Originally Posted - July 5, 2006

return home

Had Michael Schiavo allowed his wife therapy during the dozen years preceding her death, she may have recovered significantly and regained her speech, just like Terry Wallis of Arkansas.

She might have been able to relate what really happened the night of Feb. 25, 1990, perhaps the real reason why Michael Schiavo refused to allow any therapy or rehabilitative efforts for his wife.

And most likely, she would say that she didn't want to die.

Three years ago, almost 20 years after Terry Wallis suffered a severe brain injury following a motor vehicle accident, the 42-year-old man spontaneously emerged from what doctors term a "minimally conscious state" and began speaking.


Wallis' recovery and what is termed the "rewiring" of the brain, a regeneration, a growth of new nerve connections to replace ones sheared off as a result of the car crash, is the subject of a landmark study on brain damage published in the July 1 issue of the Journal of Clinical Investigation, authored by Nicholas Schiff, director of the Laboratory of Cognitive Neuromodulation at Weill Cornell Medical College in New York City.
RESEARCH ARTICLE

Wallis initially remained in a coma for one to two weeks, followed by further recovery to a vegetative state, Schiff says, and subsequently a level of function consistent with MCS within several months of injury. "Although gradual improvements in responsiveness were noted over an ensuing 19-year-period, the patient was unable to communicate using gestures or verbal output. Limited head nodding or grunting were only inconsistently present".

Schiff said that "in essence, Terry's brain may have been seeking out new pathways to re-establish functional connections to areas involved in speech and motor control to compensate for those lost due to damage".

Schiff defines MCS as a specific level of functional recovery of severely brain injured patients who demonstrate unequivocal but intermittent behavioral evidence of awareness of self of their environment.

The study involving Terry Wallis used a combination of brain imaging techniques to look at the state of his brain at various points after be become fully conscious. Wallis still suffers from complete amnesia. He's convinced that Ronald Reagan is president, that's it's still the 80's. He can't walk and needs help eating. But he can recognize people and talk, can count to 25 and shows constant improvement.

"Patients will respond to sensory stimuli. They may track objects in the room, reliably fixate their eye or respond to auditory stimuli. On the higher end [they] will respond to commands. [They] may even verbalize or intermittently communicate. But and although they show evidence of conscious awareness, patients are unable to reliably communicate".

Such was the case of Terri Schindler Schiavo who died on March 31, 2005, at 41 after her husband, Michael Schiavo and death cult attorney George Felos petitioned the court to end her life after Schiavo's attempts to kill Terri by sepsis failed. Pinellas County Court probate court judge George W. Greer made his subjective discretionary determination that Terri was in a persistent vegetative state while acting in the dual role as surrogate and judge, never once visiting his ward, ruling with such prejudgment and prejudice against the Schindler family and their witnesses that even a person totally unfamiliar with the Schiavo case can see the preconceived determination of death by Greer in the Schiavo case by reading the court transcripts and subsequent written decisions by Greer. Greer appeared so fixated on disregarding any testimony by Terri's parents, he even "forgot" to swear in one of the most credible witnesses, Dr. William Maxfield, who testified that Terri could recover and was not in a persistent vegetative state.

In addressing the misdiagnosis of some MCS patients as PVS, Joseph Giacino, associate director of neuropsychology at JFK Johnson Rehabilitation Institute in Edison, NJ, says that "there may indeed be patients who are somewhat conscious who are being misdiagnosed as being in a vegetative state, and thus being shipped off to nursing homes without given the opportunity, resources [and] therapy to get better". Giacino says that "a patient who doesn't speak, respond to voices or move their head when spoken to might still have some level of awareness. And, if they do, it is more likely that they will improve in the future". He said some doctors and insurance companies might be diagnosing a vegetative state too early.

In Terri's case, she was responsive to voices and sounds and her PVS diagnosis reverted back to the 1990s. Just like with Greer's initial death verdict, regardless of the evidence to the contrary, the PVS diagnosis was not reversed and Michael Schiavo seemingly made sure that diagnosis made early on wasn't reversed, restricting her medical treatment, testing and therapy.

As in the case of Terri Schiavo, a mother's love is a powerful stimulant, with doctors and videos indicating that Terri responded and interacted with her mother. When Terry Wallis awoke three years ago, his first word was "Mom".

Wallis' recovery puzzles doctors and neurologists but doctors at the rehabilitation center where he was receiving therapy speculate that his recovery may be due to the loving attention of his family who took him out on weekends and special occasions, providing "mental therapy". In Terri's case, Michael Schiavo refused to allow such mental therapy, refusing to allow her parents and others to take her outside, refused to allow her outside of her room, refused to fix her wheelchair, ordered her window shades to be down at all times, refused to allow her to attend church, removed all family pictures from her room, refused to allow her to receive flowers from family and friends, refused to allow certain CD's to be played for Terri, refused to allow her to listen to music through headphones, limited the visitors list, refused to allow therapeutic animals to visit her, refused to allow her to attend nursing home functions but yet he claims he was a loving husband.

