Wednesday, 8 July 2015

The Troll

The trolling in the comments here has gone from 0-100 ever since The Troll (not his real name©) decided to flaunt his stupidity around here.  I've always enjoyed getting comments on my stories, but in the past few days it has become a burden.  I've had to delete more comments in the past week than in the previous 3 years combined.  I started moderating comments to weed out the particularly stupid ones (though still publishing the truly idiotic ones just for posterity), but the way blogspot's commenting system works, publishing or deleting comments is cumbersome and awkward, especially on my mobile.

I suspect most (if not all) of the trolling comments are coming from the same person, but some of the comments are downright ludicrous.  So I thought I would share in case you missed it.  This one is my favourite of the bunch, from the "Crazy" story (about the young girl whose mother would not let her get a CT scan):
This seems to be the same The Troll who claims to be a former general surgeon and currently a lawyer.  See the "level 2 or 1 hospital" verbiage, and compare it to this comment posted about 90 minutes before on the Easy Call Day? story:

Obviously The Troll doesn't know a thing about surgery, or else he (or she, since this person insists she is not a he) would know that no X-ray, CT scan, MRI, ultrasound, or any other supporting test is necessary to take a patient to surgery.  They can sure be helpful and they are often ordered by emergency physicians before they even call us, but they are not mandatory in any way, shape, or form.  Strange - I would think a former general surgeon would know that.

Unfortunately The Troll also doesn't know that trauma surgeons don't "assist" general surgeons, because trauma surgeons are general surgeons.  ALL OF US.  I would think a supposed former general surgeon would know that too.  And in his ridiculous haste to assume that I am only a trauma surgeon, he also seems to have missed this little nugget of information that is prominently displayed on my sidebar:
Oopsie.  I hope he feels appropriately stupid.  Because he sure looks stupid to me.

Now I will apologise to the loyal readers and loyal commenters not only for boring you with this tedious dreck, but also for requiring your comments to be approved before they are published.  This is the only way to keep The Troll away.  I have prided myself on keeping the comments wide open since I started this stupid little blog, but The Troll has necessitated this.  I will do my best to approve your comments quickly, and I will also do my best to keep The Troll off the comments.

Unfortunately that means I will have to read through all of them and try to determine which are his and which are not.  It also means that I may accidentally delete some comments that are not his.  I will apologise in advance.  To prevent this from happening, I'd encourage anyone who has been commenting anonymously to take a few seconds and create a profile.  Hopefully The Troll will slink back to his cave sooner rather than later, and this will all soon be but a happy memory.

Now that that's over, we now return you to your regularly scheduled stupid patient stories.  Yes, they're coming back, and soon.  I have a whole slew of them lined up.  The idiots have been out in droves lately.

59 comments:

  1. Doc: Don't know if first comment worked computer is being wonky. Gotta say you handled this Troll wonderfully. Your blog is awesome as well as your work for mankind takes a certain person to take on the trauma bay. Keep up the amazing work...may the call gods be with you and may you get enough sleep that you need each night.

    ReplyDelete
  2. So many trolls, so many competing field guides!

    Wednesday

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  3. Doc, Keep saving lives and writing about it and whatever else you fancy. Do what you got to do to protect your blog.

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  4. That isn't even a tenth of the professions the troll has claimed.

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  5. I never read the comments. And now I feel like I've been missing out this whole time LOL

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  6. The best way to kill the troll is to stop feeding it. Trolls crave attention, it's their life source, and you're giving him that by responding to his ridiculous comments. And now you just wrote an entire blog post about him. This really isn't the way to handle it.

    ReplyDelete
    Replies
    1. I know, and I usually don't feed trolls. This one is particularly hilarious, so I'm playing with it a bit.

      Delete
    2. I totally understand...some of the posts are just SO absurd that it's hard to resist...though I totally "get" what Alex is saying too :)

      IMHO, I think the format you used for this latest blog entry was a good compromise strategy. If he posts something that is just too silly *not" to share, delete it from the real discussion thread, and save it for an occasional blog feature, maybe "This week's Troll Report" or something of the kind. This would allow those not interested to skip over it to the next entry, while those of us who want a good laugh could choose to read it, and *all* readers, no matter what our favorite topics might be, would be spared the nuisance of having the troll's comments pop up on our other discussion threads.

      Delete
  7. Isn't there a way to only allow posts connected with a profile? I seem to remember that anonymous commenting was prohibited until only a short while back.

    Other than that, I don't mind waiting for my comment to appear, I just hope the troll infestation is over soon so you can use your precious time to write more stories instead of moderating comments.

