Let's have a review of simple brain anatomy and physiology

Terri Schiavo has no cerebral cortex. The part of her cerebral cortex that was once functional has been replaced with Cerebrospinal Fluid. CSF has no dendrites, nerve endings, or nerve impulses. Her brain is gone, except for the brain stem.

Her brain stem is in tact.

Many people on this board and throughout this country are either confused about how the brain functions, or unwilling to accept documented medical fact.

Perhaps we could get a bit further in our discussion regarding Terri Schiavo and her condition if we were all a bit educated on the function of the different parts of the brain.

Being a nursing student, I've had to take significant courses in Anatomy and Physiology.

Here's some snippets from my A&P book as well as my notes regarding the Anatomy & Physiology of the human brain.

a simple reading through ANY high-school level Anatomy & Physiology book will illustrate COMPLETELY why Terri Schaivo will never 'get better', why she isn't 'there' to begin with, and why her body functions and doesn't function as it does (and doesn't)

Here's from my Nursing School-level Anatomy and Physiology book re: Cerebral Cortex (Anatomy & Physiology : Elaine N. Marieb : Benjamin Cummings Publishing 2002 pgs375-382)

"Cerebral Cortex
The cerebral cortex is the 'executive suite' of the nervous system, where our conscious mind is found. It enables us to be aware of ourselves and our sensations, to communicate, remember, and understand, and to initiate voluntary movements (bold mine). Because it is composed of gray matter, the cerebral cortex consists of neuron cell bodies, dendrites, and unmyelinated axons (plus associated glia and blood vessels), but no fiber tracts....

In the late 1800's, anatomists were able to map subtle variations in its thickness and in the structure of the crebral cortex. Most successful in these efforts was K. Brodmann who produced an elaborate numbered mosaic of 52 different cortical areas, called Brodmann areas, in 1906. With a structural map emerging, early neurologists were anxious to localize FUNCTIONAL regions of the cortex as well. Modern imaging techniques (PET scanss or functional MRI scans) have shown that specific motor and snsory functions are localised in discrete cortial areas called domains. However, many higher mental functions, such as memory and language, appear to have overlaping domains and are spread over very large areas of the cortex (emphasis mine).....

Some generalizations about the cerebral cortex:

1) THe cerebral cortex contains three kinds of functional areas:
--Motor Areas, that control voluntary motor functions
--Sensory Areas, that provide for conscious awareness of sensation
--Associative Areas that act mainly to intergrate diverse information for purposeful action

Parts of the Motor Areas:
1. Primary (somatic) motor cortex: allow us to consciously control the precise or skilled voluntary movements of our skeletal muscles

2. Premotor cortex: this region controls learned motor skills of a repetitious or patterned nature, such as playing a musical instrument or typing. The premotor cortex coordinates the movement of several muscle groups simultaneously or sequentially. Think of this region as the memory bank for skilled motor activities. This area also appears to be involved in planning movements. It can control voluntary actions that depend on sensory feedback, such as moving an arm through a maze to grasp a hiddne object

3. Broca's area: Broca's area has been considered to be a special motor speech area that directs the muscles of the tongue, throat, and lips involved in speech production. Broca's area becomes active as we prepare to speak and even as we think about (plan) many voluntary motor activies other than speech

4. Frontal Eye Field: This cortical region controls voluntary movement of the eyes

SENSORY AREAS:
1. Primary somatosensory cortex: Neurons in this gyrus receive infomration from the general sensory receptors in the skin and from proprioreceptors in skeletal muscles> They then identify the body region being stimulated

2. Somatosensory association areas: The major function of this area is to integrate different sensory inputs (temperature, pressure, etc) relayed via primary somatosensory cortex to produce a comprehensive understanding of an object being felt: its texture, its size, and the relationship of its parts. Someone with damage to this area could not recogonize hidden objects without looking at them

3. Visual Areas: The primary visual cortex receives visual information that originates on the retinas of the eyes
---Visual asscoiation area: interprets visual stimuli (color, form, movement)using past visual experiences, enabling us to recognize a flower or a person's face and to appreciate what we are seeing

