Well, let's see. Here he says he interprets CAT scans for a living: (snip)
So What Have You Seen? I've watched a steady stream of neurologists, bioethicists, and neurologist/bioethicists from Columbia, Cornell, and NYU interviewed all week on Fox and CNN and MSNBC. They all said about the same thing, that Terri's CT scan was "the worst they'd ever seen"or "as bad as they've ever seen." Here's the problem with these experts: THEY DON'T INTERPRET CT SCANS OF THE BRAIN. RADIOLOGISTS DO. *Oh* You see, a neurologist will look at the CT of the brain of one of his patients, but this is entirely different from interpreting CT's of the brain de novo, for a living, every day, without knowing the diagnosis and most times without a good history. In addition, whereas I heard Dr. Crandon say he's "seen" a thousand brain CT's... well I've interpreted over 10,000 brain CT's. There's a big difference. When I look at a CT of the brain every case is a new mystery about a patient Idon't know. I must look at the images, come to a conclusion, dictate my findings and report a conclusion. This becomes a part of the official legal record for which I am liable. I bill Medicare for a CT interpretation and am paid for this service. Neurologists do not do this. They don't go on the record, alone, in written legal documents stating their impressions about CT's of the brain. The neurologist doesn't get sued for making a mistake on an opinion of a CT of the brain THE RADIOLOGIST DOES. A neurologist has no where near this type of practical experience. And their cases are skewed according to where they practice and what their specialty is. Now, some of my best friends and some of the smartest docs I eve4r met are neurologists, but that doesn't change my observation that most neurologists I've met, in my experience, show an incomplete grasp of the nuances involved in image interpretation. I have seen several neurologists -- in the printed media and on television -- put up a Representative CT of the brain of a normal 25 year old female and contrast this with Terri Schiavo's CT. This is a totally spurious comparison. No one is disputing that Terri Schiavo does not have the CT of a 25 year old female. What I'm saying is that Terri Schiavo's CT could be the brain of an eighty or ninety year old person who is not in a vegetative state. THOSE are the CT scans we should be showing next to Schiavo's, because in THAT case you would see similar atrophy and a brain much closer to Schiavo's. Who Wants To Be A Millionaire? To prove my point I am offering $100,000 on a $25,000 wager for ANY neurologist (and $125,000 for any neurologist/bioethicist) involved in Terri Schiavo's case--including all the neurologists reviewed on television and in the newspapers who can accurately single out PVS patients from functioning patients with better than 60% accuracy on CT scans. I will provide 100 single cuts from 100 different patient's brain CT's. All the neurologist has to do is say which ones represent patients with PVS and which do not. If the neurologist can be right 6 out of 10 times he wins the $100,000. I Said What I Meant, And I Meant What I Said My points are what I first said about the image from Terri Schiavo's CT scan: 1) It is NOT as bad as the neurologists and bioethicists play it up to be; and, 2) There are many elderly patients with various levels of mental functioning who have severe atrophy that is difficult to distinguish from Terri Schiavo's atrophy I stand by what I said. And I'm putting my money where my mouth is. Posted by Doctor CBB on March 29, 2005 at 11:35 PM | On Wed, 30 Mar 2005 08:50:11 -0500, Larry C. Lyons <[EMAIL PROTECTED]> wrote: > Is that a shunt or given the slicing of the scan it could also be the > electrodes in the thalmus. But by using this as evidenced that the > scan is someone else, they have to do better than that. BTW who is the > writer, no indication that the person actually is a physician. What > are his or her credentials and specializations? > > > On Tue, 29 Mar 2005 18:06:53 -0700, Dana <[EMAIL PROTECTED]> wrote: > > Doctors disagree with your opinion. > > > > http://codeblueblog.blogs.com/codeblueblog/2005/03/csi_medblogs_co.html > > > > CSI MEDBLOGS: CODEBLUEBLOG ANALYZES TERRI SCHIAVO'S CT OF THE BRAIN > > > > THIS BRAIN IS NOT THAT BAD > > > > Thanks to reader "primer" I've been directed to the University of > > Miami Ethics program website where they posted this image from a CT > > scan of Terri Schiavo's brain in 1996. The sentence attached to the > > link for this scan on the site says: > > > > CT scan of Ms. Schiavo's brain, showing extensive cortical regions > > filled with spinal fluid. > > > > If you go to this link you can see the scan in a larger reproduction. > > > > A COURT OF MEDICAL LIGHTWEIGHTS WEIGH IN ON TERRI'S CT. > > > > The Second District's first opinion in this case explained: > > > > Since 1990, Theresa has lived in nursing homes with constant care. She > > is fed and hydrated by tubes. The staff changes her diapers regularly. > > She has had numerous health problems, but none have been life > > threatening. > > > > Over the span of this last decade, Theresa's brain has deteriorated > > because of the lack of oxygen it suffered at the time of the heart > > attack. By mid 1996, the CAT scans of her brain showed a severely > > abnormal structure. At this point, much of her cerebral cortex is > > simply gone and has been replaced by cerebral spinal fluid. Medicine > > cannot cure this condition. Unless an act of God, a true miracle, were > > to recreate her brain, Theresa will always remain in an unconscious, > > reflexive state, totally dependent upon others to feed her and care > > for her most private needs. > > > > First, I contest the theory that Terri's brain actively continues to > > degenerate as implied by the above statement. How could they gage > > serial brain degeneration without serial follow-up? And by what > > mechanism would her brain CONTINUE to atrophy? Second, Terri's > > cerebral cortex has not been replaced by fluid. That is inaccurate. > > The cortex is thinned and the sulci are enlarged. There is a > > difference. > > > > Third, and most importantly, given the amount of atrophy on this image > > I disagree with the court's inadequately considered conclusion. > > > > My Grandmother's Brain -- OK -- But Would I Stop Feeding My Grandmother? > > > > First of all, the University of Miami's appellation for this scan is > > inaccurate. "Cortical regions" are not and can not be filled with > > spinal fluid. The sulci (spaces between cortical ribbons) are enlarged > > secondary to cortical atrophy and these sulci are filled with > > cerbrospinal fluid. > > > > The most alarming thing about this image, however, is that there > > certainly is cortex left. Granted, it is severely thinned, especially > > for Terri's age, but I would be nonplussed if you told me that this > > was a 75 year old female who was somewhat senile but fully functional, > > and I defy a radiologist anywhere to contest that. > > > > I HAVE SEEN MANY WALKING, TALKING, FAIRLY COHERENT PEOPLE WITH WORSE > > CEREBRAL/CORTICAL ATROPHY. THEREFORE, THIS IS IN NO WAY PRIMA FACIE > > EVIDENCE THAT TERRI SCHIAVO'S MENTAL ABILITIES OR/OR CAPABILITIES ARE > > COMPLETELY ERADICATED. I CANNOT BELIEVE SUCH TESTIMONY HAS BEEN GIVEN > > ON THE BASIS OF THIS SCAN. > > > > The worrisome, no alarming thing, for me, was that I heard a > > bioethicist and several important figures on the major media describe > > Terri's brain as MUCH WORSE. One "expert" said that she had a "bag of > > water" in her head. Several experts described her as a "brain stem > > preparation" > > > > These statements are wholly inaccurate. This is an atrophied brain, > > yes, but there is cortex remaining, and where there's cortex (?life) > > there's hope. > > > > If you starve this woman to death it would be, in my professional and > > experienced medical opinion, the equivalent of starving to death a > > 75-85 year old person. I would take that to the witness stand. > > > > All That Glitters is a SHUNT > > > > Next mystery: Why is there a shunt in Terri's ventricle? This CT image > > is "flipped" (i.e. the CT scan is mirror-image backwards which is just > > an inconsequential error made when scanning the image into the > > computer), so the right side is LEFT and