    I have to agree with Alex though: stop feeding the troll. Delete all his/her/it's comments and don't answer to any of them. That's the fastest way to get rid of them.

    ReplyDelete
    Replies
    1. I can set it to only allow readers with a Blogger profile to comment, but I'd prefer to allow anonymous readers to continue commenting. I've already deleted several more comments of his where he claims he is now ABSOLUTELY CERTAIN I'm not a doctor and a I'm a fraud and he's reported me to various and sundry entities etc etc. It's all very pathetic.

      Delete
    2. That's pretty tame for him. I've poked him enough to earn a couple of death threats and somehow inspired him to post dead baby pics. He really doesn't like me.

      Delete
    3. This is pathetic, "he claims he is now ABSOLUTELY CERTAIN I'm not a doctor and a I'm a fraud and he's reported me to various and sundry entities etc etc. It's all very pathetic."

      Who did he report you to? The internet police?

      He is obviously, jealous of you. Many of us find you interesting. Those with medical knowledge feel that you are much better informed than he who must not be named. Actually, his google education can tell he is a fake.

      Delete
  8. Your troll hasn't even bothered to watch some ER television (NY ER, Trauma:Life in the ER, Untold Stories of the ER), which is widely available here in the US. I'm an L&D and even I know they often take unstable patients straight to OR! Still enjoying, greatly appreciating your stories. Please don't let the weirdos dismay you.

    ReplyDelete
  9. I don't mind moderated comments, either. If it's what's needed to keep the spammin' idiot away, so be it. At least the comment threads will remain, for the most part, on topic or close to it.

    For this alone, I thank you.

    I've been a long-time reader here, or at least, it feels like it's been a long time, but I come back every so often to see what new hilarity awaits. I got a kick out of the Call Gods giving you an easy day for once, after all, and while the comments about Ms. McMath have been amusing to read, I much prefer things like the idiot who crashed his motorbike, because the source is, well, something not steeped in politics.

    Plus, I get a grin every time you come up with one of your public service announcements as to why you shouldn't smoke, drink, or some other thing we all know is bad for you, because inevitably there's a hiding sneaky twist in there that is bound to have me laughing so hard that it hurts.

    So, keep up the good work, and I await the incoming hilarity from the new stories you've hinted at.

    ReplyDelete
  10. Is this the same person that trolls on EVERY Jahi McMath story out there?

    I enjoy your blog Doc B. Keep on going and do what you have to do to muffle the fool.

    ReplyDelete
  11. Love your blog! Keep on educating and entertaining us.

    ReplyDelete
  12. For someone who is both a lawyer and an MD he certainly has some horrendous grammar.....

    ReplyDelete
    Replies
    1. And, a suspiciously strange lack of professional attitude and plain common sense.

      On the other thread, s/he/it refuted one of Doc B's statements by saying something like, "I know how things are done at every hospital." It's illogical for *anyone,* in *any* profession, to assume that his or her own personal knowledge and experience, no matter how extensive, is automatically reflective of what happens in *every* situation.

      Delete
    2. not to mention the delusion that if Doc B is not part of the 33rd best medical system in the known world, he is not a real doctor.

      add in that the whole medialized artery/pseudoaneurism theory he has been cut/pasting all over the internet assumes necrotic tissue at the surgery site.

      now I'm just a dumb firefighter and i know it takes longer than an hour for tissue to become necrotic after a surgery.

      Delete
    3. Agreed. He's posted on another site that "Docbastard is a 'foreign' trained doctor who is spreading lies on the internet and defending Rosen. I caught him with his comment below: (more crap on the medialized carotid artery)."

      As though a 'foreign' trained doctor is somehow substandard? If that were true, and there were no excellent physicians and surgeons anywhere else in the world, people outside of the USA would probably still be routinely dying from the plague!

      Delete
    4. He keeps making that same erroneous argument about the carotid. Surgeons may report anomalous anatomy in our operative reports, but we aren't obligated to do so. Nor are we required to inform anyone else about anomalous anatomy. If we are concerned there may be an issue because of the anomaly, telling the recovery room nurses about the concern is definitely appropriate.

      Here is the point that I hope The Troll tries to grasp: If I am ever concerned about bleeding before I leave the operating theatre, then I shouldn't be leaving the operating theatre without addressing the area concern first.

      Delete
  13. Doc got to say you are AMAZING the patience you have against this ignorant Troll is something else he has caused so much ruckus on other blogs and sites its not even funny i.e discus etc. I know having to moderate is no fun but for someone who has been reading your blog a while (and I love it) it is soo appreaciated. Thank you for all that you do in your trauma bay and the wonderful stories on here!