4. Auditory Areas: Sound energy exiting the cochlear receptors of the inner ear causes impulses to be transmitted to the primary auditory cortex where they are related to pitch, rhythm and loudness.
---Auditory Association Areas permits the perception of the sound stimulus which we 'hear' as speech, a scream, music, thunder, noise and so on. Memories of sounds heard in the past seem to be stored here for reeference

5. Olfactory (smell) cortex: Conscious awareness of different odours

6. Gustatory (taste) cortex: region involved in teh perception of taste stimuli

7. Vestibular (equilibrum) cortex: responsible for conscious awareness of balance, that is, of the position of the head in space

ASSOCIATION AREAS

1. Prefrontal cortex: The most complicated cortical regin. It is involved with intellect, compex learning abilities, recall, and personality. It is necessary for the production of abstract ideas, judgement, reasoning, persistence, long-term planning, concern for others, and conscience. . THe prefrontal cortex is linked to the emotional part of the brain (limbic system) and plays a role in intuitive judgements and mood. It is the tremendous elaboration of this region that sets human beings apart from other animals

2. Language Areas: area for language comprehension and articulation. Nonverbal emotional compotents as well as speech mechanism. These areas allow the lilt or tone of our voice and our gestures to express our emotions when we speak and permit us to comprehend the emotional content of what we hear

3. General interpretation area: This region receives input from all the sensory association area and integrates all incoming signals into a single thought or understanding

4. Visceral Association Area: Involved in conscious perception of visceral sensation (upset stomach, full bladder, etc)

---
BRAIN STEM FUNCTIONS

From superior to inferior, the brain stem regions are the midbrain, pons, and medulla oblongata

Brain stem centers produce the rigidly programmed, automatic behaviours necessary for our survival

MIDBRAIN: conduction pathways between higher and lower brain centers. Visual and auditory reflex centers, motor centers, contains nuclei for cranial nerves III and IV

PONS: conduction pathway between higher & lower brain centers. Relay information from cerebrum to cerebellum; its respiratory nuclei cooperate with medullary respiratory centers to control respiratory rate & depth

MEDULLA OBLONGATA: conduction pathway between higher brain centers and spinal cord. Contains nuclei cuneatus and gracillis (synapse points of ascending sensory pathways transmitting sensory impulses from sking and proprioceptors) and visceral (organ) nuclei controlling heart rate, blood vessel diameter, respiratory rate, vomiting, coughing, etc

---

Hope this helps clear things up as to why Terri can breathe, but not talk. Why she can make gutteral sounds, but not move. Why her movements are involuntary and not purposeful.

Here's a photo of the Cerebral Cortex. It's generally what is being referred to when people speak of "the brain"



Here is a photo of the Brain Stem

Their cerebral cortices aren't liquid. :wtf:

that statement

I would have to concur. ;)

Her guardian says they have to get right in her face for any reaction. She has rather large teeth and her mouth is always open so the perception is that she is smiling. If she were toothless like some of the PVSs I have seen in nursing homes you would not call it a smile.

when you see Mrs. Schindler turn excitedly to make sure the camera is running, that this is not something even they were expecting, though they had a camera going to make sure they caught the Show.

that appears to be a reaction. When I touch a brainless worm it reacts.

it's that her jaw muscles and neck muscles have atrophied to the point to where her lower jaw is "pulled back"--that's what gives her that gaping-mouth smile look.

And as you said, if she were toothless, she wouldn't look like she was smiling, she'd look like she was unable to close her mouth. As it is, her teeth are intact and that gives the appearance of a smile.

Having worked with people who are in different states of consciousness, different stages of terminal illness and death, the sounds that Terri makes aren't 'hello' or 'goodbye' or 'help me'. They're gutteral sounds, sounds of the larynx involuntarily contracting and relaxing.

I posted in another thread how sometimes, when my mom's dog howls, it sounds like she is saying "I love you". The sound is actually more like "Awwrrr wooooo rooooooo". Being humans, we have a tendency to make connections between the unfamiliar and the familiar. The dog is saying "Awrrr wooo roooo" but our brains make the connection that HEY! THat SOUNDS Like a very rough "i love you". But the dog isn't saying "I love you". The dog is howling--it is we humans that attach the words to its grunts.

