Fighting for Dear Life

by David Gibbs

  Tossing a jab at the Schindlers, he quipped, ‘‘Terri Schiavo’s parents apparently believe something like that.’’3 Olbermann then introduced Jay Wolfson, Terri’s former court-appointed guardian ad litem in 2003. While I’m sure Mr. Wolfson meant well, his comments were often far from objective—or even factually accurate. His mixture of personal editorial and misstatements went unchallenged by Olbermann.

  For example, Mr. Wolfson asserted, ‘‘What this report does is it helps us, I think, say we’ve learned as much as we can learn. We’ve learned as much about this tragic case, clinically, medically, scientifically, and legally, and it closes the door.’’

  It closes the door? Really?

  Let me direct you to the concluding statement by the medical examiner on page nine of the autopsy report. Dr. Thogmartin wrote:

  It is the policy of this office that no case is ever closed and that all determinations are to be reconsidered upon receipt of credible new information. In addition to fading memories, the 15-year survival of Mrs. Schiavo after her collapse resulted in the creation of a voluminous number of documents many of which were lost or discarded over the years. Receipt of additional information that clarifies outstanding issues may or shall cause an amendment of her cause and manner of death.

  Clearly, the door has been left wide open. Wolfson went on to misstate:

  This autopsy did not have to be performed. Michael agreed to have it performed. . . . By allowing it to be done, I think Michael has helped all of us to put some closure on this.

  Perhaps Mr. Wolfson was parroting Michael’s attorney, George Felos. In a hastily organized press briefing the day before Terri died, Mr. Felos claimed that Michael had requested an autopsy because ‘‘he believes it’s important to have the public know the full and massive extent of the damage to Mrs. Schiavo’s brain.’’4 But Bill Pellan, the director of investigations for the medical examiner’s office, dismissed this as grandstanding. Pellan said, ‘‘We have determined to be involved because of the statutes . . . not because Michael Schiavo wants us involved.’’5 He was referring to Florida Statute 406.11, which requires an autopsy in the case of cremation or if someone dies in an ‘‘unusual circumstance.’’ Terri’s death most certainly fit that classification.

  Let me ask you something.

  If Michael wanted the public to know ‘‘the full and massive’’ damage of his wife’s brain, why wait until she was dead? He could have more accurately determined this information while she was alive through modern functional brain studies. The Schindlers had repeatedly requested that Terri be reexamined in 2005 before the court’s order was carried out. Terri had not been examined since 2002. Functional MRIs, SPECT imaging scans, and other evaluations, neurologists tell me, could have provided more objective information to confirm Terri’s awareness of external stimuli. Furthermore, it’s confusing how, on one hand, Michael denied Terri visitors, trips to the mall, or appearances in court supposedly because he was trying to protect her privacy. But suddenly he wanted ‘‘the public’’ to know how damaged she was after her death.

  And the press went along for the ride.

  In my view, what the IME reported doesn’t erase the moral shame of what happened. The quality of a person’s life and the hearsay testimony of a spouse—who has moved on to another committed relationship— regarding end-of-life medical treatment wishes should never again become the basis for which life can be ended. Ever.

  CHAPTER NINETEEN

  THE $64,000 QUESTION

  Why did Florida put Terri Schiavo to death? Because that was the demand of a husband who refused to divorce her and denied her medical care, while he lived with another woman. Michael Schiavo is the ACLU poster boy for family values.

  —PATRICK J. BUCHANAN1

  At the outset I mentioned the Schindlers’ case hinged upon two simple legal questions:

  AWhat was Terri’s medical condition?

  What were Terri’s wishes about ending her life in the case of a medical tragedy?

  As to the first question, the court ruled Terri was in a persistent vegetative state (PVS); regarding the second question, Florida law allowed the court to rely upon hearsay evidence to conclude Terri would want to suffer a horrific death rather than live as a disabled person who was loved and cared for by her family. As we saw earlier, Terri left no written instructions expressing her own wishes.