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  14. The Troll has moved over to the Medical Futility Blog and is now crying to Professor Pope about how Doc banned him for posting, you guessed it, his medialized artery/pseudoaneurism theory.

    ReplyDelete
    Replies
    1. And, today he posted a long diatribe against Doc B's story about Michael, the stabbing victim (more crap about how it must be a lie, since Doc B is not a "thoracic surgeon."). But...the site is the "Keep Jahi Mc Math on Life Support" FB page!

      Most of the contributors are the well-intentioned but delusional folks who keep praying for a miracle against all odds. They have no interest in any *real* medical information pertaining to Jahi's situation, much less in the *other* stuff Doc posts on this blog.

      A commenter said simply, "This site is about Jahi McMath."

      Delete
    2. He tried posting that comment here, where it was summarily nuked.

      S/he continues to prove that s/he knows nothing about trauma surgery despite his/her claims to be a former surgeon. I'm trained and authorised to operate on any part of the body from stem to stern. That said, I have never performed a brain surgery on my own (yet). And though I rarely do emergency thoracic surgery without a thoracic surgeon present, I have done so many times and will continue to do so whether The Troll believes me or not.

      Delete
  15. The Troll could be a sideshow for worlds dumbest quacks. Lawyer and MD who is omnipotent and omniscient amd knows that ALL hospitals are alike? Tell him/her/whatsit to get off their imaginary high unicorn.

    ReplyDelete
  16. As a side note
    WHY DID IT TAKE THE TROLL SO LONG TO FIGURE OUT YOU DIDN'T WORK IN THE U.S? I FIGURED THATOUT ON THE FIRST DAY AT THREE IN THE MORNING RUNNING ON TWO DAY SLEEP DEPRIVATION AND COFFEE. GAAH!
    Sorry for the all caps doc. I had to scream at something
    Also a question of the medical kind, my left middle side of my torso has been hurting like crazy. Pulled muscle or what else could be causing it? Pain level is about a six. Hurts to walk and yet, no extreme activity has been had. Just wondering if this is a hospital stay waiting to happen or just a "probably bruised it you ninny" thing

    ReplyDelete
  17. If you are familiar with Doc's blog you would know that off-topic questions are a pet peeve of his. Also, are you seriously asking him to diagnose your medical issue over the internet? Are you The Troll trying to trip him up or something? Forget about it, he's way too smart for that.

    ReplyDelete
    Replies
    1. No, I am not the troll. If I were I'd be blabbing nonsense, don't you think? I am familiar with Doc's blog thankyouverymuch and forgot off-topic questions are a pet peeve as I've been absent from his blog for about a year, besides, I don't trip people up. I'm too short to trip anyone.

      Delete
    2. No worries...I believe you, even though I have no idea who you are, because:

      1. "Our" Troll would never seek medical advice, even informally in conversation, from a "foreign" trained doctor who s/he has already accused of being a fraud.

      2. "Our" Troll would never NEED a medical opinion anyway, since s/he already IS a Medical Doctor, who apparently participates in "continuing education" on a regular basis, as offered via the University of Google.

      :)

      Delete
  18. The Troll left this post on the Keep page. Check out the fantastic leaps of failed logic in coming to his stunning conclusion:

    "The Harvard ad hoc committee to examine the definition of brain death, was chaired by anesthesiologist Henry Beecher.

    In 1965, Upjohn Company - a pharmaceutical manufacturing firm founded in 1886, sponsored Henry Beecher to explore the problems
    and complexities of clinical research before a group of journalists.

    See the connection there?

    Prednisone and prednisolone were introduced in 1955 by Schering and Upjohn, under the brand names Meticorten and Delta-Cortef, respectively.

    Upjohn, like other pharmaceutical companies were heavily involved in the development of chemicals to prevent rejection of transplanted organs. And one of those chemicals was prednisone - a steroid used to help prevent or treat rejection in organ transplantation. It prevents rejection by inhibiting the cells in the immune system that cause rejection and is given with tacrolimus or cyclosporine.


    So there you go. The definition of brain death was actually initiated by the mighty pharmaceutical industry to market the steroid 'prednisone.'"

    I can't even...

    ReplyDelete
    Replies
    1. Really! Even the math doesn't work here. How much prednisone is actually sold for use by organ transplant recipients, as opposed to the quantity *routinely* used to treat not just humans, but even our pets and livestock, for a wide variety of conditions that respond well to this particular anti-inflammatory drug? This makes as much sense (not!) as accusing Bayer of "inventing" heart disease to sell more aspirin.