THe same what that if we see this phrase, missing some letters, we can fill in the missing letters in our minds as we read the phrase and basically "see" the entire phrase as it would be written if all letters were in place:

he D g Ra Aw y

I would encourage anyone who has doubts about the terminality of Terri's situation to spend a day or two in either a hospice facility or a nursing-home situation. See people who absolutely do not possess the ability to talk because that part of their brain is damaged or destroyed. Hear their gutteral sounds. Realize that they make those same sounds whether someone is in the room or not, whether they're with family or not, whether they're being fed or not.

The part of Terri's brain that not only controls language (as in the formation of words), but the pre-conceived THOUGHT to form words is destroyed. It's Cerebrospinal Fluid. Not grey matter. No tissue. no nerves. no nerve endings. Just fluid. For her to speak would mean that her brain is intact. It's not. It's just not there.

that her eyes move and blink therefore she is not in PVS. This is wrong. Because the nuclei for cranial nerves III, IV, VI and VIII (which coordinates lateral gaze) in this patient are probably still intact, since they surround part of the brainstem that controls automics. She can look around, but she cannot see anything b/c the geniculate body and visual cortex in her cerebrum are not functioning. She can also blink b/c the levator palpebrae muscle is controlled by cranial nerve III, if you were to check her pupils they would also probably constrict with light.

This comes from basic medical neuroscience in (med school). YOu learn immediately to test for brainstem function in patients mimicking coma conditions. You would think my douchebag senator Frist would know this. My guess is that he does, but is not interested in the facts getting in the way of his twisted ideology.

They put all their energy into faith so they won't have to learn science.

Besides, they're clinging to false hope. It's all they have.

As much as we don't know about the brain, we know a FUCK of alot about it.

That's why doctors can pretty much say that someone who has been shot in the head may continue to breathe (if their brain stem wasn't affected), but they'll never again 'recover' or lead anything outside of a persistent vegetative state.

We don't know everything about the body, but we know alot about it, how it works, how it doesn't work, and what makes it function.

It's sad. The proof is there. This isn't hogwash pseudoscience. This is medical fact. And yet they still remain WILLFULLY ignorant.

There are none so blind as those who refuse to see, I suppose

They're so insulated from the outside world that I'm not sure they know what's going on.

there has been so much myth and so much urban legend type of projection from people who do not have clue as to what they are talking about=--even here on DU. I hope they read the facts as you have presented.

but those who are so set in their opinion that neurons regenerate (which they don't) and that CSF transmits neurological impulses (which it doesn't) will see this as hogwash and not read it. Or they'll skim and say "oh well it doesn't say THIS blah blah blah "and pick out one tiny word and make an issue about it.

Sigh.

At least I tried (and got a nice review of cerebral A&P to boot!)

I'm hearing CNN in the background and all I can think is Jesus Christ, Almighty! Please stop this torture.

Last night we were listening to AAR as we drove home. Garafalo was talking about it, I just tuned it down and asked my husband when he thought that the guns in front of the hospice might start blazing away?

DU'ers have conducted actions before. Do you think we could be effective if we started a "JUST STOP" action against the MSM. We don't want anymore 24/7 coverage of Terri, what else is happening in this world we live in?

It could very well be the best, most useful class they will ever take.

I wanted to take the class over again because another college in my area used human cadavers for the Anatomy part--my school used sheep's brains, cow eyes, and dead cats. As interesting (absolutely FASCINATING) as it was, I would have loved to see real life (dead) human anatomy. THAT would have blown my little mind away.

It's amazing what an absolutely complex and beautiful system we have running inside of us. Something as simple as too much Calcium, or too little Potassium can have LIFE ALTERING ramifications to our body, resulting in injury and even death.

Now that I"m in nursing school, I get to put the (very) tedious details of the body that I learned in Physiology into actual context with regards to disease and disease processes. Very very neat.

were changed. Her Dr. dismissed her many adverse effects as just new beta-blocker (metropolol) side effects that would eventually subside and did not see my mother. I went to a pharmacist and asked him if lethergy that meant my mom would not even walk ouside to get her newspaper was too lethargic to be a BB adverse effect and he said yes. My mom went to the ER for an EKG and they were going to release her until her electrolytes came back. She was admitted. Her brain was starting to swell. Her diuretic has caused a situation of too little sodium.

