A Letter from Dr. Lawrence Huntoon Commenting on the Autopsy Performed on the Murdered Mrs. Theresa Marie Schindler-Schiavo
[The letter below was sent to me by Dr. Lawrence Huntoon after he had read "Completely and Totally Irrelevant," an article about the autopsy report that was issued last month about the murdered Mrs. Theresa Marie Schindler-Schiavo. Dr. Huntoon's letter is important. Although there are Catholic physicians who reject the use of the term "persistent vegetative state" to describe the condition of any brain-damaged human being, Dr. Huntoon insists that there is such a condition. I will leave the matter to authentic Catholics in the medical profession to debate amongst themselves.
[Leaving that sole point of contention aside, Dr. Huntoon's letter demolishes the autopsy report that has been exploited by the champions of Mrs. Schiavo's court-ordered execution by means of starvation and dehydration. His demolition of the autopsy report is truly irrefutable, although some have been foolish enough to make an effort at refuting Dr. Huntoon's conclusions. I offer Dr. Huntoon's letter on this site so that readers can see for themselves the extent to which the secularists and relativists and positivists in civil authority and in the medical community have distorted Terri Schiavo's case in death just as they did before she was murdered. I thank Dr. Huntoon for giving me permission to post his letter. God bless, Mary keep, Thomas A. Droleskey.]
July 1, 2005
Dear Dr. Droleskey:
I read your article, "Completely and Totally Irrelevant," in the July issue of Catholic Family News. I was one of the neurologists who filed an affidavit in an attempt to save Terri Schiavo's life. I have training as a medical scientist - i.e. M.D. + Ph.D. (neurophysiology).
I also recently wrote an editorial on "The Perilous Vegetative State"--attached for your review. The Executive Director of the Association of American Physicians and Surgeons (AAPS) also wrote a feature article in the May issue of AAPS News entitled, "Why Terri Schiavo Had To Die." You can find this article at http://www.aapsonline.org/newsletters/may05.htm
Bioethics has, unfortunately, become almost synonymous with the "Culture of Death." There are many things that have caused this, which I will not "lecture" on here, but suffiice it to say the individual life has lost importance in favor of doing "what is in the best interest of society." "Mainstream" medicine has largely accepted this utilitarian viewpoint. Those physicians who fail to pledge allegiance to the "mainstream" viewpoint, are at risk for being labeled "disruptive physicians," which can lead to termination of a physician's career - see abuse of the disruptive physican clause, attached.
I have certainly received my share of "attacks" by other physicians because of my viewpoints on medical ethics--I believe the needs of the individual patient should be placed above the needs and wants of society --as mandated and rationed through managed care and government-run programs-- i.e. socialized medicine.
I have also seen criticisms on the internet of the statements I made in my affidavit in the Schiavo case. Some liberal, pro-death promoters felt that it was totally unreasonable to make observations based on viewing video clips on Terri's website--i.e. without examining Terri. However, I made it perfectly clear in my affidavit that I had not examined Terri (although I offered to travel to Florida to do so) and the wording of my affidavit was such that I was not making any diagnosis based on the video clips. I was, however, making observations concerning Terri's functional abilities--a perfectly legitimate thing to do. The liberal, pro-death crowd would, no doubt, be shocked to learn that the American Academy of Neurology offers accredited courses every year which feature the playing of video clips of patients (who have movement disorders, for instance), and the audience of neurologists is routinely asked--"What is the diagnosis?" If the practice of making observations based on video clips is such a horrible and illegitimate thing to do, why does the American Academy of Neurology routinely use such video clips as a teaching aid for neurologists?
I was totally shocked by the overreaching statements that were made based on Terri Schiavo's autopsy report. The silence (except for a small minority, including AAPS members) from the medical community which allowed these statements to have a "free pass," was deafening.
The statement that findings on the autopsy were "consistent with a persistent vegetative state," is a true statement, but it is misleading. One could similarly say that the findings on autopsy examination were such that Terri's brain was "consistent with" the brain of a used car salesman. "Consistent with" is a far cry from "specific for" (specific proof of), and the use of the term "consistent with" to imply causation is poor science and extremely misleading.