      I didn't even bother sharing the *other* recent post on the "Keep" page, which stated that Dr. Beecher had "experimented with LSD." But today he suggests the possibility that Beecher was dispensing LSD for his personal use, so may have been under the influence when he "came up with the brain death idea."

      Brain death isn't an "idea" that someone "came up with." The condition may not have been well-understood and well-defined until extensive studies were done, and its presentations and effects were thoroughly compared with a variety of other already-known conditions that render a patient unconscious and impair bodily functions to some degree. But it was happening, or there would have been no need to study it.

      Delete
    2. Not to mention that without the advent of mechanical ventilation there would be no death by neurological criteria because death by cardiorespiratory means would soon follow an hypoxic injury. Why are resuscitative efforts continued long after the brain passes any viability threshold? In Jahi's case they continued for 2 1/2 hours! I've read that if you have a DNR order on your living will you should make it clear to relatives they are not to call 911 or take you to an ER because they must try resuscitating regardless of your wishes. There should be some kind of standardized limit to CPR efforts. What is the point if you are left brain dead or in a PVS?

      Love your analogy regarding Bayer and heart disease!

      Delete
    3. we are required to attempt resuscitation unless we see the DNR. If we have no reason to doubt the existence of a DNR, we can take our time starting CPR while you fish it out, but the law requires us to see it.
      however, if the patient is obviously beyond saving we can call them without attempting CPR. as a general rule of thumb, we will make a more heroic effort on a child than an adult, because no parent should have to bury their child.

      the other side is, the relatives should still call 911, but they should make a point of saying there is a DNR in place, because that will get all the right people coming in your direction. you will want a medic to confirm death, and a law enforcement officer to document the death. they, in turn, will bring the medical examiner if needed, and coordinate with the coroner or funeral home. They can also dispatch a Chaplain, who, at least where I am, is also trained in the practical matters dealing with the death of a family member, like all the hoops you will have to jump through to get all the documentation taken care of, and what you will need to to to transition them from where they sit to their final resting place.

      the good news is that there is maybe 1 in 100 cases where resuscitation efforts result in a dead person with a heartbeat.

      Delete
    4. Some people are too frail from disease or old age to withstand the CPR attempts. Would you still do it if they didn't have a DNR?

      I'm thinking of my sister who passed away one night in a nursing home. She had metastatic cancer and weighed barely 65 pounds. Her heart stopped sometime in the night after all visitors had gone home. She requested full treatment and heroic efforts at every family care conference even though she was terminal, otherwise she would've been in hospice. I have a feeling CPR was not attempted by the nursing home staff but we, as a family, had no problem with that.

      Is it true that if you opt for hospice care in the event of terminal illness it is with the understanding that any care is palliative and CPR is not an option?

      Delete
    5. DNR statutes vary widely. In WI, for instance, once a DNR is issued, the person gets a bangle noting that DNR. It's distinctive, it's on your wrist (though you can take it off at any time), and it tells the ER and even the EMTs responding to an accident that you are DNR.

      If there's no DNR, they will attempt CPR no matter how frail you appear. I don't know what's worse for relatives - hearing the ribs of their loved one break during CPR or a bunch of medical people standing around, watching monitors until they can process the body. At least with a DNR, the family can reassure themselves that they are acting in accordance with the wishes of their loved one. Maybe a smidge of the sting of having a loved one die diminishes when you're acting in accordance with that person's wishes.

      DNRs do not have to be applied to living wills (some states, like MA, do not accept/recognize living wills) or POAs. They are generally separate documents, though referencing them in a POA and making sure your attorney in fact is on board and capable of adhering to your wishes is even more essential than having a POA or DNR.

      Btw, Doc Bastard - you use the phrase, "not his real name (c)" all the time. If you look into it, I think you might want to use "not his real name (tm)" instead. In the US anyway, your blog is already protected by copyright whether or not you're making a Library of Congress filing (you need that LOC filing should you want to initiate a suit against somebody, but your date for copyright purposes is the date of publication, i.e. the day you share your writing with somebody else). Trademarks, however, need to be marked accordingly in every use, and your use of "not his/her real name (c)" reads to me more like an issue of trademark.

      Delete
    6. Unlike The Troll, I do not claim to be a lawyer, but a 0.562 second Google search tells me that you're absolutely right - I should be using ™ rather than ©. I'll start doing that henceforth. Thank you kindly.