There's loop diuretics, which allow for sodium and water excretion but also cause postassium loss as well, and then there's potatssium-sparing diuretics which cause excretion of sodium and water, but save potassium.
You have to be SO careful with those things, as far as diet, hydration, adverse reactions with other medications.

My husband is on atenolol, a beta-blocker as well. Luckily, he only has to take a low dose because his BP is relatively low-high and easy to regulate via meds, but I still keep an eye on him and if he becomes lethargic or itchy or coughy, I suggest he see a Dr--sometimes the most serious signs of illness are the most easy to explain away.

I hope your mom is doing okay. My grandmother had a heart attack, but like most women, her symptoms weren't typical symptoms of heart attack---she felt like she had indigestion, not an elephant sitting on her chest, no radiating pain to arm or jaw...just indigestion and some abdominal pain.

She went to the ER b/c tums and stuff weren't working and they were about to send her home when a Dr decided just to draw her blood to make sure nothing else was going on. Thanks to that blood draw, they saw her Triponin and BNP levels were through the roof, highly indicating a heart attack. Had it not been for those blood draws, she would have died at home. As it was, she had severe arterial blockage and had a stent put in within a few hours of arriving at the ER.

My rule--when in doubt, draw labs!

I was able to get my mother to switch doctors after that episode. My cat heart disease education means I have learned a lot about ACE-I, RAAS, sympathetic activation, right-sided heart failure, beta-blockers and calcium channel blockers.

My cat has been on atenolol for 2.5 years and has had no progression of his borderline normal thickening of his left ventricle. A too fast heart rate (tachycardia) may not be the cause of HCM, but the ischemia from an increased myocardial oxygen demand can not be good for the heart. I actually think circulating levels of catecholamines may be part of the phenotypic expression of feline HCM. While there is certainly evidence of a familial autosomal dominant inheritance in ceratin breeds, cats are truly sympathetic creatures.

because they made students dissect cats among other things.

Goes against my personal ethics.

But I would have loved to have taken it otherwise.

but the cats were feral street cats from Mexico---I suppose that I'd rather there not be such an overpopulation of cats to begin with, but I suppose that if they're going to be euthanized I'd rather their bodies be used for dissection than to just be incenerated or tossed in a big hole.

BUt I would have loved to have taken the other Anatomy class at another community college in my area that dissected cadavers. THAT would have been much more useful, imo, for those of us who were studying HUMAN anatomy---I mean, we had to learn about muscles and structures and bones on a cat that don't even EXIST in a human. Kind of pointless to a degree.

see first paragraph

My fingers type faster than my brain functions sometimes. Shall change

... why are there no illustrations of the brain of one of the simplest minds around, that of George W. "Chimpy McFlightsuit" Bush?

your comment made my day!:hi:

Here's a photo from her CT scan that clearly shows the damage.

wouldn't have that big black void in the middle of the brain. It would be the bluish-gray matter seen on the outside of the black hole. It would show an intact brain. Not a partial brain. Not a brain filled with CSF instead of gray matter.

Here's a scan of a stroke victim. Notice how much less damage there is in relation to Terri Sciavo's brain.

I thought a catscan shows how much of the brain is functioning. It does show the structural matter? It shows what tissue is alive or dead versus what tissue is functioning/not functioning?

I really thought catscans were sort of course. Not very good. But cheapest so usually the first brain scan done. ITs been about 5 years since I looked into this for our own personal crisis so I'd appreciate it if you could explain.

