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In Kansas recovery, hope for Schiavo?
Advocates say the "miracle" case shows the same could happen for Terri Schiavo. Doctors say it's unlikely.
By LISA GREENE
Published February 25, 2005
 [Times photo: Carrie Pratt]
Rev. Ed Martin of Ocala displays a sign as a backdrop for a press conference Thursday. |
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 [Times photo: Carrie Pratt]
Supporters of Terri Schiavo including, from left, Jane and Mike Hargadon of Baltimore, Mary LaFrancis of Fairfield, Iowa, Marilynn Chase and Leslie Hanks of Watkins, Colo., sing Amazing Grace Thursday night outside Hospice House Woodside in Pinellas Park. |
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If her feeding tube is removed, Terri Schiavo is expected to die within two weeks at the Pinellas Park hospice where she lives.
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For 20 years, she was silent, a prisoner of a terrible accident that damaged her brain.
But last month, Kansas resident Sarah Scantlin suddenly began to talk. The media called it a miracle.
Could it happen to Terri Schiavo?
"It gave Terri's family great hope," said Randall Terry, the Operation Rescue founder who has been organizing protests on behalf of the Schindlers, Schiavo's parents. "Terri is in a better condition than Sarah was."
Leading neurologists disagree. They say that, as similar as the two women's cases may appear, Schiavo's brain injury is far more severe than Scantlin's. Recovery in cases like Scantlin's is rare, but possible. In cases like Schiavo's, they say, it can't happen.
"This recent case has no relationship to it at all," said Dr. William Kessler, chairman of the neurology department at Northwestern University's Feinberg School of Medicine. "It's like comparing apples to oranges."
When she was 18, Scantlin was hit by a drunken driver. For two decades, she has lived in a nursing home, unable to speak or to move voluntarily. Like Schiavo, she stayed alive with a feeding tube.
A spokeswoman for Scantlin's family did not return calls for comment this week. Media reports have described Scantlin as having been in a minimally conscious state, in which the injured person shows limited but clear awareness of her surroundings. Scantlin was able to blink once for yes and twice for no. Last month, she suddenly said, "okay," and progressed from there to simple conversations.
Now she can tell her parents, "I love you."
Kessler said that, based on descriptions of Scantlin's abilities before she began speaking, her damage was less severe than Schiavo's.
People with those two different brain injuries may look the same physically - but their condition is very different. Think of different kinds of infections, Kessler said.
"If you saw two patients who had a fever and trouble breathing, you might think it was the same case," he said.
But one could have an easily cured pneumonia, while the other had usually deadly Ebola, he said.
"To a neurologist, you would never equate those two cases," he said.
To Terry, of Operation Rescue, those opinions don't matter. Scantlin wasn't expected to speak again, he said.
"It shows that there are things outside the explanation of current medical science," he said. "That is what the family (of Terri Schiavo) holds can happen with their daughter. With therapy, she can improve."
Terry pointed to such doctors as Dr. William Hammesfahr, a Clearwater neurologist who has examined Schiavo for her parents, Bob and Mary Schindler. Hammesfahr has said in court that Schiavo tried to follow simple commands and that her eyes fixed on her family. Hammesfahr, who was called "a self-promoter" in a court order by the judge in Schiavo's case, declined to comment Thursday.
Brain scans show that parts of Schiavo's brain have atrophied and been replaced by spinal fluid. With such severe damage, Schiavo can't show the recovery that Scantlin has, said Dr. Michael Pulley, assistant professor of neurology at the University of Florida College of Medicine in Jacksonville.
"Those types of changes don't reverse," Pulley said. "If you lose big pieces of brain, regardless of what it is - trauma, stroke, surgery - it doesn't come back."
The only documented case of someone recovering from a permanent vegetative state came in the early 1980s, said Dr. Ronald Cranford, a neurology professor at the University of Minnesota Medical School who has examined Schiavo.
And in that case, the patient's scan showed no brain atrophy, Cranford said. "The one thing we learned from that, you look at shrinkage of the brain," he said. "Terri has massive shrinkage."
Schiavo also has more severe brain damage than two patients in a New York study published this month, Cranford said. In that study, the patients diagnosed as minimally conscious showed increased brain activity when they heard audiotapes of loved ones' voices.
Cranford said it's hard for people without neurological training to accept that people in a vegetative state can't recover and aren't aware of their surroundings. They sleep. They wake. They grimace.
"It's very hard, because when you look at Terri Schiavo, you can think she's interacting, but she's not," he said. "When you have loving, caring parents like the Schindlers, you just want to deny they're in a vegetative state. It's a terrible syndrome."
- Times researcher Kitty Bennett contributed to this report, which used information from the Associated Press, Kansas City Star, New York Daily News and People magazine.
THE LATEST
Pinellas-Pasco Circuit Judge George Greer is expected to decide today whether to give Terri Schiavo's parents time to pursue appeals. Greer's order preventing Schiavo's husband from removing her feeding tube expires at 5 this afternoon.
[Last modified February 25, 2005, 00:53:06]
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