      Delete
    7. To Anonymous15 July 2015 at 15:34, who wrote:

      "Not to mention that without the advent of mechanical ventilation there would be no death by neurological criteria because death by cardiorespiratory means would soon follow an hypoxic injury. "

      Exactly! That's one of the points made by Dr. Calixto and his team in the article I mentioned yesterday. The concept of "death by neurological criteria" evolved because of advances in medical intensive care, which gave us the technology to keep various body processes going, even when the parts of the body that would normally control these functions had failed. For thousands of years, humankind had pretty much universally accepted the fact that a person was dead once the heart had stopped beating, so blood circulation and breathing stopped too. But the line between "dead" and "alive" started getting blurred, once we had machines that could keep the lungs breathing and the heart beating, and medications that could keep other body processes regulated to some extent, even when the brain that usually controlled these processes had been irrecoverably damaged. Both medical professionals *and* their patients (and patient families) were then faced with the challenge of figuring out when technology should be used for "life support" towards the goal of achieving some degree of healing and recovery, and when it would be "futile care," if there was no realistic possibility of improvement over time.

      You also wrote:

      "Why are resuscitative efforts continued long after the brain passes any viability threshold? In Jahi's case they continued for 2 1/2 hours! "

      Other readers have already shared some useful insights. IMHO, the reason this happened in Jahi's case was most likely due to the situational dynamics, rather than any particular policy being followed:

      1. The family was present, and of course visibly distressed, and not ready to "give up" on Jahi's being stabilized. Parents who take their child to the hospital for a planned corrective surgery aren't even really thinking about the *possibility* of death, much less putting a DNR order in place.

      2. Since Jahi hadn't been presenting any obvious symptoms of distress immediately after the surgery (she'd recovered consciousness, and it's reasonable to assume that all of her vitals were monitored throughout this process and found to be OK) this was an unexpected "turn for the worse" in a patient who had been previously stable. Medical staff may have reasonably hoped that if they continued the resuscitative efforts, there was a chance of success.

      3. As Ken has stated, it's pretty normal for responders to make extra efforts with a child, just because the loss of a young life is harder to accept. Besides that, kids, at least those who've had reasonably average health before their traumatic injury or illness, often rebound from setbacks that an adult wouldn't survive.

      If Jahi had been a frail elderly person already suffering from serious illness, my guess is that the response would have been much different.

      Delete
    8. Just a legal question...does one really *need* to use a "tag" after the phrase (not his/her real name)?

      I see people write this all the time on blog and message board postings, not just by those legally and ethically bound to protect patient/client confidentiality (doctors, attorneys, social workers) but by anyone else wanting to share an experience while not violating the confidentiality of the person they reference (friend, acquaintance, co-worker, whatever). I've never seen anyone using the trademark symbol with it. SHOULD they be using it?

      Delete
    9. I use "not her real name" for clarity. I started using the copyright symbol as a joke, and it became a running joke. However, the correct symbol to use (as I learned very recently) is the trademark symbol, so I'll switch to using that. I could legally trademark the phrase if I really wanted to (assuming no one else has), not that I'm actually planning on doing so.

      Delete
  19. Another example of failed logic...

    I was trying to learn a bit more about the 1968 Harvard Medical School ad hoc Committee on Brain Death when I came across an article titled:

    "The concept of brain death did not evolve to benefit organ transplants"

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2652772/

    Published in 2007, it cites a number of historical facts that illustrate its thesis, which is that organ transplantation and the brain death concept originated and evolved separately, and that the perceived relationship between the two is a much more recent association. This wasn't a big surprise to me, since I'd figured as much, but the historical data was informative.

    The "interesting" finding was the fact that the first author's name listed as a collaborator on this paper was Calixto Machado.

    Yeah, we've seen that name before. He was one of the "experts" recruited by Dolan, through the IBRF, to submit a statement to the court that challenged the determination of brain death in Jahi McMath's case. No need to post the whole thing here again, since we've discussed all that on other threads. For those who need a refresher, here's the link, thanks once again to our diligent keeper of the records, Professor Pope:

    http://www.thaddeuspope.com/images/2014-10-14_Signed_Declaration_of_Dr_Calixto_Machado.pdf

    So...does it make sense for someone who accepts Dr. (PhD, not MD) Calixto's opinion as "expert," in challenging the determination of Jahi's brain death, to refute his "expert" opinion, supported by research he's done, to disprove the assumption that brain death was invented by the organ transplant advocates, for their own convenience?

    Maybe "someone" isn't taking all the right classes at good old Google University...