Thanks for any info

MRI (magnetic resonance imaging): the use of magnetic and radio waves to create an image of the brain (frontal, cross-sectional, and sagittal planes can be viewed). MRI and CT are used to compliment each other in diagnosing brain and spinal cord lesions MRI is excellent for viewing soft tissue (the brain is formed of soft tissue)

CT (computed tomography): Xrays are used to compose a computerized cross-sectional picture of the brain and spinal cord. Contrast medium may also be injected intravenously to see abnormalities. The contrast material leaks through the blood-brain barrier from blood vessels into the brain tissue and shows areas of tumor, hemorrhage, and blood clots

PET (positron emission tomography): An isotope (radioactive chemical) that gives off particles called positrons is injected intravenously, combined with a form of glucose. The uptake of the radioactive material is then recorded on a televison screen. The cross-sectional images show how the brain uses glucose and gives information about brain function. PET scans provide valuable information about patients with Alzheimer Disease, stroke, schizophrenia, and epilepsy

(from: "The Language of Medicine" Davi-Ellen Chabner, WB Saunders Co 2001 pgs 346, 347)

---

An MRI shows brain structure--what is there, what isn't there.

A PET scan shows what parts of the brain are FUNCTIONING at any given point in time.

That's why an MRI is the first scan done--to see if the brain is intact or not

Where did that section of her brain go? What destroyed it?

In 1990, Terri's heart stopped because of an electrolyte imbalance.

In your body are several metals (we call them electrolytes) that regulate the electrical transmissions in your nervous system. Among them are sodium, calcium and potassium. They exist in your body in a preset ratio, which is called "balance." There's some playroom here to compensate for your doing things like running marathons and fighting wars in the desert, but if one of the electrolytes goes outside of a certain range for long enough, you are in trouble. Terri's potassium level, because of her bulimia, was way out of whack--far too high. The purging that bulimics do is notorious for throwing your body's chemistry out of line.

Her heart stopped and it took them fifteen minutes to get it going again. Function of the heart: supplying oxygen-rich blood to the body. If the brain is left without oxygen for as little as four minutes it begins to suffer damage. Her brain was left without oxygen for nearly four TIMES that long.

When your brain starts dying, your body's designed to shut it down in an orderly fashion. The fancy-thinkin' parts die off first, because you can live without fancy-thinkin'--most of the people who work at the local Lowe's seem to be so afflicted. The basic bodily functions like respiration and food-intake are the last to go. In Terri's case, her brain degradation is so severe that she can't swallow.

Terri Schiavo is dying of the effects of bulimia.

which brings to light another subject that is getting forgotten in this fight over her life--what put her there in the first place--bulimia.

Great post!:D

However, I would assume it is caused by brain tissues dying due to a lack of oxygen. After a region of the brain dies the glial cells (these are the life support system for the brain) actually digest it. There are three types of glial cells -- astrocytes, oligodendrocytes and microglia.

The astrocytes are star shaped cells responsible both for providing physical support to neurons (the little computational units of the brain) and nutrition. They're also the ones that digest dead neurons through a process called phagocytosis.

Oligodendrocytes are big ball shaped cells that provide physical support to axons (the wiring that connects neurons) and also produce myelin sheathing (insulation for your brains wires).

Microglia are partly responsible for cleaning up neural debris too, but they also help protect the brain from invading microorganisms.

So basically, when parts of the brain die, they get digested and cerebrospinal fluid fills the gaps.

Hopefully someone with more of a medical background will correct anything I got wrong and provide better information.

Scary weird.

but microglia are immune cells that can get activated to make reactive oxygen and cytokines. They can destroy otherwise healthy cells too. Activated microglia are hallmarks of just about every neurodegenerative disorder including Alzheimer's, AIDS dementia, etc. Extreme inflammation makes damage after injury much worse.

I've never really understood microglia all that well. I knew that they were involved in some disease processes in the brain but I'm not too clear on how they change from being white hat glia to black hat glia. I don't have any real understanding of autoimmune disorders in general. Most of my study in college and a little thereafter was in how the brain processes information and even then psychology was just my second major.

Top notch shit here. Thanks.

to brush up on my brain anatomy while trying to do some education at the same time. My teachers would (should) be so proud :)

This is great shit.

kick

being pumped to her brain. He also stated that Terri was intubated at Michael's insistance. Can you explain the protocol for resucitation vs. pronouncing in the ER?

and I don't do my ER rotation until the 2nd week of April, so I really don't know and can only speculate.

From what I've seen and heard, a "call" (meaning calling a death) is made when all normal attempts for resuscitation have failed. I think (THINK, don't know) that if no pulse/heart beat is made after 10 minutes of recuscitation, then they stop rescusitation efforts and pronounce death.