Schiavo, his attorneys and supporting physicians claim that Terri had no chance of recovery because she was PVS, a fact disputed by numerous physicians and neurologists as well as attending nurses who dared to speak out at great risk to themselves and their professional licenses. Carla Sauer Iyer, a former caregiver of Terri's, continues to maintain that with therapy, Terri could have recovered and was, in 1995 and 1996, saying such words as "mommy, help me and pain". http://www.northcountrygazette.org/articles/062506SchiavoNurse.html
Other caregivers who could corroborate Iyer's statements may have been threatened or intimidated into silence.

There is growing evidence that seemingly hopeless cases of individuals with severe brain injuries may be able to recover with therapy and other kinds of assistance if given a chance instead of being sent to a hospice to die by dehydration.

Renowned radiologist and a specialist in nuclear medicine Dr. Maxfield, founder with his brothers of the American College of Hyperbaric Medicine, testified at the Schiavo II evidentiary hearing in October 2002 there had been improvement in Terri's brain scans between 1996 and 2002. It's conceivable that improvement would have continued and while speculative, possible that had she received therapy in addition to Zolpidem or other drugs, that she may have recovered to a stage similar to Terry Wallis.
http://www.hyperbaric-care.com/hyperbaric_maxfield.htm
http://www.northcountrygazette.org/articles/052306PVSReverse.html

But neither Greer, nor Felos nor Schiavo were about to allow that to happen.

A new study released in May indicates that the drug Zolpidem is effective in restoring some brain function to patients previously determined to be in a persistent vegetative state. The Terri Schindler Schiavo Foundation for Health Care Ethics has called for a moratorium of all potential ordinary care removal from persons diagnosed in a PVS condition.

Terri's family pleaded for years with her estranged husband and the courts to use new brain imaging studies, treatments and drugs that could possibly help to improve Terri's condition but Greer rebuffed all efforts and refused to allow any new treatments or even new testing. He steadfastly adhered to his Feb. 11, 2000, death order despite medical and scientific advances and medical opinion, determined to end Terri's life by dehydration, a determination based on self-serving hearsay and highly unreliable and suspicious, almost openly concocted, hearsay by his brother Scott and sister-in-law, Joan Schiavo who Michael himself labels as a "ditz".
http://www.northcountrygazette.org/articles/052106JoanSchiavo.html
http://www.northcountrygazette.org/articles/060906ConvincingEvidence.html
http://www.northcountrygazette.org/articles/060206ConvincingFraud.html

Terri sustained severe brain injuries as the result of a still unexplained and suspicious incident which occurred at her home in the early morning hours of Feb. 25, 1990, when her brain was deprived of oxygen for four to six minutes. The collapse followed Terri's expressed dissatisfaction with her martial relationship and the expressed desire to divorce Michael "if she had the guts". Her injuries occurred within 24 hours of an argument with Michael about the cost of having her hair done as he was often unemployed and they were incurring money difficulties because of his employment instability but lavish tastes for expensive clothes and jewelry, even buying expensive watches for male friends. Michael's brother, Scott; Terri's best friend and co-worker, Jackie Rhodes; and her brother Bobby each relate that Terri and Michael had argued heatedly in the hours before her collapse and her sister, Suzanne corroborates that Terri had expressed her desire to her to divorce Michael, indicating a less than idealistic marriage existed than Michael Schiavo relates.

After Michael and his attorneys, Gary Fox and Glenn Woodworth obtained a net sum of about $750,000 for therapy and rehabilitation for Terri following a medical malpractice trial and another $250,000 in an out-of-court settlement with another treating physician of Terri's for allegedly failing to diagnose bulimia, within months Michael ordered that Terri receive no therapy and attempted to kill her by sepsis following the suggestion of Dr. Patrick Mulroy, one of Terri's doctors, by attempting to withhold medical treatment. After the nursing home refused to honor his demand, saying it was unlawful, Schiavo then ordered all therapy be ceased and moved her to another nursing home. On the recommendation of Dr. Mulroy, Schiavo chose Dr. Victor Gambone as her attending physician who placed a do not resuscitate order on her chart. Eventually Gambone was successful in having Terri admitted to Woodside Hospice albeit she was not terminal as hospice admission requires and the hospice application did not have the required signatures of two physicians.