    ReplyDelete
    Replies
    1. but... cornboy has 10-20 thousand informations. how can he be wrong?

      I mean besides the fact that his "informations" are a combination of cut & paste google findings he doesn't comprehend and don't actually pass scrutiny and screenshots of where he got spanked by real doctors, and people with legal training, and people who have experience with brain issues, and even just people with working brains.

      Delete
    2. Ken - I think what we're seeing here is an example of someone who, sadly, has apparently failed the "people with working brains" test.

      Today's post to the "Keep" FB page is another journal article by a pair of doctors who believe that "whole brain death" can't be conclusively determined by what they categorize as the typical "bedside tests" currently in use for this purpose. OK...no problem with recognizing the fact that different people have different opinions. BUT...the first line of his post is:

      "Jahi's brain death diagnosis can be challenged in court. "

      Duh. Can he REALLY not remember that it already HAS been challenged in court, and the challenge failed because the evidence submitted to the court was found to be insufficient to justify reconsideration of the diagnosis?

      Even those of us who *don't* claim to be attorneys know that you can't bring a case back into court *just* because it didn't get the desired result the first time. There would be no purpose served by Dolan, Counselor Troll, or anyone else attempting to refile a case that would once again challenge the brain death determination *unless* some medically-significant new evidence could be presented. Not gonna happen.

      Delete
    3. there are those who suspect the "lack of working brain" may be close to the truth. he is showing signs of an irrational fixation, delusional behavior, and antisocial acting out.

      Delete
  20. Professor Pope had this to say about the matter:

    "I recently blogged about the defendants' demurrers. Since the family's lawsuit seeks future medical expenses, they are alleging that Jahi is still alive. The defendants' demurrers deny this and argue against re-litigating the determination of death.

    The hearing on the demurrers is set for July 30. Consequently, the McMath family's opposition is due by Friday, July 17 (9 court days before the hearing). That opposition brief should reveal both (a) whether they intend to re-litigate the determination of death, and (b) why they think that is warranted."

    Last fall Dolen didn't dispute the original diagnosis from December 2013. He was trying to say that new evidence suggested that Jahi's brain healed and no longer met the criteria. Since he dropped the attempt after Dr. Fisher's declaration the matter of trying to rescind the death certificate never happened.

    Dr. Rosen and CHO are citing the original court filings from January 2014 as evidence that the matter was already settled in court and a certified death certificate issued.

    The Troll is all over the internet trying to prove that the entire concept of whole brain death is flawed thus rendering the Uniform Determination of Death by Neurological Criteria invalid. That's neither Brusavich's nor Dolen's contention for the purposes of this suit. They're not that inept. Like Rosen and CHO stated through their attorneys in their demurrers, this is not the venue to change a law.

    It will be very interesting to see the court's response. I think they have no choice but to strike the part of the suit asking for personal injuries and future medical expenses. Brusavich will have to go forward with wrongful death and emotional damages if he can get Nailah to accept that.

    ReplyDelete
  21. Seems that would be the only legal option allowed in a California court, since Jahi has been considered legally dead in that state for more than a year and a half now.

    But there may be another complication in pursuing this option, even if Brusavich *could* get Nailah to understand that going for the "chump change" wrongful death settlement was her only chance at getting *any* $. We have to wonder what impact that would have on whatever may be happening in NJ.

    Remember that the NJ law doesn't state that the medical determination of brain death *isn't* a valid determination of death. It just allows a patient's family to reject acceptance of that determination, if it conflicts with their personal religious beliefs.

    Jahi's remains were sent to NJ because her mother chose to exercise that option, and because, through the IBRF, she was able to find a doctor with hospital admitting privileges who agreed with her. Basically, Nailah was seeking refuge, by claiming that although her child had been determined legally dead in CA, she wasn't able to accept that as final, due to her personal religious beliefs, so she needed to find a place where Jahi could get continued medical support, towards the goal of possible recovery. So, the medical, governmental, and law enforcement authorities are surely well aware of the fact that Jahi McMath is considered legally dead in CA, but is technically still entitled to medical support, if her family chooses that course of action, in NJ.

    But...what would happen if Nailah were to actually file a clearly-articulated "wrongful death" medical malpractice suit in California, and win a settlement? Wouldn't it then be a matter of public record that she was not only actually affirming Jahi's death, but collecting monetary compensation for it? What happens to the "religious convictions" that constitute the basis of Jahi's legal status as a living person in NJ? Would that state still be obligated to provide continued medical support (and possibly other benefits)?

