Sunday, September 10, 2006

Persistant Vegetative State: A diagnosis in search for reality

The dirty little secret about "persistant vegetative state" is that it is a misnomer.

It is a deliberatly crafted term to dehumanize people with brain damage.

And the dirty little secret is that it is highly overdiagnosed, and the diagnosis is used to "withdraw unwanted medical treatment" from people: Read feeding tubes.

But the dirty little secret is that many people on feeding tubes could eat, but the nursing home lacks staff, so pop goes the tube. And the other dirty little secret is that Neurologists often recommend removing tubes from those who are aware of their surroundings.

I once had a Native American patient with severe frontal lobe damage and who was paralyzed. Like many people with frontal lobe syndrome, she cried when she felt joy, and screamed as in pain when she watched something she enjoyed on TV.

So we had a routine Neurological evaluation, asking if any of the new tranquillizers would work for her emotional outbursts.

Instead the Neurologist spent the entire 45 minutes pressuring the family to remove the tube and "let her die" (FYI: She could eat, but we supplemented with tube feedings).

The family being Native American didn't say anything, but on leaving, one of the younger relatives turned and said: We Indians don't kill our elders. We're not like you white people.

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