A board-certified pediatric neurologist claims to have examined her and has determined that she does not meet brain death criteria. As Prof. Pope explains, the focus will be on paragraphs 30-36. I'll present some excerpts from the complaint followed immediately by my thoughts on each.
30. Since the Certificate of Death was issued, Jahi has been examined by a physician duly licensed to practice in the State of California who is an experienced pediatric neurologist with triple Board Certifications in Pediatrics, Neurology (with special competence in Child Neurology), and Electroencephalography. The physician has a sub-specialty in brain death and has published and lectured extensively on the topic, both nationally and internationally. This physician has personally examined Jahi and has reviewed a number of her medical records and studies performed, including an MRI/MRA done at Rutgers University Medical Center on September 26, 2014. This doctor has also examined 22 videotapes of Jahi responding to specific requests to respond and move.This is specifically different than their prior claims in that this time a board-certified physician, a pediatric neurologist, in fact, has actually personally examined her. According to the complaint he has also watched 22 videos of Jahi responding to verbal stimuli. This paragraph gives me great pause for two reasons. First, why is the physician not named? There is much speculation that the doctor is Alan Shewmon, who is a vocal opponent of brain death, but why not reveal his name? Second, why should he have to watch videos of Jahi supposedly responding to voice commands if he has personally examined her? Did she not respond to commands when he was with her? And are these the same lousy quality videos that have been posted and scrutinised already? This strikes me as very odd.
31. The MRI scan of September 26, 2014, is not consistent with chronic brain death MRI scans. Instead, Jahi's MRI demonstrates vast areas of structurally and relatively preserved brain, particularly in the cerebral cortex, basal ganglia and cerebellum.
32. The MRA or MR angiogram performed on September 26, 2014, nearly 10 months after Jahi's anoxic-ischemic event, demonstrates intracranial blood flow, which is consistent with the integrity of the MRI and inconsistent with brain death.Cerebral blood flow and MRI scans do not factor into clinical brain death. And why are they referencing an MRI/MRA from over a year ago? Don't they have a more recent study? If not, why not? If so, why don't they present it?
33. Jahi's medical records also document that approximately eight months after the anoxic-ischemic event, Jahi underwent menarche (her first ovulation cycle) with her first menstrual period beginning August 6, 2014. Jahi also began breast development after the diagnosis of brain death. There is no report in Jahi's medical records from CHO that Jahi had began pubertal development. Over the course of the subsequent year since her anoxic-ischemic event at CHO, Jahi has gradually developed breasts and as of early December 2014, the physician found her to have a Tanner Stage 3 breast development.
34. The female menstrual cycle involves hormonal interaction between the hypothalamus (part of the brain), the pituitary gland, and the ovaries. Other aspects of pubertal development also require hypothalamic function. Corpses do not menstruate. Neither do corpses undergo sexual maturation. There is no precedent in the medical literature of a brain dead body developing the onset of menarche and thelarche.I find it very hard to believe that Jahi, who was 13 at the time of her operation, had not started menstruating already. According to a recent study of American girls, the average age of thelarche (breast development) is 9.7 years and menarche (onset of menses) is 12.8 years (12.2 for black girls). It is highly probable that she had started menstruating already, and besides she would also not be the first brain dead child to undergo puberty, so these paragraphs are essentially irrelevant. What bothers me most about this paragraph is that she had already started to develop breasts before her surgery as this picture proves:
35. Based upon the pediatric neurologist's evaluation of Jahi, Jahi no longer fulfills standard brain death criteria on account of her ability to specifically respond to stimuli. The distinction between random cord-originating movements and true responses to command is extremely important for the diagnosis of brain death. Jahi is capable of intermittently responding intentionally to a verbal command.This is the key paragraph. The anonymous neurologist claims that she responds to stimuli . . . intermittently. If this is actually true, then she is not brain dead. However, that is a very big "IF", and it hearkens back to the question of whether or not she was able to respond when examined by the neurologist or only on video. If she was only responding to voice on the videos, that is worthless as evidence in my opinion. If I were the presiding judge, not in a million years would I accept those vague and unreliable videos as evidence of anything. What this paragraph does not say is that the doctor performed (and that Jahi passed) a bedside brain death exam. Perhaps I'm reading too much into it, but perhaps not.
36. In the opinion of the pediatric neurologist who has examined Jahi, having spent hours with her and reviewed numerous videotapes of her, that time has proven that Jahi has not followed the trajectory of imminent total body deterioration and collapsed that was predicted back in December of 2013, based on the diagnosis of brain death. Her brain is alive in the neuropathological sense and it is not necrotic. At this time, Jahi does not fulfill California's statutory definition of death, which requires the irreversible absence of all brain function, because she exhibits hypothalamic function and intermittent responsiveness to verbal commands.There are numerous reports of brain dead patients being kept on somatic support for years without their bodies deteriorating, so the fact that this has not happened to Jahi is also irrelevant.
In all, the evidence supplied by Jahi McMath's lawyer is suspect at best, worthless at worst. I am incredibly curious why the neurologist was not named - this seems a very strange way to run a high-profile legal case. Perhaps the anonymity was maintained because it is so high profile, but perhaps one of the lawyers here could shed some light on whether or not this is typical. Regardless, I will wager these claims will be enough for the judge to allow the case to continue.
My one takeaway from this update is that if paragraph 35 is true, if she is truly able to respond to verbal stimuli, even intermittently, then she IS NOT DEAD. Full stop. Keep in mind that any claims of responsiveness made by the family will need to be verified by an outside neurologist.
And with that, I will open the comments to whatever wild speculation your brains can come up with, except for one particular individual who remains banned and whose comments will be deleted immediately (you know who you are).