Again, though, I've not done my ER rotation so I don't know this for sure--only what I've seen on shows like Trauma and those types of real-life ER shows.

Maybe someone else can help out, though.

I can tell you that after 4 minutes w/o oxygen, the brain begins to die. At 10 minutes, the chance of normal brain function returning is practically nil (not to say it doesn't happen, but it's the exception rather than the rule).

Hypokalemia is abnormally low serum potassium <3.5 mEq/L (miliequivalents per liter). I'll abbreviate K+ for Potassium from now on :) Usually results from excessive K+ loss or inadequate K+ intake. Clients who are NPO (nothing by mouth) for extended periods, as well as clients with anorexia nervosa are at risk for hypokalemia

Excess K+ may be lost through the kidneys or the GI tract. Drugs such as corticosteriods, diuretics, and some antibiotics are a major cause of excess K+ loss from the kidneys. Gi loss may be caused by severe vomiting, diarhea or excessive ileostomy drainiage

A temporary shift of K+ into the intracellular space may occur because of alkalosis (alkaline blood levels--high blood pH), rapid tissue repair (following a burn or trauma) or high blood insulin levels

Hypokalemia affects the transmission of nerve impulses and the normal contractility of smooth, skeletal, and cardiac muscle (which is why it's associated with heart failure). Mnifestations of hypokalemia are generally not seen until the K+ level falls below 3.0 mEq/L. Serious and potentially life-threatning cardiac dysrhythmias are a major concern, particularly clients who are receiving digitalis (a drug, such as Digoxin) to treat heart failure

Lasix is a loop diuretic, and it promotes the excretion of sodium and water, but it does not prevent the loss of potassium. Patients on Lasix that I've dealt with in the hospital usually take a potassium supplement like K-Dur, K-lyte, etc along with their loop diuretic to replace any excess losses of potassium

Also, if you're on a loop diuretic and taking a potassium supplement, DO NOT USE SALT SUBSITUTE because most salt substitutes are potassium based, which can cause HypERkalemia--too much K+, which is just as damaging as too little

Man! I'm just totally reviewing all of my shit before school starts again on Monday. You guys are helping me be SO totally prepared :)

diuresis. There is a dieter's tea available OTC that contains senna, a bark that acts as a laxative irritant.

Terri's heart attcak was reportedly precipitated by extreme hypokalmia.

I know it is an issue when lasix is used for right sided heart failure. My cat has hypotrophic cardiomyopathy and I have learned so much by reading vet articles. I love PubMed and I have been looking up any doctors involved in the Schiavo case. Some of the doctors suggesting new treatments are proposing alzheimers medications. An Alzheimer brain has lesions, but it is still there.

to your original post

I hope this helps those who are being influenced by the RW fundie talking points to understand the facts of the case.

with the knowlege I have.

.

--IMM

better ratings as people keep coming back expecting to 'get it"

That would be a useful way to make something positive out of this sad situation.

Whenever they decide to tell us about some president's colonoscopy or prostate problem, they end up showing diagrams, don't they, pretending to be explaining the information we the masses need to know.

Somewhere along the line, science became no different than voodoo- and so trying to explain something like neuroanatomy in even basic terms is pretty well pointless.

Here's some of the responses I got after patiently trying to explain this (in multiple posts) on another board.

"You are a lot about science but have you ever heard of miracles?"
-----------------
"I have come to the conclusion that medical science is just that a science? ...there is so many things we don't know and can't know about Terri's case. I believe that the feeding tube should be put back in."
------------------

"i havent refused to believe s h i t ..and its really not your place to determine that...
-------------------

Other responses just ignored the science altogther and just accused Michael Shiavo of this or that-

Finally, one of the "leaders" on the board (a Brit) put her foot down:

"Yes there are such things as miracles, but when that part of the brain degenerates, atrophies, and liquifies, as it has and nobody is arguing that - what are the odds?

Nobody suffering from this has ever recovered, they have been given the chance.

Could everybody please stop challenging depakid as he has removed himself from the discussion, which we all decided was now best left before it triggers more people."

it's quite incredible to me that otherwise educated and rational people are willing to just COMPLETLEY disregard proven medical science for the hope of a 'miracle' occuring.

