Um, maybe we should wait until they're actually brain dead, what do you think? I'm a strong believer in organ donation--I'm a donor myself, if any parts of me are still useful. But this ghoulish eagerness to give up on him and give his organs to someone else, who is of course very deserving of them, if it weren't for the fact that George III is happily still using those organs.

One of the reasons people are afraid to be donors is that they fear there might be just such a hasty decision to call them dead while they're still fresh, so to speak.

But I have to go back to the diagnosis of brain death by the Tomball Regional Medical Center in Houston. Not being a doctor, I can't imagine what lead them to this conclusion. They couldn't have followed any of the standard procedures to diagnose brain death, which is irreversible. Once brain death occurs, there can be no recovery. And the diagnosis should be pretty cut and dried.

However, a few days after I learned of the Pickering's drama, I read a shocking article in the LA Times about the differing definitions of brain death among hospitals. Many of their protocols haven't kept pace with the science of this literally life-or-death diagnosis.

I'm reminded of the issue I've pondered countless times about the one in five consciousness disorder patients with covert cognition. How many of them have had their plugs because they were written off as basket cases, as I was? But until now, I didn't have the same worry about those who have been diagnosed as brain dead. After all, nothing more could be done for them...assuming they're really most sincerely brain dead.

Obviously, you can't endorse the father's desperate gambit, but you can certainly sympathize with his desperation. After all, he yelled, "I'll kill you all," as he pointed his gun at hospital personnel. But, the fact that his son was about to have his life support shut off, yet he's now fully recovered, does tend to lend credence to his sense of urgency to action. The courts seem to have agreed. One of the charges against him were dropped, and the other was reduced to time served. This is what George Pickering III went on to say:
It was love. It was love. It’s the duty of a parent to protect your children and that’s all he did. Everything good that made me a man is because of that man sitting next to me.”
And he was sitting there because of him, too.

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Coma Girl

Coma Girl

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In July of 2013, I fell into a six-week coma and nearly died. When I awoke from the coma, I could barely lift my head. It has been a hard road to recovery. The doctors advised my loved ones to give up all hope for my full recovery, but while they were shining lights in my eyes to gauge my level of consciousness, I was telling them grumpily to leave me alone because I was trying to get back to sleep...in my coma-dream. I was experiencing covert cognition, and the coma-dream was my version of a near-death experience. I'm a skeptic, so I saw surreal images instead of spirits or dead loved ones. According to my research, as many as one in five people with consciousness disorders have covert cognition.

Not a miracle recovery, but a miracle of modern medicine

In 2013 I fell into a six-week coma and nearly died after I contracted legionella. The Legionnaire's disease was in turn triggered by immunosuppression caused by the prednisone I was taking for my rare autoimmune disease, dermatomyositis.

I suffered a series of strokes on both sides of my brain when the sepsis caused my blood pressure to plummet. I fell into a deep coma. My kidneys and lungs began to fail, as my body was began dying one organ at a time. My doctors told my loved ones to give up hope for my full recovery. They expected me to die, and even if I somehow lived, I would remain a vegetable or at best left so hopelessly brain-damaged that I would never be same. But unbeknownst to them, while they were shining lights in my eyes and shaking their heads, I was telling them in my coma-dream--my secular version of a near-death experience--to leave me alone because I was trying to get back to sleep. I was experiencing what is known as covert cognition, the subject of my Skeptical Inquirer article "Covert Cognition: My So-Called Near-Death Experience," which appeared in their July/August issue.

But it wasn't a miracle--despite what so many continue to believe--that I recovered so fully. I owe my life not to God, but the miracles of modern medicine, as well as the nature of the watershed-area brain damage I suffered, as I detailed in my article and in this blog.