gargle.org - rinse vigorously

Since this case has been getting so much attention, I've been looking into it a little more deeply.

First, I admit to having been careless. I did not realize that Terri is not on artificial life support, but only a feeding tube. And I should not have trusted my hazy memory of the video.

Second, I went back to the video clips, which I looked at more closely. You can find them at
http://www.paulieworld.com/blog/archives/001955.html
and
http://www.raven1.net/terrivids.htm

I do not find these videos definitive. On the one hand, there seems to be a lot of reaching for responses that may not be meaningful, some wishful thinking from the parents. Some of the responses (eyes tracking a balloon, face flinching from a cold swab), may be subcortical reflexes.

On the other hand, at times her responses sounded as if they could be meaningful. At moments she seemed to vocalize in response to something her father or mother said.

The videos do not provide enough evidence to be certain.

I have worked with many patients like Terri. That is what is giving me pause. Some of my patients seemed even less responsive than Terri, yet the responses were nevertheless meaningful. So I can't simply write this off.

What the videos do not tell you, however, is what Terri does when no one is trying to get a response out of her. Do the videos capture certain lucky coincidences that you're bound to get if you just keep filming long enough? Or is Terri in fact very different when people are not interacting with her?

I don't know, and I can't tell just from this. The only way I could know for sure is if I had a chance to work with her myself. There are cues I could pick up from that kind of contact that you can't get from a video. Since I haven't had that opportunity, I cannot offer a definitive opinion.

Of course, what no one seems to know for sure is what would Terri herself have chosen? I don't think I would want to stick around like that for 15 years. But in this case that's not my decision to make. One can argue, why not keep feeding her, she's going to die anyway, it's just a matter of time, so if there's a chance of anything even slightly meaningful why end it now?

If Terri were tied to a ventilator, my opinion would be more definite. I very rarely get meaningful responses from ventilator patients. But patients like Terri are different. Very often I do sense there is still a person there.

So I have to conclude: I can't really conclude. I just wish they would let me work with her for a few days. But I really don't think that's likely (even though I'd do it for free).

The only thing I know for sure at this moment: I can't be too swift to condemn either side.