quote:I was merely suggesting that an additional reason might have been to prevent her from asking questions that doctors do not want to answer until she is stronger.
And it surprises you that some people considered this an offensive possibility?
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quote:But Giffords has done this before, a few other office-holders have, and nothing has happened.
Every senator and congressperson I have ever had has made a regular routine out of doing this sort of thing.
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quote:Originally posted by Ron Lambert: For those who may not remember, a few days ago doctors removed her from the artificial respirator, and she has been breathing on her own ever since. BUT they left in the breathing tube--they SAID, to protect her airways. I was merely suggesting that an additional reason might have been to prevent her from asking questions that doctors do not want to answer until she is stronger. To my knowledge, doctors have not yet removed the breathing tube.
You live in a strange, strange world.
You actually believe that a doctor would gag a patient to stop them from asking about something difficult.
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Yeah, seriously. I want to know where anyone gets the idea that a doctor might have even plausibly left a breathing tube inside someone for that reason. I mean, for what reasons does someone think her doctors would do that?
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Doctors are probably more likely to believe in things like evolution, and thus not to be trusted.
ETA:
quote:Most congress people, when trying to touch base with their constituents, sit in their local office and allow people to come in to see them--in a more controlled setting.
And, no, this isn't true at all either. Particularly before and after campaigning, congress members do wide-open public appearances frequently. Are you going to stand by this strange statement, Ron, or pretend it never happened?
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ok, i'm providing this link just for a laugh. It's not about 'all conservatives having a monopoly on violent rhetoric' or whatever, it's just a lolworthy statement on the part of this individual right-wing radio host.
quote:Local conservative talk radio host Bob Durgin hasn’t pulled his on-air punches in the wake of Saturday’s shootings in Arizona, lambasting liberals for using the tragic event to slander conservatives like Sarah Palin and Glenn Beck.
“God, I hate the liberal media,” Durgin said Monday during his highly rated afternoon show on WHP580. “It’s like, if you don’t follow Obama and believe in Obama’s policies, then you are a potential terrorist.”
In talking about The New York Times, often seen as queen of the left by conservatives, Durgin added, “Somebody ought to burn that paper down. Just go to New York and blow that sucker right out of the water.”
posted
The LA Times (and other outlets) have released, courtesy of Pima Community College, a video Loughner made of himself wandering around the campus making angry statements. The video, recorded about 4 months ago, was the final straw in his expulsion from the college.
A transcript (to the best of my ability and patience) of Loughner's rantings:
quote:Alright, so here's what we're doing. We're examing the torture of students. We are looking at students who have been tortured. Their low-income pay in two wars. The war that we are in right now is currently illegal under the constitution. What makes it illegal is the currency. The date is also wrong. It's impossible for me to...it's mind-control.
(sees someone walking out of a building) How's it going!? Thanks for the 'B'; I'm pissed off. (chuckling laughter as man walks off with a confused 'Wha?'). I lost my freedom of speech to that guy. And this is what happens. And I'm in a terrible place. This is the school that I go to. This is my genocide school, where I'm going to be homeless because of the school.
I haven't forgotten the teacher who gave me a 'B' for my freedom of speech. This is where my sociology class was. And here's the microwave that I'll be using when I'm homeless, in the cafeteria where they make illegal transactions.
This is Pima Community College, one of the biggest scams in America. The students are so illiterate it effects their daily lives. Here's the best part; the bookstore. The bookstore, the bookstore, the bookstore. It is so illegal to sell this book under the Constitution. We are also sheltered by our freedom of speech. They are controlling the grammer. They control the grammer.
This is the police station. This is where the whole shaboozie goes down with the illegal...activity.
If the student is unable to locate the external universe, then the student is unable to locate the internal universe. Where is all my subjects? I could say something sound right now, but I don't feel like it.
All the teachers that you have are being paid illegally and have illegal authority over the Constitution of the United States under the First Amendment. This is genocide in America.
