Terri Schiavo and the “Unconscious” Interactive Patient

I can’t let it go: I just can’t.

A lot of people thought about poor Terri when it was revealed that a British patient diagnosed as PVS was clearly interactive, based on MRI testing. That brought to many people’s minds, mine included, the request of Terri’s folks that she receive a test that would measure brain function rather than mere structure. This was refused adamantly by Judge Greer.

I have been checking to see if the test used on the British woman would have been usable with Terri. The answer is no. The test in the British case was a form of MRI. Terri couldn’t have an MRI because the strong magnetic field generated by the test would not have been safe due to the fact she had electrodes implanted in her brain from an experimental procedure she received early in her disability.

However, she could have had a PET scan, which uses radiation to measure function. This was the test the Schindlers requested. Which raises the question of whether a PET scan could have provided the same kind of details about Terri that were revealed about the British patient from the MRI. So, I have been asking doctors I know to find out.

One doctor, a neurologist, told me the PET would indeed have been able to measure the extent of Terri’s brain function. But a different doctor, a brilliant man with 5 board certified specialties, but not in neurology, told me that while the PET could have measured function, it couldn’t have delivered the kind of sophisticated results that were described in the UK case. Based on what both these physicians have told me, it seems that some measure of function could have been measured, but not the kind of quick snapshots of specific brain centers firing when the UK patient was asked, for example, to imagine herself playing a game of tennis.

Still, the bottom line is that while Terri was lying in the bed waiting for the appeals courts to deliver her death warrant, it would have done no harm to give her a PET scan to see what could be seen. Nor would it have harmed anyone for Judge Greer to have permitted very respected rehabilitation therapists, who believed they could have helped Terri relearn how to swallow on her own, to give it a try. Judge Greer’s adamant refusal to permit a PET scan and therapy is inexplicable—if,that is, he wanted the fullest record possible before the helpless woman he was duty-bound to protect was dehydrated to death.