Friday, 29 June 2018

Finally over

It's over.  After nearly 5 years, the Jahi McMath saga is finally over.

Almost.

If you aren't aware of the Jahi McMath story, then you obviously have not been reading this blog very carefully, because I have written about her rather extensively, first here, then here, here, here, here, here, here, and most recently here.  The short version is that Jahi was a 13-year-old girl who underwent a series of upper airway procedures for sleep apnoea in December 2013 which was complicated by bleeding, cardiac arrest, anoxic brain injury, and brain death.  Jahi's family refused to accept the diagnosis, and thus began a battle between Jahi's mother, Nailah Winkfield, and Children's Hospital Oakland over whether Jahi was really brain dead (she was) and what should have been done with her (nothing).

Eventually Nailah and CHO came to an agreement that Jahi would be released from the hospital to her mother's care, and after moving from California to New Jersey (one of only two states where brain death can be refused on religious grounds), Jahi has remained on a ventilator, completely unresponsive, still brain dead, at a private apartment.

Over the ensuing years there was a report that she had started menstruating, despite evidence to the contrary that she had already had her first period prior to surgery.  There was a video supposedly showing her breathing over her ventilator, despite the fact that in April while she was in hospital she never did.  There were videos released by the family purportedly showing Jahi moving her finger or a foot to voice commands despite radiologic evidence that her cerebral audio pathways were completely destroyed and she had no anatomic mechanism by which that could be possible.  A neurologist rather ludicrously claimed, based solely on these videos, that Jahi was not brain dead, but rather severely disabled.  Despite these claims, Jahi never woke up, never opened her eyes, never showed any sign of life other than a beating heart.

Ever since this adventure began, I've been rather adamantly averring that Jahi was dead and that delaying her burial was unethical and nothing short of cruel to her and her siblings.  There have been a multitude of deniers, people full of hope and wishes and thoughts and prayers, that claimed Jahi would wake up.  Through it all I have continued to maintain that brain dead is dead, that Jahi would never wake up, that no one in human history who was properly diagnosed as brain dead had ever recovered from it, even a little bit.  While that may on the surface seem callous and uncaring, it is in fact quite the opposite.

And though sometimes I don't want to be right, I was right.

On June 22, 2018, over 4 1/2 years after she lost her life, Jahi finished passing on.  For the sake of simplicity, I will refer to this event as her death, even though she actually died on December 9, 2013 and was declared dead on December 12, 2013.  I have known about her final death since it happened, but I decided not to write about it until it was reported in the news out of respect for her family and what they are going through. 

Jahi had been hospitalised several times for various issues, including January and April of this year for some kind of undisclosed "intestinal issue".  I suspect it was intestinal ischaemia (decreased blood flow to the gut), though I cannot confirm this.  She was treated with antibiotics both of those times, and the surgeons seemed unwilling to operate on her.  Finally in early June she was taken to surgery, where they apparently found nothing grossly wrong.  Nailah and her supporters of course declared this as some kind of miracle.  I, on the other hand, knew that it was simply the beginning of the end. 

Jahi started a slow but steady decline since then, including renal failure and lactic acidosis, culminating in disseminated intravascular coagulation, multi-system organ failure, and fulminant liver failure causing uncontrollable bleeding.  She was apparently brought back to the operating theatre for "one last look" on June 22, got back to the intensive care unit, promptly coded, and died.  Again.

It's finally over.

I suspect Nialah will continue her legal battle against CHO, though I would be shocked if CHO doesn't immediately settle the wrongful death lawsuit out of court just to get it over and done.  But Nailah plans to pursue a federal civil rights lawsuit to get the date of death on the death certificate changed from December 12, 2013 to June 22, 2018.  I haven't a clue what she thinks that would accomplish nor how much time and effort this would take away from her caring for her three other children.

I don't know details of Jahi's various illnesses or operations, nor can I divulge how I know this information, nor is that in any way important.  What is important is that Jahi can finally be laid to rest after being abused for so many years.  And her siblings can finally move on with their lives.  And I can finally stop writing about this case. 

Until the next one comes along.

NOTE: I realise it has been over a month since I have written anything here, and for that I apologise.  It isn't that I haven't had any interesting cases, because I have.  However, it has become increasingly difficult to frame my stories in a way that I have not before, and I don't want to risk becoming boring and/or repetitive.

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