vice versa. However, everyone > > can see, easily, the ovoid white object sitting in the front of the > > big black butterfly in the center of Terri's brain, correct? > > > > That shining object is the tip of a shunt. A shunt is a tube > > inserted into the brain to reduce pressure caused by build-up of > > cerebrospinal fluid (CSF) in the brain. That big black butterfly in > > the middle of Terri's brain is her ventricular system, which holds the > > CSF and in Terri's case, it is enlarged (dilated). > > > > Now...why was Terri being shunted in 1996? First, if Terri's brain > > damage was due to oxygen deprivation, her enlarged ventricles would be > > by a passive mechanism -- which is not amenable to shunting -- not by > > obstruction of the egress of CSF. To me, the presence of a shunt > > indicates obstruction to the flow of CSF that needs to be > > circumvented. Obstruction to flow is hard to postulate given the > > mechanism of Terri's brain injury (oxygen deprivation). > > > > It would NOT be hard to postulate, however, if she had BLOOD in her > > head at some point in the past. So did she? Was there a history of > > trauma? I would like to see the BONE SCAN taken of Terri that > > purportedly showed evidence of traumatic type osseous uptake! > > > > It is quite unusual to see high-pressure hydrocephalus when the > > mechanism of brain injury was INFARCTION; and, more so six years after > > the event. > > > > So > > > > IS THIS REALLY TERRI'S CT? > > > > IF it is then her atrophy is SEVERE, BUT not as bad as has been > > implicated by the press and the courts > > > > IF it is then why did she have hydrocephalus six years after her non > > traumatic infarction > > > > IF it is... why was she shunted...AND IS SHE STILL shunted? IF not, > > why was the shunt removed? > > > > IF it is, why does the Second District Court NOT mention Terri's > > hydrocephalus in it's dissertation on Terri's woeful cerebral > > condition?? > > > > IF Terri DOES have hydrocephalus from ventricle blockage, was there > > trauma that caused bleeding that lead to hydrocephalus on the basis of > > a blood clot obstructing ventricular outflow? > > > > IF so, what was that trauma? > > > > IF Terri had hydrocephalus in 1996, she may still have hydrocephalus > > now; some patients with hydrocephalus respond to shunting with > > increased mental functioning! > > > > IF THIS IS NOT TERRI'S CT THEN WHERE IS HER CT? > > > > Based on this evidence Terri Schiavo should have a CT scan repeated. > > She should also have an MRI and a PET scan to gage the severity of her > > brain dysfunction. > > > > IF THIS IS TERRI'S CT OF THE BRAIN, SOMETHING MAY BE VERY WRONG > > > > Posted by Doctor CBB on March 21, 2005 at 04:49 PM | Permalink > > > > Dana > > > > On Tue, 29 Mar 2005 08:44:54 -0500, Larry C. Lyons > > <[EMAIL PROTECTED]> wrote: > > > Nope that's easily discernable on the CT scans from 1998. > > > > > > > > > On Mon, 28 Mar 2005 14:25:54 -0700, Dana <[EMAIL PROTECTED]> wrote: > > > > So less than an hour is enough to decide that she doesn't have a > > > > cortex, but not enough to decide she does, is that what you are > > > > saying? > > > > > > > > Dana > > > > > > > > On Mon, 28 Mar 2005 16:01:12 -0500, Larry C. Lyons > > > > <[EMAIL PROTECTED]> wrote: > > > > > Dana, > > > > > > > > > > You have to have a cortex in order to perceive, to feel, to do > > > > > anything except lie there and breathe. She does not have that. The CT > > > > > scans are very clear about that. What you see in those scans is a > > > > > decorticate individual. There is nothing there to perceive. > > > > > > > > > > As for the other stuff, that is irrelevant. The diagnosis is very > > > > > clear. Those, like the DFA neurologist (Cheshire?) who have objected > > > > > have an agenda and accordingly find something different. Here we have > > > > > someone who is associated with an anti-abortion/pro-life group, who > > > > > has not conducted an examination - at most a cursory review of the > > > > > records, looked at some heavily edited videos, and spent less than an > > > > > hour with the patient - just observation, no examination. > > > > > > > > > > larry > > > > > > > > > > > > > > > On Mon, 28 Mar 2005 13:30:57 -0700, Dana <[EMAIL PROTECTED]> wrote: > > > > > > But see, we don't really know that. I'm not speaking from sort of > > > > > > sentamentalism here. I'm looking at the level of science that is > > > > > > keeping people from believing the what they see and hear. > > > > > > She has been diagnosed PVS therefore anyone who says she does > > > > > > anything > > > > > > incompatible with the diagnosis is either mistaken or lying. Let's > > > > > > review some other things that were believed at about the time the > > > > > > diagnosis of PVS first proposed. > > > > > > > > > > > > Circumcision is painless > > > > > > Animal test subjects don't feel pain > > > > > > Discharging waste into rivers is ok because it gets diluted > > > > > > > > > > > > See my point? If you believe the neurologist whose affidavit I > > > > > > posted > > > > > > earlier, she not only feels pain but understands language. But > > > > > > oops, I > > > > > > forgot; she can't do that because some doctor diagnosed her as > > > > > > something incompatible with the ability to do that years ago, and we > > > > > > all know that doctors are never wrong and medecine never changes. > > > > > > > > > > > > Dana > > > > > > > > > > > > On Mon, 28 Mar 2005 14:18:39 -0500, Jim Davis > > > > > > <[EMAIL PROTECTED]> wrote: > > > > > > > > -----Original Message----- > > > > > > > > From: Dana [mailto:[EMAIL PROTECTED] > > > > > > > > Sent: Monday, March 28, 2005 1:58 PM > > > > > > > > To: CF-Community > > > > > > > > Subject: Re: Schiavo > > > > > > > > > > > > > > > > It's easier to believe that, of course. I can't blame anyone > > > > > > > > who does. > > > > > > > > > > > > > > Actually I think it's much easier to think as you do. > > > > > > > > > > > > > > Most people (decent people) like to think that anything is > > > > > > > possible, that > > > > > > > miracles can (and do) happen and that all this woman needs is > > > > > > > more time. > > > > > > > > > > > > > > They see her eyes open, her mouth gaping and say to themselves > > > > > > > "look, > > > > > > > there's obviously something there." Murder is wrong and this is > > > > > > > murder. > > > > > > > > > > > > > > Furthermore it makes people feel good to fight for an underdog, > > > > > > > somebody > > > > > > > that can't defend themselves. Regardless of the outcome people > > > > > > > like this > > > > > > > can hold their heads high knowing that they fought for "the right > > > > > > > thing". > > > > > > > > > > > > > > To force yourself to look deeper, to see and accept the tragic > > > > > > > truth that > > > > > > > the scientific evidence describes while forcing yourself to put > > > > > > > aside the > > > > > > > false hope provided by the anecdotal and wishful evidence > > > > > > > presented. > > > > > > > > > > > > > > To ignore her face and force yourself, against instinct and > > > > > > > desire, to > > > > > > > remember that there's nothing there underneath. To kill her when > > > > > > > common > > > > > > > sense says that recovery is so clearly, tantalizing close but is > > > > > > > in actually > > > > > > > fact impossible. > > > > > > > > > > > > > > Damn - that's hard. > > > > > > > > > > > > > > Some people would like to see this whole thing end with the long > > > > > > > delayed > > > > > > > (but inevitable) death of her body. Her mind died long ago, it's > > > > > > > not coming > > > > > > > back. > > > > > > > > > > > > > > Painting such people as cold and heartless or worse as hateful and > > > > > > > vindictive is unjust, I think. > > > > > > > > > > > > > > Jim Davis > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~| Find out how CFTicket can increase your company's customer support efficiency by 100% http://www.houseoffusion.com/banners/view.cfm?bannerid=49 Message: http://www.houseoffusion.com/lists.cfm/link=i:5:152300 Archives: http://www.houseoffusion.com/cf_lists/threads.cfm/5 Subscription: http://www.houseoffusion.com/lists.cfm/link=s:5 Unsubscribe: http://www.houseoffusion.com/cf_lists/unsubscribe.cfm?user=11502.10531.5 Donations & Support: http://www.houseoffusion.com/tiny.cfm/54