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Tom, there is nothing nefarious about doctors not wanting someone in critical condition to be aprised of really tragic news. It is a matter of obeying their oath to "do no harm." Doctors and nurses frequently withhold information about a spouse dying in the same accident inwhich the patient was injured, until the patient is off the critical list. The patient may demand to know, but normally doctors will not volunteer that information. I used to be married to a nurse who worked in Critical Care.
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Really? Did she tell you that they would intentionally gag patients to prevent them from asking questions?
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I do believe that doctors routinely withhold bad news if they feel it will hinder the patient's immediate recovery.
But I do not believe would purposely leave in a breathing tube to help avoid the issue. I would think the removal of the breathing tube when the patient is ready for it to be removed is important and a valuable diagnostic measure.
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I only suggested that maybe this was one reason they left in the breathing tube. What is the matter with some of you people? You are the ones who are showing stubborn pride. You jump on me for making a reasonable suggestion? If you think it is not a reasonable suggestion, then show why. What would be wrong with doing so? Has anyone asked the doctors if they are keeping the news of how many died from Giffords? Keeping the breathing tube in would prevent Giffords from talking. Anyone deny that? So why is the breathing tube still in, several days after she was weaned off the respirator, and a day or so after she has shown that she can see, she can focus, she has enough motor control to move her arms and hands and fingers in a directed manner?
All I have gotten from my habitual, knee-jerk critics is "Oh no, a doctor wouldn't do that!" How do any of you know? How about asking a few doctors whether they would consider that "unethical," or in some other way improper.
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quote:You jump on me for making a reasonable suggestion?
You're being questioned about it, in the 'wait, why would you think that they would do that?' because it's not a reasonable suggestion. It is unethical, and improper, and virtually all doctors maintaining an intubated patient would know it. It's not plausible, but we want to understand why you're fixated on the notion that it is. Where does it come from? Where have you gotten the idea that something like this is plausible or in any way commonplace? Why wouldn't you view your own presupposition with even a tenth of the skepticism that you apply to stuff that you aren't individually invested in?
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"All I have gotten from my habitual, knee-jerk critics is "Oh no, a doctor wouldn't do that!" How do any of you know?"
Because it is unethical. Because if a doctor did that, he could lose his license to practice medicine. Ron, having a breathing tube kept in your airway is not safe. It can cause damage to the larynx and vocal chords, it carries a risk of infection, and it is emotionally and physically distressing to the patient. The only reason; again, the *only* reason one is kept in is if taking it out would be considered a greater risk than leaving it in. In this case, the woman was shot in the head. Brain injury and consequent swelling and bruising of the brain can have unpredictable effects on breathing. They don't know what kind of control he has over her airway. They are probably not sure if she will have problems swallowing, keeping herself from gagging, and regulating her own breathing reliably once the tube is out. If she turns out to have these issues, it will have to be reinserted, which carries further risk of complication.
Understand, as well, that a person who is intubated is not typically kept fully alert. They are sedated, while the airway is maintained and the body is given a chance to heal. So it's not like she's sitting there desperately waving her hands and trying to communicate with people. Hell, Ron, all she'd have to do to ask these questions is write them on a piece of paper. She's not even in a state to do that.
In short, Ron, the suggestion that they left it in to effectively gag her is utterly, patently, ridiculous. Her family would likely not stand for it, and a medical review board would *certainly* not. As a patient, she has rights- and one of those rights is not to be subjected to the continuation of an invasive and dangerous procedure out of some shadowy wish not to emotionally distress her. You are so far out of your depth that you are having trouble recognizing that there are people in this discussion with some knowledge of this subject beyond your own. This includes me- I was in the past a licensed medical technician. I am aware of the risks and complications of both intubation and brain injury, and I am telling you, from that position of authority, which is not even an impressive one, that you have no clue what it is you are talking about.
So, I'm telling you, I *know* the doctor wouldn't do that if he were a responsible physician. It's a really, really stupid idea.
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I was aware of that from regularly watching House M.D. And if I can recognize the flaws in your knowledge of something based on their layman's viewing of a prime time cable television show, Ron, perhaps you ought to re-evaluate the certainty with which you make some claims.
Then again, I'm just one of your knee-jerk, atheist/agnostic critics or something. No need to engage the brain God gave you and think about what I'm saying, particularly since it's criticism.