    I honestly don't know how this would play out legally. But IMHO, if one's "religious belief" causes a parent to believe a brain-dead child is still alive, and demand that she be treated as a living person, just because the heartbeat can be sustained mechanically, how can that same "religious belief" allow that parent to not only acknowledge the child's death, but claim compensation for it, in another jurisdiction?

    ReplyDelete
  22. Strange that despite his apparent obsession with the Jahi McMath case, Dr./Counselor Troll either hasn't followed the story too well, or hasn't comprehended the information, related to the actual events.

    Today's post to the "Keep" FB page focuses on his disagreement with Dr. Fisher's observations and conclusions. More of the usual crap about the brain not being "completely dead," so I won't bother reposting. But the last line summarizes:

    "Based on all the inconsistencies surrounding Fisher's brain death examination, his BD diagnosis should be invalidated and the BD exam repeated. "

    Again, he just doesn't *get* the fact that no one, including the court AND the attorneys who actually represent Jahi's family, sees any reason to revisit the "determination of brain death" issue again.

    If Dolan had better evidence to present after the initial submissions last October didn't win the argument, he would have done so. And, if he'd seen any valid reason to refute Dr. Fisher's findings, he would have done that too. But ...he actually stated that he believed Dr. Fisher's original findings were appropriate at the time, considering Jahi's condition in January 2014. The presentation of the "new evidence" was intended to prove that the condition of Jahi's brain, and whole body, had actually improved somewhat *since* that time, due to a reduction in the brain's swelling since its initial injury, and to the administration of appropriate nutrition, hydration, and medication required to facilitate healing. But that didn't work. The fact that the brain and body had been preserved, to a degree, from additional deterioration didn't prove that actual *healing* had taken place.

    And, let's be real here. What does he think would happen if a genuine, qualified medical doctor actually *did* repeat the brain death examination, or actually did *any* type of physical exam, *now*? We have no real idea how deteriorated the remains of this poor child must be, nine months *after* the "evidence" presentation in October. But we can reasonably speculate, based on the fact that the family hasn't seen fit to post any new pictures for, what, maybe a year now? And even Paul Byrne's account of his "visit to Jahi at her home in New Jersey" contained just one picture of what he stated was his hand holding her hand. Yeah, he's been more than a bit goofy in recent years, in terms of his anti-brain-death crusade. Still, as someone who was once a practicing medical doctor, he has enough sense to know that putting pictures of a corpse with an article that describes a miraculous story of healing and recovery just won't fly.

    It makes no sense to believe that any medical tests done on what's essentially a preserved corpse, more than a year and a half after death, could yield "better" results.

    ReplyDelete
  23. and we have no proof it is not LITERALLY a preserved corpse - as in the heart stopped some time back and it has been in a deep freeze while the grift goes on.

    ReplyDelete
    Replies
    1. Ken, I've thought about that too. There really aren't even any "updates" on the "Keep" FB site any more.

      Delete
  24. The Troll is actually calling for another bedside exam? Does he realize that in spite of all his "informations, memos" plastered all over the internet the bedside exam will not be including a test to see if one or two brain cells are still metabolizing glucose? He's gone off the deep end because he's been shut off from commenting anywhere but the Keeper page and if he continues to call for another bedside exam they'll be shutting him down too.

    ReplyDelete
  25. Today's contribution to the "Keep" page is yet another cut-and-past, taken-out-of-context job. Dr./Counselor Troll cites an entry from what looks like a legislative journal, from 1986, referencing a bill that was introduced to allow the religious/moral exemption to accepting DDNC as a determination of death.

    As anyone knows who's had contact with the process of legislation knows, not every bill that's introduced ends up becoming law. Some stuff just doesn't pass the first time around. Some will pass in one legislative body and not the other. Some passes both, but gets substantially amended in the process. And, some gets wiped out later on down the road, when a subsequent bill amends or entirely rescinds the earlier one.

    It appears that today's featured item was cut and pasted from the article titled:

    Primary California Legal Authorities on
    Accommodating Objections to the Determination
    of Death by Neurological Criteria
    Thaddeus Mason Pope, JD, PhD
    January 2015

    Link here...great reading if the subject interests you.

    http://www.thaddeuspope.com/images/Pope_SCBC_handout_laws_.pdf

    As always, Dr. Pope has done extensive research on his subject, and illustrates how policy and case law have evolved *over the years.*

    Problem is...the "information" posted on the "Keep" FB page is just:

    "You can fight them all the way. Cal. A.B. 3311 (1986) (Katz)"

    (followed by the section of that bill that includes the statement "providing that an individual, as specified, is not dead if the determination of death would violate the religious or moral beliefs or convictions of the individual."

