Got all that? Good, let's move on.
In the intervening 2 1/2 years, we've had sporadic "updates" from the family (and anti-brain death quack Dr. Paul Byrne) claiming that Jahi is alive because she no longer meets the criteria for brain death. The "proof" for her resurrection has been, shall we say, lacking. One of the pieces of evidence was a video of Jahi supposedly moving her foot to command, and another was a video of her moving her arm to command.
My last update was over a year ago in March 2016, but it was just a couple of vague pictures of Jahi, still with her eyes closed. More recently than that in October 2016 a video was posted of Jahi supposedly breathing over the ventilator, again in response to verbal commands.
So what are we to take away from all of this? What does this all mean?
The short answer: Nothing.
As usual, the "evidence" is meaningless. How do I know this? Because it is no longer merely implausible, it is quite literally impossible.
Thanks to Professor Thaddeus Mason Pope's Medical Futility Blog, we now have access to some information that has up until now been mere educated guesses. A case management statement (whatever the hell that is) was submitted by Jahi's surgeon, Dr. Frederick Rosen, which contains the statements of two experts on brain death, Drs. Thomas Nakagawa and Sanford Schneider. For a bit of background, Dr. Nakagawa is the division chief of critical care medicine and the director of the paediatric intensive care unit at Johns Hopkins All Children's Hospital in St. Petersburg, Florida, and he has over 25 years of clinical experience in paediatric critical care. Dr. Schneider is a clinical professor of neurology at the College of Medicine, University of California, Irvine and has been in paediatric neurology practice for 48 years.
These two guys know their shit - THEY ARE EXPERTS. Both doctors reviewed all available records, starting with her original hospitalisation in California, all the way through the end of her hospitalisation in New Jersey and the release to her mother. In their statements they disclose some very interesting, and very revealing information.
Dr. Nakagawa describes the several EEGs that were done as ancillary brain death tests (note than an EEG is not a definitive test for brain death). On December 12th there was no brain activity, and the technician noted that her right arm and left leg were both moving during the EEG. They also tried auditory and painful stimuli during the test as well as shining a light in her eye, but there was no brain activity in response to anything. Another EEG was performed on December 17th, and again there was no response to painful stimuli, light touch, or sound. Yet another EEG was done on December 23rd, which was exactly the same. This is very important information, because it means that her movements are in fact spinal movements, not caused by brain activity. Also keep in mind there was no response to sound. This will come into play a little later.
Nakagawa also goes over Jahi's brain flow scan on December 23, 2013 (page 33) which showed a complete absence of blood flow to the brain, which Dr. Fisher calls "beyond definitive". Brain tissue cannot survive more than a few minutes without blood, and this was 13 days after her anoxic event and cardiac arrest. Thirteen days is more than enough time for the brain to die.
He also describes Jahi's clinical exam during her 8-month hospitalisation in New Jersey, and at no time was her examination ever not consistent with brain death. She never had any purposeful movement, she never opened her eyes, she never had any cough, gag, or pupillary reflex, and she never had any spontaneous breathing.
Drs. Nakagawa and Schneider both talk about the other ancillary tests that were done on September 26, 2014, including MRI, brainstem auditory evoked potentials, upper extremity somatosensory evoked potentials, visual evoked potentials, and EEG. None of these are accepted ancillary tests for brain death, but they still revealed something very interesting: they were still consistent with brain death. Additionally, on page 46 of the document Schneider states that the somatosensory evoked potentials demonstrated some integrity of the spinal cord up to the level of C5, but there was no function above this.
It is a medical impossibility that J. McMath is moving in response to verbal commands. The brain stem auditory evoked potentials test performed at University Hospital on September 26, 2014 . . . demonstrates that as a result of J. McMath's brain death she has no auditory pathways; there were no evoked potentials to maximum aural stimulation. This test result establishes to a reasonable degree of medical certainty that J. McMath cannot respond to verbal commands because she has no cerebral mechanism to hear sound.In plain English, the videos of Jahi moving in response to her mother's voice are nothing more than spinal reflex movements, because Jahi CAN NOT HEAR and her brain CAN NOT CAUSE MOVEMENTS because it is dead. It is now plainly obvious that they simply caught Jahi at a time when her hand and foot were twitching, and they took a video of it while Nailah told her to move. I don't know if this was deliberately deceptive on Nailah's part, but I suspect it was not. I believe that she honestly believes Jahi can hear her. However, she can not. It is 100% impossible.
In summary, Nakagawa and Schneider exhaustively evaluated everything that had been done to and for Jahi from her surgery up until her release to her mother on August 25, 2014 (there was no evidence that Jahi had been re-evaluated for brain death since that day), and all of the brain death evaluations that were done in California were deemed completely valid. There was no evidence that anything was awry in any way. They also both stated, quite definitively, that nothing that had been done since her declaration of death -- no subsequent tests, no exams done at St. Peter's University Hospital, no nothing -- could . . . well, I'll let Dr. Nakagawa sum it up:
There is nothing in McMath's medical records from Saint Peter's University Hospital that would cause a reputable expert in pediatric or adult brain death to question or reconsider the accepted brain death assessments of Dr. Robin Shanahan, Dr. Robert Heidersbach, and Dr. Paul Fisher.He makes the same statement regarding additional tests she had done in September of 2014, none of which are accepted tests for brain death. Dr. Schneider then says this, which Nakagawa also averred:
There is absolutely no medical possibility that J. McMath has recovered, or will someday recover, from death.It seems I may have said something very similar many, many times.
So there you have it. That's about as definitive as it gets. Comments, as always, are welcome. But please keep them respectful.