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quote:Originally posted by Ron Lambert: How about asking a few doctors whether they would consider that "unethical," or in some other way improper.
Absolutely. The risk of pneumonia and other associated sequelae of being mechanically ventilated unnecessarily makes detubing at the earliest possible time the medically appropriate thing to do. There are other, better [less invasive and less dangerous] ways to keep her from asking questions if that were the concern [for her mental health, and I can barely make a potential case for that in my head] -- e.g., keep her mildly sedated on something like Valium, but not sedated enough to require the (medical) trauma of mechanical ventilation.
---
Edited also to add: Orincoro said it so well, really.
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Now you guys are just being blindly authoritarian. Why are you so certain what would be unethical for doctors to do? Are any of you doctors? How about asking a doctor, before you presume to make any more of your bold, authoritarian pronouncements. I think you will probably find that most doctors would consider it clever to leave in the breathing tube for a few extra days to prevent the patient from asking questions that could lead to a great increase in emotional trauma for a patient who is already critical. She was shot through the head, for crying out loud. You don't want anything to increase her blood pressure while her brain is still in danger of swelling or renewed bleeding.
By the way, CT, the purpose for leaving the breathing tube in is to PREVENT aspiration pneumonia from happening. That's what they mean when they say they left it in to protect the airway. What doctors desire to do as soon as possible is wean the patient off the respirator (which they have done, thankfully), because if a patient is on the respirator too long, the body comes to depend on that, and it can be a protracted and difficult process to wean the patient off a ventilator. The problem is not the breathing tube, the problem is the automatic respirator breathing for the patient.
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So I know this is shifting the conversation away from doctors and intubation and all that, but...
I'm baffled by all the people in this thread that keep sticking with the idea that conservative politics is somehow infused with more violence or violent rhetoric than liberal. I mean... genuinely confused.
I'm not currently addressing the issue of whether or not conservatives should embrace or decry the violent rhetoric that really is propagated by their side; for the most part I think that sort of inflammatory language is counterproductive but I don't think any of it, on either side, is perhaps as bad as some of you do. I don't think that rhetoric on either side has anything to do with Loughner's actions, nor do I think it makes sense to use his actions as a reason to bring up this discussion in the first place. But that's really irrelevant to what I actually wanted to comment on.
So many people in this thread keep repeating the narrative that, while both sides might engage in some violent rhetoric, conservatives are obviously the really guilty ones. Really? Are you sure? That hasn't been my perception, certainly.
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quote:Originally posted by Ron Lambert: Now you guys are just being blindly authoritarian. Why are you so certain what would be unethical for doctors to do? Are any of you doctors? How about asking a doctor, before you presume to make any more of your bold, authoritarian pronouncements. I think you will probably find that most doctors would consider it clever to leave in the breathing tube for a few extra days to prevent the patient from asking questions that could lead to a great increase in emotional trauma for a patient who is already critical. She was shot through the head, for crying out loud. You don't want anything to increase her blood pressure while her brain is still in danger of swelling or renewed bleeding.
By the way, CT, the purpose for leaving the breathing tube in is to PREVENT aspiration pneumonia from happening. That's what they mean when they say they left it in to protect the airway. What doctors desire to do as soon as possible is wean the patient off the respirator (which they have done, thankfully), because if a patient is on the respirator too long, the body comes to depend on that, and it can be a protracted and difficult process to wean the patient off a ventilator. The problem is not the breathing tube, the problem is the automatic respirator breathing for the patient.
Actually, I'm pretty sure that CT is a doctor.
Furthermore, even if she wasn't a doctor, you aren't a doctor either. If I was to assume that everyone in this thread was just making logical guesses as to the value of the use of a breathing tube as a gag, then I'd say you're falling way behind in this debate. Everyone on the "NO!" side of this debate has offered perfectly reasonable explanations as to why it would be wrong, dangerous and/or unethical to use a breathing tube for that purpose. Nothing on your side seems to adequately rebut and of their arguments.
But that's just a hypothetical. CT is right.
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quote:Originally posted by Dan_Frank: So I know this is shifting the conversation away from doctors and intubation and all that, but...
