Schiavo Autopsy Results: Dr. Frist Is Incompetent

by DemFromCT

The Schiavo autopsy results, which clearly show the unfortunate Ms. Schiavo's brain to be half the normal adult size due to atrophy and deterioration, were released today to much media bruhaha.

An autopsy on Terri Schiavo, the severely brain damaged woman whose death sparked an intense debate over a person's right-to-die, showed that her brain was severely "atrophied," weighed less than half of what it should have, and that no treatment could have reversed the damage.

During a televised news conference in Largo, Fla., the Piniellas-Pasco Medical Examiner, Jon Thogmartin, also said the autopsy showed that Ms. Schiavo's condition was "consistent" with a person in a persistent vegetative state. That point had become a key issue in the debate over whether to prolong Ms. Schiavo's life and whether she had a chance to recover normal brain function.

Dr. Thogmartin said that recovery was not possible because of the massive brain damage that occurred after Ms. Schiavo collapsed in 1990. Her brain weighed 615 grams at the time of her death on March 31.

"This damage was irreversible," said Dr. Thogmartin. "No amount of therapy or treatment would have regenerated the massive loss of neurons."

This was the lead story on ABC World News, and their in-house medical expert, Dr. Timothy Johnson, picked up on what was most distressingly obvious about this case.

It was not concern over the religious beliefs of Schivo's parents or their supporters, who are entitled to believe whatever they wish. It was not that opportunistic politicians glommed onto what appeared (at the time) to be a win for those trying to stoke the wingnut base (that's too much de rigeur these days to have any shock value, anymore).

No, what Dr. Timothy Johnson lasered in on, in a clear set of remarks,  was the disappointing performance by a certain Senator who insists on using Doctor in his title whenever possible. Doctor Bill Frist made an ill-informed and wrong-headed diagnosis based on watching an edited videotape rather than actually bothering to examine the patient (never mind that he does not have the clinical skills to act as a neurologist).

"I question it based on a review of the video footage which I spent an hour or so looking at last night in my office," [Frist] said in a lengthy speech in which he quoted medical texts and standards. "She certainly seems to respond to visual stimuli."

This breach of medical standard of practice has offended doctors everywhere, and it was most interesting to see Dr. Johnson call Frist on it in a very public way, based on the autopsy.

And despite a widely televised video that appeared to show Ms. Schiavo responding to voices and other movement in her room, the autopsy said that Ms. Schiavo was blind in her final days. The medical examiner said she would not have been able to eat or drink had she been fed by mouth, as her parents had requested.

Nor would she have been able to recognize family or respond to smiles and facial cues. Frist is about as competent a neurologist as he is a Senate Leader, neither of which position he has ever had proper training for (he's a heart surgeon, not a neurosurgeon).

It remains to be seen as to which of Frist's jobs will ultimately be judged to have caused the greater amount of harm to the public body. By all rights, this autopsy should serve as yet another embarrassment to a man seemingly incapable of any. This, and the Bolton/stem cell/ social security fiascos aren't even on center stage. The likelihood is that when they are, they will make certain one descriptive term more than any other will be associated with Frist's term as Leader: incompetence.

Senator Lott must be laughing his head off.

[UPDATE]: More on Dr. Frist's Schiavo problem.

Aides to Dr. Frist, a likely presidential candidate in 2008, angrily said he had never made a formal diagnosis and thus had nothing to retract.

Democrats cited the autopsy results as proof that Ms. Schiavo's husband - and critics of federal intervention - had been vindicated.

"I think it will be seen at some point as a turning point in America about what's going on with the Republican Party - namely that you have this fanatical party willing to impose its own views on people, and frankly, powerful enough to do it," said Representative Barney Frank, Democrat of Massachusetts, who was among the most vocal critics of the Schiavo bill. "This is particularly a problem for Dr. Frist. This is a direct refutation of his TV diagnosis."

Dr. Frist did not respond to questions about the autopsy findings, saying he had not had time to review them. His spokeswoman, Amy Call, sought out reporters who asked about the case to assert that Dr. Frist "never made a diagnosis."

Comments

[DemFromCT]

Best post so far is at redstate.org:

Our boys Frist and DeLay look like idiots as a result of this.

[DemFromCT]

I see Nico was way ahead of me. But truth is truth.

[muledriver]

Good analysis.

Frist was willing to violate the standards of his (medical) profession by diagnosing a patient long distance in a failed effort to score political points. The result 0-2. Sad, really.

[emptypockets]

This story - I'm not getting it. It is showing up everywhere. Granted, I never found the Schiavo story very compelling. I wished everyone would let her die (or live) in peace, and when she finally passed away I thought that was the end. It is ghoulish to see her autopsied corpse now dragged through the presses again.