  Understandably, when the independent medical examiner, Dr. Thogmartin, filed his autopsy findings, the $64,000 question on everybody’s mind was this: Had Terri been in a persistent vegetative state as the court had ruled? Could she feel pain? Could she think? Did Terri really recognize her mother and cry when Mary left the room? Or was Judge Greer right when he insisted that ‘‘all of the credible medical evidence this court has received over the last five years’’2 pointed to her being cognitively unresponsive?

  Dr. Thogmartin began by making it clear that ‘‘PVS is a clinical diagnosis arrived at through physical examination of living patients’’ (emphasis added). Terri was dead. How, then, could Dr. Thogmartin make a definitive postmortem determination as to whether or not Terri was in PVS? He couldn’t . . . and didn’t.

  You might want to read that again.

  The IME did not declare Terri to be PVS.

  About as close as he got was to rely upon the findings of consulting neuropathologist, Dr. Stephen J. Nelson. Let’s not forget that Dr. Nelson never saw Terri when she was alive either. Like Dr. Thogmartin, he didn’t have the benefit of looking at a ‘‘living patient.’’ He only had a severely dehydrated body and brain to work with.

  In Dr. Nelson’s view, ‘‘There’s nothing in her autopsy report . . . that is inconsistent with persistent vegetative state.’’3 Which is, frankly, like saying, ‘‘Maybe she was, but it’s impossible to determine that by an autopsy.’’ He also didn’t rule out the possibility that Terri might have been in a minimally conscious state (MCS) instead of in PVS. You see, there are no reliable studies on what the PVS brain of a corpse looks like when compared with that of a deceased MCS brain.

  I was told by one neurologist that the neuropathological features of MCS are not even known as yet. It is, therefore, impossible to differentiate between a brain that supports minimal consciousness from one that does not through an autopsy. In fact, I am told, the same neurological indications might support different levels of consiousness. Dr. Nelson never claimed to compare Terri’s brain with the brain of a deceased MCS patient. The news media, however, eager to justify Terri’s death, did not consult knowledgeable neurologists about these subtleties.

  Here’s my point.

  Although it was widely reported that the pathological findings were consistent with PVS, the news media did not report the equally plausible conclusion that the findings could have been equally consistent with MCS—a condition from which patients have improved.

  Nevertheless, George Felos was quick to put the best spin on the IME’s findings. With the IME report in hand, Mr. Felos trumpeted the news that ‘‘in the words of the medical examiners, the results are very consistent with a persistent vegetative state.’’4 Mr. Felos got as much mileage as possible out of this nonconclusion in order to lead the public down the road toward a belief that Terri was indeed PVS. I’m not surprised that Mr. Felos placed his spin on the IME’s findings. According to his view, Terri had as much life as a ‘‘houseplant’’—a term he had previously used to characterize Terri.

  Here’s what’s troubling.

  The medical examiner was not in any position to confirm or deny whether Terri was in PVS because he never examined her as a living patient. PVS is a clinical diagnosis that must be made on a living patient, not a diagnosis that can be based on autopsy findings.

  Nevertheless, the media dutifully reported the PVS verdict with little regard for these facts.

  CHAPTER TWENTY

  A LIFE WORTH LIVING

  By 2040, it may be that only a rump of hard-core, know-nothing religious fundamentalists will defend the
view that ever y human life, from conception to death, is sacrosanct.

  —PETER SINGER, PRINCETON UNIVERSITY PROFESSOR1

  Meet Clinton McCurdy.

  At age thirteen, Clinton doesn’t speak. He can’t play ball or ride bicycles with his friends. He can’t walk. He can’t go to school. He can’t dress or feed himself. For the last eleven years, Clinton has been confined to his bed or his wheelchair. You see, when Clinton was twenty-three months old, he fell into a swimming pool and drowned. He was underwater for approximately seven to ten minutes before being pulled out. CPR was performed on him immediately and his heart began to beat again. Being deprived of oxygen for several minutes caused Clinton to suffer severe brain damage, much like Terri Schiavo.