The Schiavo autopsy revealed that Terri was not bulimic and had not suffered a heart attack thus the claims filed in 1991 and 1992 by Michael Schiavo, his attorneys, Daniel Grieco, Fox and Woodworth, were fraudulent insurance claims. The findings of the autopsy were based on medical records which were provided by Fox, some of which were missing. From within hours of Terri's collapse when Grieco quickly appeared at the hospital to convince the Schindlers to sign away their rights to having a say in Terri's medical treatment and records, until the autopsy, Grieco, Fox and Woodworth controlled the fate of Terri Schiavo, sealed by death cult attorneys George Felos, Deborah Bushnell, Hamden Baskin III, Jon Eisenberg and others. Even though Michael ultimately decided it would be Terri's wish to live and directed Felos to stop the death march, Felos refused saying it wasn't about Terri, it was about the right to die movement in America.

From Feb. 25, 1990 until March 31, 2005, Michael Schiavo controlled virtually every facet of Terri's life……and death and ensured that no exhumation, no second autopsy, no review would ever be done by ordering her cremation, even trying to skirt the autopsy until learning it was required by Florida law. Questions continue to compound surrounding the autopsy report and why Dr. Jon Thogmartin, Pinellas County medical examiner, refused to allow any other physician, medical examiner or pathologist to observe the autopsy.

Schiavo and Felos were persistent in their claim that Terri was PVS, the standard they needed to establish to cause Terri's death by court order, in addition to showing clear and convincing evidence that Terri would want to die. Judge George Greer aided and abetted them in their claim, disregarding ulterior and conflicting motives of Michael and repetitively attacking all reliable evidence that established that Terri was not PVS. When Schindlers' attorney Patricia Anderson made a forceful attack on the creditability of "expert" witness of Dr. Melvin Greer, proffered by Schiavo and Felos, who allegedly gave false testimony in Bradley and Bradley v. Allstate Insurance Co., Judge Greer quickly sided with Felos, refusing to let Greer answer if the circuit court had issued a case order for a new trial partly for the reason that the court believed that Dr. Greer had given false testimony on behalf of the insurance company.
2002 TESTIMONY - PART 2

In his testimony at the October, 2002 medical "trial" in the Schiavo case, remanded by the Second District Court of Appeals, Terri's attending physician Gambone testified that he was not qualified to determine if Terri was PVS and instead "felt that she was in a persistent vegetative state".

In their motion in 2000 to set aside Greer's 2000 death verdict, the Schindler family had alleged that there was evidence of a new treatment that could dramatically improve their daughter's condition and allow her to have cognitive function to the level of speech, much like Terry Wallis.

The DCA said that the "Schindlers will need to support similar evidence at the hearing to support their claim for relief from judgment". At the evidentiary hearing in October 2002, testimony was presented by five doctors and Gambone, two doctors chosen by the Schindlers, two by Schiavo and one by the court. After hearing the testimony, had Greer accepted the argument, and evidence, now growing by leaps and bounds, that Terri had a chance for recovery with treatment available, he could have ordered a new trial.

Gambone testified that he saw Terri "every four months or so" for about 20 minutes which consisted of reviewing her medical record, talking with the staff and doing a physical examination which lasted "maybe 10 minutes". Therefore, over the course of a year, Terri's attending physician spent 40 minutes or less conducting physical examinations of her but yet determined that she was PVS with no hope for recovery. Gambone also testified that he deferred to Michael Schiavo's recount of Terri's medical history and testified that Schiavo had "declined" all therapy evaluations of Terri, both speech and physical therapy. Testifying that he had been her attending physician by Michael's choice since 1998 and that he took all direction on her medical treatment from him, Gambone said that Terri had no physical or speech therapy since in his care since 1998.
2002 TESTIMONY - PART 1

Gambone testified that the decision to move Terri to Woodside Hospice was made by Michael and that while the guidelines were that hospice patients were expected to die within six months, Terri had been at Hospice Woodside the longest, admitted in April 2000 when Felos was a member of the board of directors.

Gambone admitted that he could not read a CT scan and that when Terri came into his care in 1998, he accepted then seven-year-old diagnosis of Mulroy and others that she was in a chronic persistent vegetative state. He did virtually nothing to independently attempt to confirm that diagnosis except to read reports of other physicians and his own 10 minute exams four times a year. His first "examination" consisted of spending an hour with Terri, part of which was spent looking at reports, and he never saw her in the presence of her family with whom there is evidence that she visibly interacted.

Gambone testified that all information concerning Terri outside of the written medical record he received from Michael Schiavo and that he had never interviewed the Schindlers.

PATRICIA ANDERSON: (Schindler's attorney): So in addition to using your voice and putting your hands over her eyes and checking her reflexes and reading reports, what else did you do to satisfy yourself that she was in a persistent vegetative state"?

GAMBONE: I felt that I was satisfied from that point. I examined reports, discussed with the staff, reviewed the records. I felt that she was in a persistent vegetative state. She has not changed during the four years I have taken care of her".

Maxfield Pg. 33
Q. How many separate days did you see her?

A. As I remember, I observed her on three different days. And then I had another day when I went in and examined her or watched actually perform certain functions which I videotaped.