Persistent vegetative state can certainly occur, and does occur, when there has been substantial damage to both cerebral hemispheres. And, in the situation where both cerebral hemispheres have been totally destroyed, there is little doubt that such a finding would fully support the clinical diagnosis of persistent vegetative state. The autopsy report in Terri's case did not indicate that both cerebral hemispheres were totally destroyed. Short of total destruction of both cerebral hemispheres, the specific volume of cortical destruction needed to produce a persistent vegetative state is unknown--i.e. there is no specific finding on an autopsy which can confirm or rule out a diagnosis of persistent vegetative state. Pathologists don't "make the diagnosis" of persistent vegetative state. PVS is a clinical diagnosis which is made while the patient is still living. To imply that the autopsy somehow "confirms" PVS is a totally erroneous conclusion.
Statements, based on the autopsy, that Terri could not swallow food and water even if it was offered to her, likewise received a "free pass" from the media. I have taught neuranatomy, neurophysiology and I have taken sufficient neuropathology to know that one cannot possibly make such statements about swallowing function based solely on an autopsy. Statements regarding lack of cognitive thought based solely on an autopsy are also incredulous - how can one possibly know if one is capable of "thinking" based on an autopsy? The sharpest neurologists in the world can't even determine if a living person is capable of thought - and recent research (reviewed in my editorial) reveals that people with severe neurologic impairments have functional brain processes that heretofore we did not appreciate.
Likewise, statements based on the autopsy that "Terri was blind," and "incapable of visual tracking," fail to explain Terri's apparent ability to visually track a balloon which could be clearly seen by anyone who visited her website and viewed the video clip.
Statements based on the autopsy that because of "massive loss of neurons" Terri would never have improved irrespective of whatever treatment or therapy would be given, are simply not supported by science. There is absolutely no way one can conclude from her autopsy findings how she would or would not have responded had she been given aggressive therapy or other treatments.
I have treated a patient (about Terri's age) who was neurologically devastated because of multiple strokes and a bout of herpes encephalitis. Both of his frontal lobes and both of his temporal lobes were severely atrophied to the point of almost being absent-- i.e. a massive loss of neurons. That is 4 lobes of the brain that were almost totally gone. Based on the faulty hypothesis that such a large volume loss in the brain means that the person is incapable of responding, one would conclude that this patient's situation was hopeless. But, the fact of the matter is the devastating anatomy seen on CT scans and MRI scans did not preclude this patient from responding. Each and every time he came into my office, he would recognize me and he would smile, make some "happy" (albeit unintelligible) noises, and he would extend his hand (the one that wasn't paralyzed) to shake mine (i.e. he had social abilities). One day, in total defiance of those who would conclude that such a severely neurologically devastated patient could never communicate in any meaningful way (since he mainly made unintelligible noises), I asked him to say his ABCs and to count with me. Much to my total amazement, I started the ABCs, and he finished them. I started counting from 1 to 10, and he finished it. I could understand his speech--it wasn't unintelligible. No one had ever asked him to do this before because they felt he was incapable--i.e. a self fulfilling prophecy. I subsequently tried to get him speech therapy, but my attempt was not successful because under the socialized medicine program of Medicare (which rations medical care), he "didn't qualify" because speech therapists could not promise that he would definitely improve with further speech therapy. Again, if you don't give the therapy, it becomes a self-fulfilling prophecy - no improvement.
Shortly after Terri was killed, via dehydration and starvation, came the case of Buffalo fire fighter Mr Donald Herbert. Mr. Herbert was in a persistent vegetative state (pro-death people like to say persistent vegetative-like state to try and set it apart from Terri's case). He was in a severely impaired, vegetative state for more than 10 years. By any "pro death", "death with dignity" standard, it was "hopeless." But, unlike Terri's case, where her spouse did not push for continued aggressive therapy, Mr. Herbert's spouse was extremely persistent. One day, shortly after Terri was killed, Mr. Herbert awoke and started talking coherently with friends and family. Had a judge determined 2 years ago that Mr. Herbert should be put to death because he was in a PVS with "no hope" of recovery, his family would never have gotten this opportunity to have him back again, nor he to have his family back again. It should also be noted that Mr. Herbert's brain suffered the same type of injury (due to lack of oxygen) that Terri's brain suffered (an "irreversible" injury). As news articles about Mr. Herbert's remarkable recovery circulated, certain prophetic medical examiners were left red-faced and speechless.
L.R. Huntoon, M.D., Ph.D., F.A.A.N.
Journal of American Physicians and Surgeons