  His parents, Tim and Betty McCurdy, brought Clinton with them to hear me speak in Hammond, Indiana. After I had finished my comments, they pushed him in his wheelchair to the lobby of the auditorium to meet me. As we visited, I learned about his injury and the details of his care. I was struck by the similarities to Terri: He was not hooked up to machines nor was he in a coma. All he needed was help with food and water, something that, even in Florida before the new end-of-life legislation was passed in the late 1990s, had always been considered ordinary care, not life support. His parents showed me how Clinton was fed through a small feeding tube inserted under his shirt.

  There was one primary difference, however.

  I could tell that young Clinton was far less responsive than Terri. For her part, Terri smiled, kissed her parents, cried, and could purposefully interact and respond to external stimuli. But as Tim and Betty shared their story, Clinton didn’t respond verbally, nor did he pay any attention at all to our conversation—at least not outwardly. Not wanting to be rude, I bent down to speak with him. As I started to engage him, Betty gently placed a hand on my arm and said, ‘‘David, don’t worry. He doesn’t even know who we are.’’

  After allowing her comment to sink in, I told them that they were remarkable parents for loving their boy and for not giving up on him. I asked them, ‘‘Has it been tough?’’ Betty said, ‘‘Sure. He has to wear a diaper and we have to bathe and dress him. But Clinton still gives us joy. He may not communicate, but we’re still his parents and he’s still a part of our family.’’

  His father, Tim, added, ‘‘Yes, it’s been very difficult, but we made a decision to love and care for Clinton and we will stick by that decision.’’ At that point Tim said something that shocked me. He said, ‘‘David, we made the same decision that Michael Schiavo made.’’ For a moment, I thought Tim was confused. I thought he meant to say that they had made the same decision as Bob and Mary Schindler. After all, it was the Schindlers who wanted to save Terri’s life while Michael was working to end it.

  ‘‘No,’’ Tim assured me, ‘‘we made the same decision Michael Schiavo did—at first.’’ When I asked what he meant by that, he said, ‘‘The night our son was rushed to the hospital as a twenty-three-month-old, we were told that Clinton had suffered a traumatic brain injury. The doctor informed us, ‘I think he’s going to be severely injured; I’m sorry, he’s too far gone. Do you want us to try to save him?’’’

  I had a hunch where Tim was going with this.

  Tim said, ‘‘Standing in that emergency room, my wife and I made the same decision that Michael Schiavo made the morning Terri was taken to the hospital. We told the doctors, ‘We realize Clinton might not be as healthy as he was. But please do everything you can to save our little boy’—just as Michael asked the doctors to do everything they could to save Terri in February of 1990. That’s a decision you have to live with. Once you make a decision to save a life, you’re committed.’’

  As the McCurdys shared their story, I remembered reading how Michael stayed by his wife’s side for days on end after her brain injury occurred. Without question, he worked hard alongside Mary Schindler to care for Terri. This teamwork went on for the first couple of years. By all accounts Michael was a diligent husband and a faithful caretaker who made sure that Terri was given proper treatment. He even sought rehabilitation therapy in the early days.

  Unfortunately, Michael’s model behavior ended. I don’t pretend to know Michael’s heart. What is clear is that he wasn’t happy with how his choice turned out; his actions demonstrated that he didn’t want to live with the consequences of his initial decision to save Terri’s life.

  BUYER'S REMORSE

  Initially, after learning of her prognosis, Michael could have said, ‘‘You know what? Terri’s too far gone. Let her go.’’ But he didn’t.

  Michael did the right thing by giving a mandate to the doctors to try to save her. Frankly, I’d be the first in line to congratulate him. He saved Terri’s life. She would have died that day in 1990 if Michael, as her husband and guardian, hadn’t made the initial decision to do whatever was necessary to keep her alive.

  However, I also believe that when you make the choice to save somebody’s life, you have a continuing duty to that person. That’s where Michael’s story deviates from the McCurdys’ journey. Michael changed his mind and reversed his decision when he decided he wasn’t happy with Terri’s ‘‘quality of life.’’ To this day, Michael is fond of saying, ‘‘I kept my promise’’ to Terri. In fact, he had that phrase etched on her cemetery headstone.