    Of course, the *rest* of the information in Dr. Pope's paper includes lots of examples of how the state policies, and various hospital policies over the years, have since defined reasonable accommodation to these objections, and have allowed families anywhere from a few days to a few weeks or more, in some cases, to accept the situation. He also clearly states the fact that this reasonable accommodation is ONLY vent support until the heart stops beating as nature takes its course...hospitals are NOT required to perform any other procedures, or administer any other medications, since the patient is already dead.

    But of course Troll chooses to present this single, 29-year-old item of "information" as though it were current law, and Jahi's family could go into court with a petition based on this alone, to declare her alive just because *they* choose to believe she is!

    Again, his memory is failing.

    Jahi's family already HAS legal representation. If Dolan would have been able to succeed in establishing Jahi's status as a living person just because Mama said so, due to her great faith, Oakland Children's Hospital would never have refused to perform the requested life support procedures, and would not have given the family a time limit for terminating the vent support. And...if Jahi could have retained her "legally alive" status in California, there would have been no need to ship her body all the way across the country to New Jersey, just to find a doctor and hospital to continue ICU-level care.

    Life could have been SO much easier for Nailah and her family if only she'd retained Counselor Troll as her attorney! :)

    ReplyDelete
  26. UPDATE! A few minutes ago, I wrote about Troll's latest post to the "Keep" FB page. (Can't see my post yet as it awaits Doc B's review, so I can't edit).

    The Troll post I referenced has, just recently, been DELETED from the FB page, though the previous ones are still there. I guess they ARE getting tired of him....

    ReplyDelete
  27. Just for laughs...

    http://medicalfutility.blogspot.com/2015/07/dr-byrne-examining-jahi-mcmath-eol-in.html

    ReplyDelete
  28. the response to the demurrer is on Pope's page - and it appears Brusavich is planning to argue against brain death. of course, I expect the judge will say "okay, bring in an unbiased doctor to administer the test" and that will be that.

    ReplyDelete
  29. I read that too. Looks like it's a case management statement, rather than an actual response to the points raised in the demurrers. I posted the link on the "Jahi McMath lawsuit" thread but hasn't gotten through moderation yet...probably a busy weekend for Doc B!

    http://www.thaddeuspope.com/images/31875779_1_1_.pdf

    ReplyDelete
  30. Today's troll turd on the "Keep"page just regurgitates his conflict of interest allegation against Dr. Fisher.

    "Nobody caught this one but fisher lied when he said he was NOT affiliated with UCSF Benioff Childrens Hospital of Oakland. Fisher received his medical education at UCSF School of Medicine in 1989. This is important. One of the prelude in becoming a court appointed indepependent medical examiner includes disclosures of any conflict of interests. Fisher did NOT disclose the fact that he attended UCSF School of Medicine in 1989. Fisher should be disqualified. You can file a motion to squash and bring this to the court's attention. Without Fisher, the court would have to find another independent doctor to examine Jahi."

    Well...no....Dr. Fisher didn't "lie." He graduated from medical school at UCSF in 1989. That was 24 years ago! So what? There's no record of his actually *practicing* at the hospital at which Jahi's surgery was performed, nor even at the one with which it later merged.

    UCSF Benioff Children's Hospital of Oakland didn't adopt that name until January 2014, when the merger took place between UCSF Benioff Children's Hospital and Children's Hospital and Research Center Oakland on January 1.

    Jahi's surgery took place on December 9, 2013, and the diagnosis of brain death was done on December 12, 2013. What happened afterward was determined by the court. Dr. Fisher was appointed by the court, he did his work, and Judge Grillo entered his ruling - that Jahi was legally dead - on December 24, 2013.

    And, again, Troll is still pushing to have "another independent doctor examine Jahi."
    SMH...

    ReplyDelete
  31. What's really funny is that it WAS disclosed on Fisher's CV which is in court documents. The troll even quoted it himself.

    ReplyDelete
  32. I suggest ignoring the troll. Refutations don't bother him one whit and he WANTS attention on this blog even if he can't post here.

    ReplyDelete
  33. Point well taken. :)

    There are actually some interesting legal developments in the case, with Brusavitch's filing of his opposition to both demurrers, and the upcoming case management conference on July 30. Much more interesting than troll turds!

    Hope Doc B will reopen the "Jahi Mc Math Lawsuit" thread for comments, or start a new one. See Thaddeus Pope's site for more info.

    ReplyDelete

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