But, I mean, the other thing I don't get -- her brain? If it was down to half normal mass? Shouldn't they have picked that up with, like, a simple MRI or something? I am less appalled that a nonpracticing doctor, religious-ideologue politician like Frist would make medically unsound pronouncements that were religiously motivated and politically calculating. I am more appalled that her own doctors, what, missed this?, that her brain was half normal size? And that it never entered the debate before they pulled the drip?

I mean, what the hell?

[emptypockets]

p.s. also, how long does a freaking autopsy take? didn't she die, like, a month ago?

[DemFromCT]

emptypockets, the CTs, as I understand it, as well as other testing, suggested exactly that.

But after reviewing reams of medical evidence and testimony, Greer and the appeals court have repeatedly agreed with Michael Schiavo that her parents are living on false hope. They ruled that Terri Schiavo's cerebral cortex has all but disappeared and her parents are mistaking involuntary moments as a sign of awareness.

"CT scans just don't lie. When you look at that picture, you see a big black hole filled with water where her brain used to be," Felos said. "There is no cognition, no thought process, no awareness."

But no one on Randall Terry's side was willing to accept that her neurologists (not the phoney religious-based fools masquerading as experts) knew what they were talking about. The idea that Dr. Frist would rather rely on a videotape than her CT or MRI is absurd. As a medical man, he should be held to a higher standard than DeLay or Dobsen.

He should have known better. He either didn't (incompetence)... or worse, he did.

[DemFromCT]

emptypockets: Google sez:

How long does it take to get a report?

NAS will contact the person giving the consent for the autopsy with preliminary results right after the autopsy. A complete report will be mailed to the client family members within thirty days after the autopsy. If special tests have to be conducted, it could take longer for a completed report. Brain analysis usually takes approximately four to six weeks to complete.

[Plutonium Page]

I swear, watching Dr. Johnson on ABC News tonight was one of the few times we've shouted at the TV to say anything other than "you a$$hole" (yes, referring to Bush).

Tonight it was more like "oh SNAP" and "you tell them".

And yes, Frist is beyond incompetent. If only he were practicing, because then his license could be yanked for this crap... couldn't it?

[DemFromCT]

PP, blast from the past.

[emptypockets]

Right. Thanks for the reference. I would repeat my question about why this fact didn't enter the media debate originally (why did we see pictures of her sitting in bed, and not of her CT scan next to that of a normal brain - or did we?) but the answers are obvious and have been worked over ad nauseam.

I'd also say this is another case of one of those (rare, really) times when faith and science clash, and that it may say something about fundamental modern American attitudes that faith won out -- the belief in her spirit was more compelling than a CT scan, which goes along with magical thinking about angels, deistic higher powers to save you from credit card debt, deliver lottery winnings, and on and on.

The belief that prayer trumps natural consequences -- I think it is more damaging than what Frist has done. I guess what I'm trying to say, is that I by no means defend Frist (by all means, as a political tool for kicking Frist around, throw her brains at him, I guess. RIP.), but he is just one guy and not in my view a particularly popular or influential one. I worry not as much about what he says and does, as I worry that so many Americans are ready to believe these outlandish notions.

And for that, perhaps, we do have people like DeLay and Dobson to credit. And of course Janis Joplin: "Oh lord, won't you buy me a Mercedes-Benz?... Oh lord, won’t you buy me a night on the town? I’m counting on you, lord, please don’t let me down. Prove that you love me and buy the next round." Although I think when Frist sings it, he means it.

[DemFromCT]

Frist is contemptible, more so than the constituents he purposefully deludes with false hopes. His is a cynical (and shallow) approach designed to serve himself (and himself only) in 2008.

He is, like it or not, the Senate majority leader, and responsible for the Senate agenda. Since the WH and House are beyond reach at the moment, the Senate (because of its rules and traditions) remains an important power locus, and a place to slow the Bush agenda. And, therefore, Frist doesn't have to be popular (or even skilled) to matter.

[Meteor Blades]

Here's my guess. After Frist gets booted from his leadership spot, he'll return to doctoring, but as a multi-million-dollar medical expert on Fox. Perhaps Deepak Chopra will become Senate Majority Leader.

While I agree with your sentiment, emptypockets, about the ghoulishness of this whole affair, since the rightwingers were the ones who turned this into a pro-"life" circus with three whole rings devoted to ass-clownery, I say we squeeze every bit of mileage out of it we can. They sought political advantage from somebody's personal pain, and the American people pretty much busted them on it. So now, let them reap the whirlwind for a few days.

(By the way, everyone, if you haven't gotten your durable power of attorney and advance directives together yet, as you vowed you would do when Schiavo was in the news every day, don't wait until it's too late.)