I'm baffled by all the people in this thread that keep sticking with the idea that conservative politics is somehow infused with more violence or violent rhetoric than liberal. I mean... genuinely confused.
I'm not currently addressing the issue of whether or not conservatives should embrace or decry the violent rhetoric that really is propagated by their side; for the most part I think that sort of inflammatory language is counterproductive but I don't think any of it, on either side, is perhaps as bad as some of you do. I don't think that rhetoric on either side has anything to do with Loughner's actions, nor do I think it makes sense to use his actions as a reason to bring up this discussion in the first place. But that's really irrelevant to what I actually wanted to comment on.
So many people in this thread keep repeating the narrative that, while both sides might engage in some violent rhetoric, conservatives are obviously the really guilty ones. Really? Are you sure? That hasn't been my perception, certainly.
I think if you look, it won't be hard to find examples of violent sounding rhetoric on the liberal side of the aisle. To me, it's necessarily about being able to come up with 100 incidents over the last 10 years and say "look! they do it too!"
It's about the constant drum beat on the Conservative side. I think they are largely to blame for poisoning politics in to what it has become. They've demonized the entire Democratic party and liberals in general (I mean geez, who made it their life's mission to turn liberal into a dirty word?) as anti-American, anti-Democratic, anti-Freedom, etc. It's not even about the random speech that uses violent metaphors, though I find those especially problematic. It's about a culture of demonization, and you can find a lot of individual examples on the left I'm sure, but you'll likely never be able to convince me that it exists to nearly the same degree as it does on the right. Democrats have been trying to compromise for years, and for years they've gotten slapped down and demonized for it. It's only gotten worse since 2006 when Democrats became the majority, and ever since then, Republicans have generally refused to participate in the process at all except to grind it to a halt, and every word out of their mouths is about how evil Democrats want to take your freedoms and how unAmerican they are. We've been hearing that since around September 12, 2001.
I think part of it is just that Republicans are so damned good at staying on message as a team. They all parrot the same lines that are handed down from on high, and they do it into every microphone that's turned on within speaking distance of them. They saturate the press with it. It's about the national mouthpiece, not just about the fringe elements that both sides have. When it comes to that aspect of national discourse, yes, I think Republicans are far, far worse.
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Ron, CT is 1) a physician, 2) a professor of medicine, and 3) holds a doctorate in philosophy with (if i remember correctly) speciality in ethics). You are a fool to disagree with her on this and an even greater fool to presume you could lecture her on the topic.
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quote:Originally posted by The Rabbit: Ron, CT is 1) a physician, 2) a professor of medicine, and 3) holds a doctorate in philosophy with (if i remember correctly) speciality in ethics). You are a fool to disagree with her on this and an even greater fool to presume you could lecture her on the topic.
Hey Ron - seems like this is the ultimate test to me.
You can admit that you're likely way off base and drop your stupid argument, in which case all your detractors who have (correctly thus far) pointed out that you are incapable will have to adjust their position (at least slightly).
Or you can act in your usual fashion and "stick to your guns" in a baseless arrogant fashion.
Which is it going to be? I know where the safe money is...
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A sudden moment of clairvoyance has come upon me. I'm seeing... the future! I see... Ron... he's dropping this topic and... he's not posting again in this thread until the discussion has shifted to something entirely different and people have given up trying to show him why what he said is crazy...
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quote:Originally posted by Ron Lambert: Are any of you doctors?
Yes, I am a medical doctor.
quote:How about asking a doctor, before you presume to make any more of your bold, authoritarian pronouncements. I think you will probably find that most doctors would consider it clever to leave in the breathing tube for a few extra days to prevent the patient from asking questions that could lead to a great increase in emotional trauma for a patient who is already critical.
No, the question came up specifically in my training (in an ICU, working as a physician). The answer was "no" because the medical risks are so great. There are other ways to deal with the problem that are not so invasive. [see above]
It's bad medicine to keep a patient intubated just for that reason. We don't go for "clever," but for "medically appropriate."
quote:By the way, CT, the purpose for leaving the breathing tube in is to PREVENT aspiration pneumonia from happening. That's what they mean when they say they left it in to protect the airway.