Q. Now, when you observed her and when you examined her, were any family members present?

A. Yes, they were.

Q. Who were they?

A. Initially it was her mother and her father and then when the videotape was made her father was there and she talked -- her mother talked to her on the telephone.

Pg. 36
A. I have looked at the CT scan that was done in 1996 and also the one that was done in July of this year. And the SPECT brain scan that was done, I believe, in August.

Q. I want you -- I have a blowup and I want you, before the Court, now I want you to tell me if these are the two CT scans that you examined?

A. Yes. Those are blowups of the images that I examined.

Q. Now, in addition to the blowups that are on the easels here in the courtroom, were you also provided with cell-by-cell blowups of the two CT scans?

A. Yes, I have reviewed the ones of the first ones, and the second set of scans I haven't had a chance to directly compare.

Q. Okay.

A. The second set of blowups, I mean.

Q. Have you formed any opinions, with a reasonable degree of medical certainty, about any changes in these scans?

A. Yes, I have.

Pg. 60
……..And the brain tissue on the '02 study, in my opinion, is more homogeneous than it is on the study from '96.

Q. What do you mean by homogeneous?

A. That there's a more uniformed pattern, that you don't have as much gradation of density in this area as you did on the '96 study. And when you look at the ventricular system the ventricles have not enlarged really in the six-year interval between the two studies.

Q. So the ventricles have remained basically the same in size, correct?

A. In my opinion, yes.

Q. And the brain tissue on the 2002 scan is more homogeneous in appearance than it was six years ago?

A. That is my opinion.

Pg. 61
Q. What does that tell you as a radiologist?

A. It tells me that the brain tissue on the '02 study has a more normal appearance than it did on the 1996 study.

Q. What would account for that?

A. This is what we have learned is that there can be some regeneration of brain tissue. When I was in medical school we were taught that brain tissue never regenerated, but the experimental animal data and also the current clinical data is now telling us that that is not true.

Q. Have you formed an opinion, within a reasonable degree of medical certainty, that she has more brain today as shown on this 2002 scan than she did as shown on the '96 scan?

A. I wouldn't put it in terms of actually more brain. I would say that the brain that we see is more normal in pattern than on the '96 study. That we can look at other areas and see the brain tissue and we can see a more uniformed pattern.

Pg. 70-71
Q. Are there other areas of Terri's brain that you can identify look more homogeneous on the '02 scan than on the '96 scan?

A. Essentially all of the areas when you look at the brain tissue look, in this cerebral hemisphere looks more uniform. And we've talked the about the frontal lobes and the temporal lobes and the occipital lobe and the motor areas so that these areas have a pattern that is closer to what you would see in a normal brain scan.

Q. Wouldn't you expect Terri's clinical symptoms to be different as between; '96 and '02?

A. There probably has been some improvement and this would relate to more ability to see things and more recognition than things around them.

Q. Okay. Is there anything else of note in comparing these two scans?

A. Not really except to come back to the point that there has really been no increase in the degree of the enlargement of the ventricles.

Q. What would that tell you?

A. That there has been no progression of her loss of brain tissue. And based on what I see of the scans, the brain tissue that's demonstrated appears more normal than it did on the '96 scan.

Pg. 105
Q. Dr. Maxfield, have you formed any opinion, within a reasonable degree of medical certainty, whether Terri Schiavo can be helped to the point where she can recover cognitive-- better cognitive function?

A. Yes, I have.

Q. What is that opinion, sir?

A. In my opinion, there's a significant probability that she would improve with hyperbaric oxygen therapy based on what I have seen in the CT of the brain, the SPECT scan, and my observation and examination of the patient.

Pg. 109
Q. Dr. Maxfield, do you have an opinion, within a reasonable degree of medical certainty, whether Terri Schiavo is in a persistent vegetative state?

A. Yes, I do.

Q. What is that opinion?

A. That she is not in a persistent vegetative state.

Q. Upon what do you base that opinion?

A. The fact that she has the ability to track the balloon when you observed her. That she has visual tracking of lights. That she recognizes her mother. That she can breathe. She can swallow by herself.

Pg. 110
Q. Dr. Maxfield, do you have an opinion, within a reasonable degree of medical certainty, whether Terri Schiavo's -- the fact that she is 12, nearly 13 years out from her injury, precludes her recovery were she to receive therapy?

A. In my opinion, it does not. Particularly with the data that's coming out on the stem cell research and what the clinical potential is for this technology.

Q. Had Ms. Schiavo received physical therapy during the last 10 years, would you have expected to see different brain studies?

A. I don't know that the physical therapy would have changed the brain studies though there are people who feel there is some degree of feedback that works that way. And I think you can look at the data that's recently come out about Steve (Christopher) Reeves and his ability to start to wiggle things a little bit that relates to the recovery process.

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