Wednesday, March 23, 2005

Gupta Still Sticking With "Severe" Brain Damage

Dr. Sanjay Gupta, CNN medical correspondent and a trained neurosurgeon himself, refereed a torrid debate between the bioethicisist and hothead Art Caplan and Congressman Smith over the merits of considering additional evidence. Caplan's arguments were either argumentative or based on since-questioned medical testimony. Smith's points were based on concerns about the evidence coming to light. When Smith brought up new allegations Caplan was indignant and used up part of Smith's airtime to talk over him.

In the melee Dr. Hammersfahr's reputation was challenged by Mr. Caplan who said, among other things, that his name ought to be (and probably is) registered on a website designed to report medical "quacks". (That he didn't make the same case for Dr. Cranford is revealing.)

Smith leveled the counterclaim that Dr. Hammersfahr had performed a competent and thorough diagnosis.

Pat Boone was also on the show as a guest. I thought he did a wonderful job. He talked about his own son who was the victim of both a brain injury and a competent but incorrect diagnosis. The message: stick with your charge, they may improve (as his son has). He was the first willing to remind viewers that the diagnosis of heart attack through potassium imbalance was only speculation, and that many suspicions linger about the night of Terri's incident. He reminded the audience that once the ambulance crew arrived on the scene and saw the mess they immediately called the cops. Those cops intended to press charges for attempted murder until the "bulimia -> potassium imbalance -> heart failure -> cerebral hypoxia" excuse weakened their authority to act.

Dr. Gupta is still of the opinion that Terri's EEGs showed relatively flat activity. I recently read a blog post discussing how there are conditions with the patient might obscure an EEG in a patient like Terri. He isn't convinced of the new claims. He discounted doctors' testimony not because it was wrong, but because they (allegedly) did not evaluate the victim in person.

Smith retorted that the newest court-appointed neurologist arrived at the examination convinced that she should have her feeding tube removed, and in a "seven-page single-spaced" report argued that the diagnosis had been wrong and that he had been compelled to change his mind.

What he should have addressed were the charges that Dr. Cranford and others spent less than an hour each, some much less so, on their own examinations of Terri.

We know all this already. A lot can be summed up in the difference between proving something and disproving it. It takes much less evidence to falsify PVS than it does to prove it. You or I can disprove PVS for [most of ;] the people we interact with everyday. Surely it's wrong to assert that the verboten videos don't show compelling evidence of lack of PVS. But that's kinda what Gupta did.


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