Yes, that is one concern. And if she cannot protect her airway (which is an issue of functioning reflexes, not of mood), then it is the medically appropriate reason to keep the airway in.
There is also a well-known and quite problematic issue of ventilator-associated pneumonia (it even has an acronym, VAP). The Wikipedia article is pretty good. Excerpt:
quote:VAP primarily occurs because the endotracheal or tracheostomy tube allows free passage of bacteria into the lower segments of the lung in a person who often has underlying lung or immune problems. Bacteria travel in small droplets both through the endotracheal tube and around the cuff. Often, bacteria colonize the endotracheal or tracheostomy tube and are embolized into the lungs with each breath. Bacteria may also be brought down into the lungs with procedures such as deep suctioning or bronchoscopy.
Additionally, as Orincoro noted above, there is airway trauma from the tracheal tube itself. Even when "cuffed," or cushioned by an inflatable doughnut-shaped balloon, it is damaging to the surrounding tissues to remain intubated. And just having the tube in place is associated with increased intracranial pressure, which -- as you note -- is low on the list of what you want to be happening. So much so that medications are chosen to suppress that effect in head trauma patients.
It's a big deal to be intubated and an equally big deal to stay intubated. On daily rounds in the ICU, each day we would assess whether the tube could safely be removed, or whether it had to stay for medical reasons. If no compelling medical reason to keep it, the chest X-ray was cancelled for that day (checking position of the tube -- another reason not to leave it in unless absolutely necessary) and it was pulled out.
---
Edited to add VAP excerpt, tidy up typos, and the following: Ah, I see others have posted meanwhile. Ron, it's a reasonable idea to have, but it isn't feasible or defensible in practice because the situation is much more complicated physiologically than you might think.
quote:Originally posted by Ron Lambert: Now you guys are just being blindly authoritarian. Why are you so certain what would be unethical for doctors to do? Are any of you doctors? How about asking a doctor, before you presume to make any more of your bold, authoritarian pronouncements. I think you will probably find that most doctors would consider it clever to leave in the breathing tube for a few extra days to prevent the patient from asking questions that could lead to a great increase in emotional trauma for a patient who is already critical. She was shot through the head, for crying out loud. You don't want anything to increase her blood pressure while her brain is still in danger of swelling or renewed bleeding.
No, this is a very, very silly supposition, and you are simply wrong. Sorry to be "authoritarian," I forgot that in your world, everyone is entitled to his own facts.
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CT, Thank you for the clarification. I always appreciate your politely and calmly reasoned explanations on issues of medicine and medical ethics.
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quote:Originally posted by Dan_Frank: So I know this is shifting the conversation away from doctors and intubation and all that, but...
I'm baffled by all the people in this thread that keep sticking with the idea that conservative politics is somehow infused with more violence or violent rhetoric than liberal. I mean... genuinely confused.
I'm not currently addressing the issue of whether or not conservatives should embrace or decry the violent rhetoric that really is propagated by their side; for the most part I think that sort of inflammatory language is counterproductive but I don't think any of it, on either side, is perhaps as bad as some of you do. I don't think that rhetoric on either side has anything to do with Loughner's actions, nor do I think it makes sense to use his actions as a reason to bring up this discussion in the first place. But that's really irrelevant to what I actually wanted to comment on.
So many people in this thread keep repeating the narrative that, while both sides might engage in some violent rhetoric, conservatives are obviously the really guilty ones. Really? Are you sure? That hasn't been my perception, certainly.
You're forgetting that conservatives are more likely to be gun owners, and tend more to fit the typical profile of an NRA member.
If you don't own a gun, it's harder to shoot people. So I hear, anyway.
Conservatives, as a group, are MUCH more likely to support totally unfettered gun ownership.
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Thank you, CT. You may be correct. I was only suggesting it might be a possibility that doctors were leaving the breathing tube in--even after taking her off the respirator--for a FEW DAYS extra to help prevent her from asking questions about the shooting that they don't want her to know until she is out of the woods. Everything I said remains true, about the main concern being to wean the patient off the RESPIRATOR. Leaving the breathing tube in is a separate issue. Did you make that distinction in your comments? I am not sure you did.