[ltsply2]

Her CT scans were indeed floating around the internet at the time. I remember there was quite a little bruhaha over whether it was a major HIPAA violation. In any case (and I don't remember where I saw them) it was pretty clear to even the untrained eye that there was something wrong there. The wingnuts dismissed them as being in different planes or otherwise apples and oranges. Needless to say, every trained doctor that saw them knew exactly what was coming in the autopsy.

[emptypockets]

This may be a fundamental difference in our point of view. Which is not to say I feel that strongly about it, but it's interesting to discover these differences -- I often am not aware I think something until I meet someone who thinks the opposite.

My feeling is that there will always be evil, corrupt, and stupid people (and some who are all three), and so in a way I don't blame them. Someone's got to do it. But the people who elevate those contemptibles to higher office, particularly in a representative democracy: that seems more rotten to me, just because there are so many of them.

I guess my view would be that there will always be 1 psychopath in every 100,000 people, give or take, and you can't get too upset about it. But when more than 50,000 of 100,000 voters put that nutjob in office, there is something really wrong.

Insert half-sized brain (or, optional, blindness) reference here.

[DemFromCT]

emptypockets, I see your point. I just think many of Frist's constituents are sincere (misguided, by definition ;-) but sincere). I don't blame them... they're political opponents, not the enemy. Those who deliberately mislead and encourage them... they are a different kettle of fish altogether.

Put another way, it's YA reason I dislike GWB, not those who voted for them. Many of them already have buyer's remorse.

[emptywheel]

According to this diary at Kos (using admittedly problematic methods), Frist's approval ratings are sinking even faster then the Dear Leader's. So maybe we're NOT the only ones to have noticed what an incompetent Fristie is.

[DHinMI]

With all his screwups, and with this just further emphasizing how almost everything thought to be an asset with Frist is turning into a liability, I can't help but wonder if the boys over at NRO are scouring through Frist's personal background to see if he ever said something positive about the Klan.

[RonK, Seattle]

"Schiavo Autopsy Reveals Frist Brain-Dead"

[~DS~]

lemme just say flat out. If I'm in a PVS I want lots of IV opiates until such time as Stem Cell Treatment or any other can grow me a new brain, even if it doens't have any memories of the earlier one. Preferably all at the expense of the wealthy taxpayer.

[muledriver]

NY Times Editorial

"The autopsy results released yesterday should embarrass all the opportunistic politicians and agenda-driven agitators who meddled in Terri Schiavo's right-to-die case. There is no evidence that Ms. Schiavo's husband did any of the awful things attributed to him, and no hope that her greatly damaged brain would ever have recovered. The courts were right to conclude that she should be allowed to die after 15 years in what her doctors described as a persistent vegetative state with no hope of recovery.
snip

Those conclusions underscore how shallow and cynical were the judgments-from-afar by the Senate majority leader, Bill Frist, who is a doctor, and by other Republicans in Congress who contended that Ms. Schiavo looked responsive and that her condition might be amenable to treatment."

[charles]

Dr. "she responds to visual stimuli" Frist. That should be his name henceforth.

Charles

[emptywheel]

And NOW, from the land of makebelieve, Dr. First says he never made a diagnosis!!

Senate Majority Leader Bill Frist, a surgeon who had questioned Terri Schiavo's diagnosis during the intense national debate on whether to remove her feeding tube, said the autopsy documenting her severe brain damage brings ''a very sad chapter to a close.''

''She had devastating brain damage, and with that the chapter is closed,'' Frist said Thursday on ABC's ''Good Morning America.''

Frist, R-Tenn., said he never made his own diagnosis but did argue there wasn't enough information about Schiavo's condition to justify allowing her husband to remove her feeding tube against her parents' wishes.

''I raised the question, 'Is she in a persistent vegetative state or not?' I never made the diagnosis, never said that she was not. I did say that certain tests should be performed to determine that before starving her to death,'' Frist said in the interview.

I'd love to find someone with a Tivo to see whether the "reporter" followed up on this claim. Such as, "Dr. Frist, you said this blind woman was responding to visual stimuli. What are you, Jesus or something?"

[DemFromCT]

"I question it based on a review of the video footage which I spent an hour or so looking at last night in my office," [Frist] said in a lengthy speech in which he quoted medical texts and standards. "She certainly seems to respond to visual stimuli."

Well, he certainly SEEMS to be a liar and an incompetent buffoon. I have nothing to retract.

[DemFromCT]

the funny thing is Frist thinks that type of defense will work for him. All of a piece.

[Kagro X]

So should we now all be standing out in front of the Capitol with red tape over our eyes, bearing the message, "Diagnose me?"