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Jahi McMath, the media, and the science

January 8, 2014

Hi Reader,

Unless you’ve been under a rock, you have heard of the Jahi McMath saga. Jahi is the 13-year-old girl from California who was declared brain dead on December 11th, 2013. Along with many others, I have been following this case since it hit major media outlets around Christmas. It has been fascinating to watch the media turn from giving major support to the family to providing a somewhat better understanding of Jahi’s condition and questioning the ethics of transporting a dead body from the coroner to an “undisclosed facility”.

I must first state that I do feel a great deal of sympathy for Jahi’s family. I have a child who had his adenoids removed, and though his particular procedure was very straightforward and quick, I was on high alert for the duration, as any parent would be if their child is under anesthesia. I can only imagine my grief and outrage had my son been one of the extremely rare cases who had a severe adverse event afterward. However, a few things must be pointed out regarding Jahi’s surgery. First, it was not, as has been widely reported, “a simple tonsillectomy”. Apparently, Jahi had a tonsillectomy, adenoidectomy, and also had her uvula and palate tissue removed. This combination of procedures considerably ups the ante from a mere tonsillectomy.

What happened next is not completely clear, due in part to the attorney for the McMaths duking it out with the hospital, Children’s Hospital & Research Center Oakland. However, all parties appear to agree that Jahi suffered tragic complications from her surgery, including heavy bleeding, and went into cardiac arrest. As mentioned above, she was declared brain dead on December 11th. Sadly, many in the media expressed outrage over the hospital’s stance that Jahi should be taken off of a ventilator. The family felt that Jahi might actually “wake up”. Unfortunately, a judge humored their belief just before Christmas, by ordering that Jahi’s body could not be removed from the ventilator until December 30th; this order was later extended to January 7th.

The outrage amped up a notch all over the media. How can a hospital decide to take a person off of life support? Isn’t this the parents’ decision? The answer is no, it is not the parents’ decision in this case. A hospital does not have an obligation to leave a dead person on life support. If that sentence sounds ridiculous, then that’s okay, because it sums up the entire arc of this story. Even before Jahi was moved to an “undisclosed facility” on January 5th, at least three physicians had testified in court that she has no activity or blood flow to the brain, and therefore, Jahi is dead. Nonetheless, the attorney for the McMaths as well as members of the McMath family continued to make statements indicating that Jahi was “improving”, and that other physicians had told them that she is “definitely not dead”. Unfortunately, both of these things are impossible in Jahi’s situation. As has more recently been clarified, Jahi’s condition is no way analogous to that of a person in a coma, or even a person with any brain stem function. She is dead, and that is the sad fact. Yet people continue to express their outrage about this situation, arguing among other things that the parents should get to decide when Jahi is dead.

Why is this proposal a problem? Well, to answer this I have to be horrifying blunt. Jahi has no blood flow to her brain. If you can imagine a finger with a tourniquet around it for a week, it may help to understand what is happening and is going to continue to happen to Jahi’s brain. It is, quite simply, decomposing, as is the rest of her body, which cannot function properly without messaging from the brain stem, even if she’s on ventilation. Her muscles and internal organs cannot process the signals that would normally tell them how to function–for example, how to clear toxins from the system. According to a physician who testified in court, Jahi has not had a bowel movement since the brain death, apart from what appeared to be secretions that were the body releasing the gut lining, as Dr. Heidi Flori, a pediatric critical care physician, testified to in court. As might be expected, Jahi’s body is going to continue to decompose.

This is not a matter of faith or God’s will. Jahi is, tragically but undeniably, dead. A death certificate that was issued this week has given the date of death as December 12, 2013. Nothing is going to bring her back, and that is the sad truth. It seems clear that sometime in the near future, Jahi’s family will reach a state where they can no longer deny that the 13-year-old is dead, due to the continued decomposition of her body. Hence, this story has reached a macabre nadir.

This is just one more example of the media getting it wrong and the lack of scientific literacy in the United States.

From → Uncategorized

  1. This reminds me of a case when I was a nursing student. We had a patient who’s suffered a major brain bleed and had no brain function left. He was on ventilatory support, tons of drugs to keep his heart beating, his blood pressure stable, kidneys outputting urine, etc.

    The hospital tried to get a DNR on the man (not even remove him from support!) but the next family member refused as “it was his belief (the member, not the patient) that as long as the body was breathing, the soul was there.” In vain we tried to get across that the body *wasn’t* breathing. We were doing it all for him. No luck.

    The patient remained in the ICU stepdown unit for nearly 8 months, being coded 3 times during that period, until everything shut down so completely that he couldn’t be revived.An enormous financial cost and who knows what pain and suffering?

    But I do understand families can’t let go. It’s just so sad.

  2. Thanks for sharing that story. This whole thing is terribly sad. I can’t help but wonder if poor communication was the ember that started this down the path to a total conflagration. The family obviously does not trust the hospital. Whether the lack of trust is warranted or not, I can’t say, but as more and more information comes out I lean away from that position.

    I will say that the absolute refusal by the family to accept the bare facts of this situation is disturbing, as is the encouragement for this position that they have received from their attorney, some media outlets, and worst of all, by some dodgy people who claim to be members of the medical community.

    Whomever inserted the feeding and tracheostomy tubes yesterday needs to have their license revoked. It’s truly disgusting.

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  1. More on Jahi McMath | SkewedDistribution

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