Passive reactions or a woman fighting for her life?
She moves. She menstruates.
Or she doesn’t move, not as a cognitive motion, a message sent from her brain — despite dramatic video that shows Taquisha McKitty bending her limbs, stretching her toes, rolling her head.
Nearly a month after the Torontoarea woman was declared legally dead.
And the blood, well that proves nothing.
“I am aware that there was vaginal bleeding,” Dr. Andrew Healey told a hearing in Brampton Superior Court on Wednesday. “Nobody knows if that was menstrual.”
Yet neither do they know, definitively, it wasn’t. Cadavers don’t bleed, do they? Yet Healey, when pressed on his answer to the menstrual questions, responded with palpable tetchiness. “What part of my sentence do you not understand?”
If a month passes and she bleeds — menstruates again — would that be convincing? A month might not be granted to McKitty, depending on how a judge decides.
But they — the doctors aligned against McKitty’s desperate family — would have us believe that their interpretation of “whole brain death” is correct. How could they possibly be wrong, those physicians, who signed off on a death certificate on Sept. 20?
Several injunctions have been granted by the court since then, allowing the family to pursue their case, an interim ruling that has kept McKitty on a ventilator.
The ventilator, argued Healey — critical care physician and division head at Brampton Civic Hospital — is keeping McKitty alive, or the illusion of alive.
Her exhalation is a passive response to the air being pumped into her lungs, no different than a balloon flattening when the air is released, an analogy belittled by family lawyer Hugh Scher. “She’s breathing now,” said Scher. Henley: “No, she is not. “The ventilator is doing all the work of breathing and the expelling is a passive reaction,” Healey insisted under cross-examination.
It’s a circular argument: She’s dead because we say so, because there’s no evidence of brain stem function. Evidence to the contrary is unscientific, but only because that is the definition that has been adopted in most jurisdictions.
We are apparently not to believe what we can see with our own eyes — the distinct movements McKitty has been making and which have grown more compelling, the family maintains, as time passes, rather than diminishing. They are adamant that McKitty has responded to the stimulus of their voices, that in some way, out of the depths of her darkness, she is voluntarily making her aliveness known.
Whole brain death, which equals the finality of death, is a legal definition constituting death in Ontario: The absence of clinical neurological function, “irreversible loss of the capacity for consciousness,” said Healey.
More explicit and absolute than being in a persistent vegetative state, where a patient “would still have some capacity for consciousness.”
It’s an anguishing state of disagreement, for the doctors who claim to have science on their side but far more so for the family, who have only their instincts and their emotions and their refusal to give up on a beloved daughter, sister, aunt, niece, mother.
The doctors argue that McKitty’s movements are nothing more than a reflex and shouldn’t be mistaken for signs of life.
As court has heard, nurses have not documented any of these persistent movements on McKitty’s medical file, though the phenomenon has been discussed with the family by nurses and other doctors who’ve been involved in McKitty’s treat- ment. Which, frankly, has been scarcely any treatment at all. The drugs that have been administered, her parents say, were intended from the outset to best preserve the woman’s organs for possible transplant. McKitty had signed an organ donor card. Doctors do not dispute that was the reason for giving McKitty L-thyroxine after she was declared dead.
In essence, patients must be kept “alive” — blood and oxygen flowing to the organs, heart continuing to beat on a ventilator — for organs to be harvested.
The family accuses the doctors of rushing to harvest, focusing on the organs rather than McKitty as a human being. That view was supported by a retired American doctor who was brought in by the family to testify on Tuesday.
In most medical circles, Dr. Paul Bryne would be considered a heretic.
“It’s not a simple reflex, it’s more than that,” said Byrne.
No, countered Healey. It’s automatism — actions without conscious thought or intention — or spinal cord reflex, which are possible in brain-dead patients. But still, nearly a month later?
Healey said he wasn’t aware of any “good science” which shows that spinal reflex “cannot happen” after a significant period of time.
McKitty was brought to hospital on Sept. 14, suffering from a drug overdose. Tests revealed she had a mixture of oxycodone, benzodiazepines, marijuana and cocaine in her system.
And that, the family contends, influenced the decisions that were made, although no evidence has been produced to support the allegation. (Some of the social media commentary about the case has been appallingly merciless: Pull the plug on the druggie!)
“Why not her?” McKitty’s father, Stanley Stewart, demanded outside court, pleading for treatment, for a second chance at life for his daughter. “Why not in this case? What’s so special about her that she doesn’t deserve treatment, that she doesn’t deserve all of the best efforts to give her the opportunity to live? Why, because she came in under a drug situation? Is that why? So her life is less valuable because of the circumstances?”
A dozen family members were in court yesterday. The legal battle, which could run up to $200,000 in bills, is being supported by a GoFundMe campaign started by McKitty’s cousin.
“It’s been hard from day one,” said Stewart. “It’s almost gotten a little bit harder to hear some of the evidence. A lot of the things we thought are now being actually exposed. The fact that she didn’t receive treatment, any intervention. The fact that some of the stuff they did after (the death certificate was issued) were towards her organs and not towards helping her. We felt that we knew it but now it’s on the record.”
Stewart claimed that Healey hasn’t even seen his daughter in three weeks.
He alleges attending physicians have been told not to document McKitty’s movements. “What are they scared of? They (doctors) know that we know the truth and the truth is that those are not reflex, automated reflexes. Those are actual movements that are stimulated by our voices, by our touch.
“She’s not brain dead. She has brain injury.”
Alyson McKitty says there are still too many questions about what happened to her daughter. “We feel like we need answers. We feel like this wasn’t done the right way. I don’t think there were enough tests done to be able to determine that she was already deceased. It was done too quickly.
“Definitely she’s moving her entire body. She’s moving her head, she’s moving her arms, she’s moving her legs, her feet, everything.”
The family wants the death certificate revoked and a 72-hour video recording made of the patient, a request that would apparently violate the hospital’s patient privacy guidelines and institutional policy.
The family comes to the medical establishment with their heart in their hands.
The medical establishment responds with bureaucracy. Rosie DiManno usually appears Monday, Wednesday, Friday and Saturday.