Thursday, March 24, 2005

Neurologists Say: Recording of Terri Shows She's Not PVS

You'll recall the audio recordings of Terri and her father which were posted at the Matt Drudge and the Family Research Council websites earlier this week. These recordings (actually two different versions of the same recording) were made last year, and include Terri's father, Bob Schindler, talking to Terri, and Terri making noises which seem to be efforts to respond.

I sent the recordings to the four neurologists I interviewed for my National Review Online article from last week, "Starving For A Fair Diagnosis": Dr. Mack Jones, a neurologist in Florida; Dr. Thomas Zabiega, a neurologist in Chicago; Dr. William Bell, a professor of neurology at the Wake Forest University Medical School; and Dr. Peter Morin, a neurologist researching degenerative brain diseases.

Three of the four neurologists reported that they believed that Terri was responding to her father, and was attempting to form words. The fourth, Dr. Peter Morin, demurred, saying that he did not want to venture an opinion based on an audio recording without accompanying video.

The remaining neurologists all expressed confident opinions regarding what they heard in Terri's recording. Dr. Mack Jones said "She does appear to be responding to her father's questions and attempting to form words." Dr. Bell concurred, saying that Terri "did respond [to her father's voice] as she seems to pace her vocalization to his voice and not the reverse (his voice to
her vocalizations)."

Dr. Jones added: "If she responds in a like fashion to other close members of her family and not to strangers, it would be even more convincing that she recognizes her family and therefore demonstrates evidence of higher brain function."

According to the neurologists, if Terri verbalizes, that is, attempts to form words, that is clear evidence that she cannot be in a PVS. Dr. Bell explained:
Verbalization in general requires two phonemes with the intent of communication. "Papa" is two syllables and two phonemes and so is a verbalization regardless who is present to hear it, but "pa" would be meaningful if she said it if only her father was in the room. Just vocalizations that do not have set phonemic patterns are problematic, but if there is a definite vocalization to a question and silence when there is silence then this becomes a pattern in itself and this suggests at least conscious awareness and responses compatible with the minimally conscious state. The minimally conscious state suggests that portions of the cerebral cortex are still functioning.

Dr. Bell said that at one point he believes that Terri did verbalize, saying "hi". He added that "none of this is surprising," since, in his judgment, "she is not PVS, but in a minimally conscious state, despite what the courts say."

Dr. Zabiega expressed the strongest opinion, saying:
I believe she is making verbalizations on the tape.  In fact, around 45 seconds, when she is asked "How are you doing" she definitely changes her voice and says "good".  She appears to say "yeah" several times... then at the end of the tape when she is asked "do your ears hurt" she definitely says "no". Even if none of the words were discernible, the fact that her voice changes during the tape to different questions suggests she is understanding what is being said to her.  A patient in PVS does not respond and does not have any changes in verbal output. 

Dr. Zabiega adds, "Any clear-headed neurologist would rule out PVS just based on this audio tape. What she may actually have is aphasia, an inability to respond to questions which she understands.  Many people who are completely functional have aphasia after a stroke, and it can be tragic how they cannot communicate with others.  But we don't put them to death for it."

Indeed we don't , doctor. At least, not yet.

As It wrote in my NRO article, the history of the Terri Schiavo case is that of Michael Schiavo, George Felos, and Judge Greer attempting to prevent additional information from being presented and considered by the authorities. For the 2002 evidentiary hearing, the Schindlers submitted affidavits by speech pathologists who testified that Terri did try to speak. Now these neurologists say much the same thing. Will they too be ignored?