  As for the notion that he kept his promise, I beg to differ. He promised the Schindlers and a jury in a court of law that he intended to care for Terri for the rest of his life. He also said that he had promised Terri on their wedding day before God and man to remain faithful to her ‘‘in sickness and in health.’’

  Imagine if the McCurdys had, after five years of unproductive therapy, said, ‘‘Clinton is really much more handicapped than we expected. This is a lot harder than we ever anticipated. It’s costing us time and money that we can’t afford. Let’s just starve him to death.’’ Unthinkable, right?

  What kind of society would permit such a thing?

  After hearing me speak, however, the McCurdys began to wonder whether they were now living in an America that might someday decide to take Clinton away from them and deny them the privilege of caring for him. They were worried that a judge, a social worker, a doctor, or an insurance provider somewhere might decide that Clinton didn’t have a quality of life worth the time and resources to maintain. That’s a legitimate concern.

  Not to be an alarmist, but America is already turning down the road where human life is disposable. It happened openly for the first time in March 2005, when Terri died horrifically before the eyes of all the world, but it is estimated that several thousand Floridians died secretly in the same manner before Terri’s public court-ordered death.

  This is a roadway that has been traveled before.

  Remember what happened under the Third Reich?

  LIFE ON A SLIPPERY SLOPE

  A troubling doctrine is being advanced in the medical community today. It argues that because Terri, Clinton, and people like them are unable to work and unable to be productive, they’re a ‘‘burden to society,’’ rather like Hitler’s ‘‘useless eaters’’—a label he used to justify the deaths of the disabled as well as the Jews. The Associated Press cited a new report that found that more than two hundred thousand ‘‘physically-deficient’’ people were eliminated in Nazi Germany simply because of their disabilities.

  2 You might be thinking, Whoa! Time-out, David. We’re nowhere near Hitler’s day. We’re a reasonable, freedom-loving people who care for everyone. Really? You might want to press your ear a little closer to the pavement. Many people are now making the decision for others to die, as Michael did. And there’s a growing trend in the halls of medicine to disconnect those whose lives appear to have no meaningful place in society.

  Today, ‘‘progressive thinkers’’ are informing us that disabled persons ‘‘tax the medical system’’ by draining health insurance dollars for their constant care. We’re told these people have no ‘‘quality of life’’ worth preserving, that
any medical care would be futile for them. As the seeds of these pro-death ideas take root, the elderly as well as those suffering from dementia, epilepsy, Down syndrome, Alzheimer’s, or Parkinson’s disease are summarily lumped into the ‘‘useless eaters’’ pot.

  Using the logic this school of thought produces, the most expedient solution is to ‘‘let nature take its course’’ (passive euthanasia) by withholding futile medical care and, as in Terri’s case, even food and water. The other option frequently advocated is to actively advance a person’s death (labeled benignly ‘‘terminal sedation’’ or ‘‘assisted suicide’’).

  Is that difficult to believe?

  Let’s learn from what happened to Terri.

  The only ‘‘medical treatment’’ Terri required to stay alive was assistance at mealtime. Even newborn infants cannot feed themselves.

  Which begs the question: If food and water are now considered ‘‘medical treatment,’’ what prevents a doctor from ‘‘terminating’’ a disabled or unwanted baby after birth by withholding nutrition? If doctors can purposely starve a woman in Tampa who can’t feed herself, why not a baby boy in Boston who is also dependent on someone else to bring him a bottle?

  You might not know this, but a number of leading ‘‘ethics’’ professors at America’s leading universities are already teaching students that infanticide—the killing of an already born infant—is morally acceptable, especially when the infant is debilitated. Take, for example, professor, ethicist, and self-proclaimed atheist Peter Singer at Princeton University’s Center for Human Values.

  Considered the grandfather of the animal rights protection movement, Singer gives his students some rather inhumane lectures about humanity. Why? Because Dr. Singer believes that there is nothing ethically wrong with ‘‘terminating’’ one-year-old physically or mentally disabled children. You might want to read that again. Mr. Singer is on record saying: