| Pope John Paul II has died. I believe the passing of | | | | examined Ms. Schiavo and they all came to the |
| this extraordinary man of God is an opportune | | | | same conclusion: Terri Schiavo was in a persistent |
| moment for all people, including a Methodist like | | | | vegetative state. For another physician to |
| me, to reflect on his life, his actions and his faith. | | | | question this diagnosis without examining the |
| John Paul made the papacy relevant once more | | | | patient is arrogant, unprofessional, and cruelly |
| on the world stage. He was truly a world leader. | | | | meddlesome. |
| He helped to inspire changes in his native country | | | | President Bush and his point man Senate Finance |
| that led to Polish independence. He spurred similar | | | | Committee Chairman Charles Grassley (R.-Iowa) |
| developments in Chile (1). Some historians have | | | | continue to hammer away at Social Security with |
| even given Pope John Paul credit for the fall of | | | | their plan for personal retirement accounts. The |
| the Soviet Union. Besides having a hand in political | | | | concept is to give us free access to our money |
| events, the pontiff was a champion for the | | | | because they believe, in true Republican laissez |
| poorest and most oppressed souls on our planet, | | | | faire fashion, that private citizens can manage |
| an inspiring friend to young people, and a serious | | | | their money more efficiently than the |
| environmentalist. But, paradoxically, he chose to | | | | government. Maybe. Currently all the money that |
| turn his back on women, and he discouraged | | | | we pay into Social Security sits in an account |
| activist priests. Worst of all, he did not act quickly | | | | somewhere that we really can't get to. But if you |
| to rid the American Catholic church of | | | | have a private account, when you get in a bind, |
| child-molesting priests or their apologist-protectors | | | | you may tap your retirement money as collateral |
| such as Cardinal Law of Boston. Why didn't he | | | | for a loan, or as funding for a new car. I fear that |
| say, "If you molest a child, we will defrock you | | | | private accounts will present most of us with an |
| immediately and make sure you go to jail?" For | | | | irresistible temptation to borrow money that |
| these reasons, I am a bit bewildered by this great | | | | most of us cannot afford to pay back. In the |
| man. But I hope and pray that he rests in peace. | | | | end, we will have nothing but debt when |
| On March 31, 2005, Terry Schiavo died after a | | | | retirement comes around. If the question is how |
| gut-wrenching public battle-one that was legal, | | | | do we make Social Security solvent, the answer |
| medical, and moral. While the medical community | | | | is not private accounts. Our first priority should be |
| has little data on what patients like Mrs. Schiavo | | | | to guarantee Social Security solvency. No one |
| go through during the last days of life, the one | | | | wants to pay any more in taxes, therefore the |
| thing that we do know is that she was not in pain. | | | | answer is obvious. Benefits must be decreased |
| Although the press covered this case ad | | | | and/or the retirement age must be raised. Of |
| nauseam, they didn't write much about this; there | | | | course, the president's tax cuts could be |
| were other ways in which the press failed in its | | | | reversed. |
| coverage of this story. First, as a doctor, I firmly | | | | Recent news: |
| believe that this case was never (as many | | | | * Did you notice that we just sold F-16 fighter |
| disabled Americans have feared) about disabilities. | | | | jets to Pakistan? I thought we were promoting |
| It was about how we view "next of kin" and | | | | democracy throughout the world? Didn't our |
| spokesmanship. To be specific, it was about this | | | | president mention that in a state of the Union |
| question: who should we empower to speak for | | | | address? Didn't President Pervez Musharraf of |
| those who cannot speak for themselves? In the | | | | Pakistan come to power in a military coup? Well |
| case of adult patients, should it be the spouse, as | | | | on the good side, Pakistan is the largest and |
| both Biblical and English common law have long | | | | longest surviving democracy in the area… |
| maintained? A majority of states-thirty two to be | | | | oops, that's India. Pakistan, our partner in the War |
| precise- say yes (2). In medical school, I was | | | | on Terror, did help to seal the border with |
| taught that the patient should have the final say in | | | | Afghanistan to prevent the escape of Osama bin |
| all treatment decisions. When patients are unable | | | | Laden through the Torah Bora Mountains. Wrong. |
| to speak for themselves, physicians are trained to | | | | They didn't do that either. So, why did we sell |
| talk with family members. This can be a very long | | | | them F-16's? |
| and difficult process. When a loved one is at | | | | * When are we going to spend the money to |
| death's door, families are inundated with many | | | | make our school children safe? How many more |
| conflicting feelings and thoughts-their own as well | | | | crazed, disaffected youth need to attack our |
| as those they believe the patient might feel or | | | | schools before we act? The events in Red Lake, |
| think. The skillful physician can usually help family | | | | Minnesota sadden me to the core. As I write this |
| members put their own feelings aside, so they | | | | newsletter, a football coach is fighting for his life in |
| can concentrate on what they believe the patient | | | | my hospital. He is the victim of a school shooting |
| might want. It is astonishing how people who find | | | | at one of the high schools in my own community. |
| themselves violently thrust into crisis and who | | | | The videotaped reports I watched on the national |
| face heart-breaking and often irreversible | | | | news made it clear that this is a school that has |
| decisions can and do make rational decisions. | | | | spent a lot money on its building and |
| When they can't-or when they can't all agree-then | | | | grounds-what will it cost to make our schools not |
| we have cases like Terry Schiavo's. The only | | | | only beautiful, but also safe for students and |
| answer must be a nationwide movement to | | | | teachers? |
| make living wills a commonplace-if not a law. | | | | * Michael Jackson. I was a huge Michael Jackson |
| Besides making a case for some kind of | | | | fan. I have seen him in concert three times. I |
| comprehensive living will policy in this country, the | | | | have albums and CD's. I loved his fabulous videos |
| Schiavo case also raises a question that modern | | | | and was glad when his albums went platinum. |
| medicine has made increasingly more pressing: | | | | Today, his story is just tawdry. I'm tired of |
| When is enough enough? With modern technology | | | | seeing him on my TV screen. I do not know if |
| and medical therapies we can keep many people | | | | Michael Jackson molested his (latest) accuser. I |
| "alive" long after their brains have stopped | | | | just hope that justice is served and served |
| functioning. Brain death is defined as no brain | | | | quickly. |
| function. There is no debate over these patients. | | | | * Congress decided to hold hearings to discuss |
| Instead debate exists over those patients with | | | | steroid abuse in baseball. Why? Imagine that you |
| severely depressed brain function like Terry | | | | are a minor league baseball player. You make |
| Schiavo, who was in a persistent vegetative | | | | almost nothing in salary. If you take steroids you |
| state. In this state the patient has lower brain | | | | may have the power to muscle one or two more |
| function-breathing, heart rate, eye opening, | | | | fast balls out of the park. You might be able to |
| etc.-but no higher brain function. These patients do | | | | catch up to a few more fast balls. You might be |
| not have the ability to do any voluntary functions | | | | able to throw a little farther or run the bases a |
| such as blinking or moving a finger or a toe on | | | | little faster. That difference could mean the |
| command (3). They can look around | | | | difference between the minor leagues and the |
| spontaneously, but their eyes wander rather than | | | | major leagues. You can take steroids and possibly |
| focusing upon specific objects. Despite reports to | | | | make millions in the majors or you can wear |
| the contrary, they do not have the ability to look | | | | yourself out in the minors. What would you |
| at the family they once loved or to understand | | | | decide? There will always be athletes who are |
| what is said to them or to communicate in return. | | | | willing to push the envelope, believing that they will |
| From an ethical and moral standpoint, what do we | | | | not develop any of the physical complications of |
| do for these unfortunate people? One | | | | steroids. Who will pay the price of their bad |
| consideration that must be taken into | | | | decisions? |
| account-alas-is cost. Our modern health care | | | | * Paul Wolfowitz as chairman of the World Bank? |
| system, with all its miracles, comes at a price. | | | | Why? What has this man done in the last four |
| Costing between $80,000 to $100,000 per patient | | | | years to convince anyone that he is a competent |
| (in a persistent vegetative state) per year, we | | | | leader or an internationalist? (Does it seem like the |
| are talking about a great deal of money. Where | | | | administration is just shuffling around the same |
| will this money come from? President Bush has | | | | five or ten people to you, too?) |
| proposed cuts to Medicare in his 2006 budget, so | | | | * The latest economic figures reveal that wages |
| the Republican's don't seem to be a likely source. | | | | continue to be stagnant and job growth continues |
| Many private citizens already have to choose | | | | to be anemic. When is somebody going to stand |
| between medicines or groceries. Clearly the | | | | up and say the President's economic and job |
| Schiavo case raises many questions, ones that | | | | stimulus package has not worked? It has not |
| we are going to have to discuss and solve in the | | | | created a significant number of new jobs and the |
| coming decade. | | | | average worker is no better off today than he |
| Congressional leaders aren't much help, though. | | | | was four years ago. I feel as though I'm stuck in |
| Recently they have stooped so low on so many | | | | an episode of Hogan's Heroes. For those of you |
| levels it is hard to know how to comment. They | | | | who don't know the program, Hogan was the |
| spent many hours and tax dollars passing a law to | | | | dashing American POW who always outsmarted |
| help Mrs. Schiavo's parents find a judge who might | | | | Colonel Klink, the incompetent German |
| help them wrest control of their daughter's | | | | commander of Stalag 13, and Sargent Schultz, the |
| situation from her husband? What about the | | | | bumbling guard whose tag lines were "I see |
| others? Between 30,000 and 40,000 Americans | | | | nothing. I know nothing." But I'm wondering: where |
| are in a similar predicament (persistent vegetative | | | | is Hogan? Is Congress playing Klink? And are the |
| state). Will Congress take their cases on one by | | | | rest of us see-nothing/know nothings? |
| one, too? And how ironic it is that Congress did | | | | * with writing and editing assistance of Catherine |
| see fit to pass a law making it harder for citizens | | | | Ross, PhD. |
| to shop around for judges who might help them | | | | 1. Wayne Svoboda, "Chile Bearer of Unwelcome |
| sue a potentially negligent corporation | | | | Tiding," Time, April 13, 1987. Accessed on April 30, |
| (Class-Action Fairness Act of 2005). | | | | 2005. |
| Finally, as a physician, I must rebuke the other | | | | 2. Daniel Eisenberg, "Lessons of the Schiavo |
| doctors who chose to step into the limelight and | | | | Battle," Time, April 4, 2005. |
| offer diagnoses of Mrs. Schiavo's case without | | | | 3. George J. Annas, JD, MPH, "'Culture of Life' |
| ever examining her. Many aspects of this case | | | | Politics at the Bedside - The Case of Terri |
| are worthy of physicians' comment, but Mrs. | | | | Schiavo," New England Journal of Medicine, March |
| Schiavo's diagnosis is not one of them. It is totally | | | | 22, 2005. |
| unconscionable for them to offer a diagnosis | | | | © 2005 Errington C. Thompson, MD All |
| based on a couple of minutes of videotape, when | | | | Rights Reserved. |
| multiple court-appointed, independent neurologists | | | | Dr.Errington Thompsonwhereistheoutrage. |