It's as if...I don't know...as if there's ANY proof that neurological damage (or total destruction as in this case) has EVER spontaneously regenerated to the point of having someone with a brain that once consisted of gray matter that now consists of CSF having a functional life in any ability. It's just impossible. Impossible for the degree of degenration and destruction Terri Schiavo's brain has gone through to regenerate itself, to repair itself in a fashion that is conductive to life.

People argue that her feeding tube isn't life support---it is. It's absolutely life support in the same way that a respirator is life support. In the way that a heart-lung machine is life support.

The part of her brain that controls VOLUNTARY MOVEMENTS such as swallowing is GONE. Her gag reflex is GONE. THe ONLY thing keeping her alive is the forceful introduction of nutrients and electrolytes into her body via a PEG tube. If it weren't for that tube she would die. Just like someone who can't breathe on their own would die without a respirator. It is life support, and it troubles me that people can't seem to grasp that very simple concept.

Then there's the hyperbolic and emotional language "But she's STARVING!" "you'd go to jail if you STARVED a dog, but it's okay to STARVE a human"---I wonder if these people consider removing a respirator "suffocating" or "asphyxiating" a human as well? Certainly we can't suffocate or asphyxiate a dog, but when a ventillator is removed, that's different...that's not suffocation...it's end of life..(by suffocation).

This whole issue is troubling. Not because of the difference of opinion--people have a right to think and believe in any way they wish. What is troubling, especially from DU'ers, is the ABSOLUTE WILLFUL IGNORANCE with regards to PROVEN MEDICAL SCIENCE AND INFORMATION. This isn't stuff that was just drummed up in the past 5 years. It's not like yesterday they 'think' they found out what the cerebral cortex does. This is proven science. And it's being disregarded like it's fucking conspiracy theory.

THAT is troubling.

it comes to our pets. Most of us do not force a cat whose lungs are full of fluid from congestive heart failure to drown in their own fluids.

reading posts like yours do give give me a little bit of hope.

I can tell you're going to be a damn good nurse.

And I can tell you something else- more than a few of nurses in my MPH program have a better grasp of public health issues than the docs....

They also tend to write better papers! ;-)

I know you typed that all out and I really appreciate it.

/sarcasm. :hi:

"Let's have a basic lesson on how God can make a woman without a brain suddenly get up, do the watusi across the hospice ward, and go to Sizzler and order a T-bone, medium rare"

of work and I thank you.
So much of what you discuss in this whole thread directly applies today regarding my husband but I lack the technical knowledge and typing skills to discuss it...but I'm very interested and learned so much. It certainly has warned me of many signs to watch for. I'll bookmark this thread for future reference.

Good luck with school and you're going to make a great nurse.

if you want links to informative, yet simple-to-understand (and not in a dumbed-down way) medical links, PM me and I'll send them to you. Even though I've taken all these classes and medical terminology, sometimes I get deep into some disease process reading and my eyes go wonky and I just think WHAT THE HELL DID I JUST READ FOR THE PAST 2 HOURS? So I found some really great websites that just break it down into simple terms while retaining the integrity of the complex nature of medicine and the human body

:hi:

I second Auntie's sentiments. In fact, I hope that someday you may choose training as a Nurse Practitioner. Yes, I'm fast forwarding into the future, but there's no doubt that you have a gift for explaining complex medical concepts into clear explanations that are fully understandable to those folks lacking a science background.

Now, that's commendable.

Best wishes for an successful and fulfilling nursing career.

just so I can go on and be a Nursing School Instructor...you can't have nurses unless you have nurses to teach them, right?

:)

:hi:

don't cha know? = Sean Hannity says that all that *science* lies. Sean KNOWS Terri can talk! Her husband is paying off the liberal elitist judges. FOX says so and they have people who had exactly what Terri has and recovered. Oh those horrid liberal activist judges are killing our Terri! /sarcasm off

My point: Don't even try to reason with a Fundy.

BTW, FOX is merely Right Wing Fundy propaganda NOT a new's outlet.

You got that right! Don't we all know (progressives) that the world is totally screwed-up when we find ourselves concurring with Scalia (or Bucannan) on almost any political issue? :wtf:

how any judge who "sides" with Michael is an ACTIVIST JUDGE---however, if the judges were to "side" with the Parents, they woudln't be ACTIVISTS...they'd be upholding the rule of law blah blah blah

And I use "side" in quotes because I don't think the judges are taking sides, as much as people here and across the country would like to think so. They're objectively looking at all the data and basing their decision upon the stated wishes of Terri when she was a cognicent, thinking, feeling human being. There are no "sides" here except for the "side" of Terri's wishes, and the "Side" against Terri's wishes.

I wish that people wouldn't see these court cases, and the death of a young woman, as "winning" or "Losing". No one wins in this situation, not even Terri. Her wishes should have been followed in the beginning and instead, years and years of tying up the courts and legislature with personal emotional and religious beleifs.

Also---why no cry from Republicans about the frivilous lawsuits being filed again..and again...and again..and again by her parents? Where's the call for TORT REFORM now? Where's the call for outlawing BASELESS COURT CASES THAT TIE UP THE SYSTEM?

interesting---the silence, I mean...

:)

I'm up early to touch up a shirt but mostly to enjoy some real "quiet time" before I must rouse DA troops (my family).

Happy to assist ;) :kick:

. . a great overview of neuroanatomy.

The answer to the mystery as to why some (many) people can't accept simple facts about Terri's brain is also found in your diagram.

As we grow from infant to adult the pre-frontal cortex oversees the process of creating an elaborate set of ''truths'' that we believe about the world and our place in it. I call it our personal worldview - but it is far more important than the usual sense of the word. It is the thing that makes us who we are.

We depend on it for day to day decisions as well as the really important ones - like pulling the plug on a loved one who is beyond the ability to live any kind of life and will never recover. In fact, the more important the decision - the less likely we will be able to objectively consider new information - and the more we will depend on what's already in there.

For people who have managed to put into their worldview the notion that scientific knowledge and facts, though imperfect, are the best way to solve difficult problems - it's not so difficult to figure out what the best and most humane course for their loved one should be.

But, if someone believes in witchcraft or miracles or God (I mean literally, not socially) - they simply will not be capable of seeing the reality of a situation that is emotionally important to them and that disagrees with their worldview. Their pre-frontal cortex will not allow them to consider it, much less believe it.

Thanks again for all the work you put into this. I sure hope if and when I end up in a hospital - you'll be there.

to inform us. It makes so much sense when you read it in black and white rather than listen to the crazy wishes of those who think she can be rehabilitated. The whole situation is just sad--starting way back to her need to vomit after eating causing her to go into this heart failure. This is the real story that the media should be pushing. The effects of bulimia.

Great job and good luck in nursing school. You are going to be a great nurse:D:thumbsup:

kick

Good job, Heddi! Very informative!:thumbsup:

:hi:

"he broke my spleen he broke my knee and then he really laid in to me. Friday night in out-patients, who said I lied to her...."

Sorry---only Moz quote I could think of that had medical connotations....

:)

I only thought of it as I was driving in the car a minute ago

(and tasteless as it may be, it is Moz, king of...er...mozishness)

Girlfriend in a coma, I know
I know - it's serious
Girlfriend in a coma, I know
I know - it's really serious

There were times when I could
Have "murdered" her
(But you know, I would hate
Anything to happen to her)

NO, I DON'T WANT TO SEE HER

Do you really think
She'll pull through ?
Do you really think
She'll pull through ?
Do ...

Girlfriend in a coma, I know
I know - it's serious
My, my, my, my, my, my baby, goodbye

There were times when I could
Have "strangled" her
(But you know, I would hate
Anything to happen to her)
WOULD YOU PLEASE
LET ME SEE HER !

Do you really think
She'll pull through ?
Do you really think
She'll pull through ?
Do ...
Let me whisper my last goodbyes

I know - IT'S SERIOUS

Alright, it was WAY too obvious. :D

Here I am, driving in the car, singing along to "Late Night, Maudlin Street" and it just hit me...I totally rushed back home to make that post....running over several small children in the process but hey! Don't play on a fenced playground if you're not willing to take the chance of getting mowed down by a Mazda Protege, right?!

n/t