There are people here who are so madly obsessed with contradicting everything I say about anything, it is hard to maintain even a reasonable suggestion in the face of their blizzard of hateful insults and ill-informed assertions. I just hope you are not one of them.
I look forward to the announcement that doctors have finally removed the breathing tube, and to being informed when Rep. Giffords was told about the full scope of the shootings. Unless the doctors involved say otherwise, I will still suspect that they left the breathing tube in at least partially for the purpose of forestalling questions about that until she is out of the woods, and the emotional trauma would be less likely to kill her. None of you have given me a logical reason to believe otherwise.
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You are simply suggesting something totally unreasonable. It´s just not reasonable. There is nothing about it that approaches reason. You have been provided with ample explanations of why that is. You continue now only out of stubborn pride. You lose. Good day sir.
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quote:Originally posted by Ron Lambert: Everything I said remains true, about the main concern being to wean the patient off the RESPIRATOR. Leaving the breathing tube in is a separate issue. Did you make that distinction in your comments? I am not sure you did.
Yes, I made the distinction. As I noted, the breathing tube itself is a primary medical problem -- see again, e.g., the excerpt on ventilator-assisted pneumonia (it references the problem the tube poses because it presents a direct pathway for the bacteria to enter lungs and cause pneumonia). Additionally, it is the tube which traumatizes the trachea.
There are also problems with being on a respirator, as you note. That doesn't mean there aren't serious problems with the tube itself, as well.
quote:There are people here who are so madly obsessed with contradicting everything I say about anything, it is hard to maintain even a reasonable suggestion in the face of their blizzard of hateful insults and ill-informed assertions. I just hope you are not one of them.
I don't think we have spoken before. You haven't really been on my radar, Ron, and I suspect I haven't been on yours. We seem to move in different threads, and I think it will stay that way.
I care about this issue because physicians are being presented as [of questionable ethics and competence], and that doesn't aid in public confidence at all. I'm fine if you want to hold whatever belief about what decisions would be made in that setting -- but as someone from that setting, I also want to be on record as disagreeing with that belief.
quote:... and the emotional trauma would be less likely to kill her. None of you have given me a logical reason to believe otherwise.
a. She could have had the tube removed and be mildly sedated enough on valium to keep her from being coherent enough to form questions -- if that were the goal -- rather than keep the tube in, if the tube were not medically indicated for airway protection.
b. The presence of the tube and the suctioning of secretions it requires actually increases the pressure in the brain, which -- as you noted -- is what should be avoided if possible. See (a) above.
--- Edited to add: I respect that you care enough about her well-being to try sorting through this. I am also not interested in dogpiling on you. As I said, we have tended not to interact, and I'm not going to chase the issue here just for points' sake. At this time, I'm sure we are in accord at our best wishes for her wellbeing, and we can leave it at that. I will.
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I'd like to point out that at this point no one knows if she could speak even if the tube were removed. Brain injury could prevent her from having muscular control of her vocal chords and other muscles required for speech, she may also have damage to the speech centers in her brain, and thus not be able to form words. All we do know is that she can hear and recognize the meaning of words.
Until the tube is removed, there isn't even a chance to find out if she is capable of speech, and I would think that that information would be a pretty important part of forming a prognosis with respect to her recovery.
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Good points, Glenn. If I remember right, though, the speech center is on the middle side of the left hemisphere, and the bullet would have passed through the frontal lobe entering from her temple to exit at the opposite side of her forehead. Seems like it would have likely missed the speech center. Of course, the bullet must have produced damage in the immediately surrounding tissue from the heat and shockwave of its passage through the brain--this is why it is so uncertain as yet what faculties she may have left, and why it is so encouraging that she can see and can respond to instructions. There is also a speech center in the right hemisphere, that is used more often for singing. There is the famous case of one of the Beach Boys who suffered damage in an accident to the speech center in his left hemisphere, and could no longer talk--but he could still sing!
Week-Dead, please explain why my suggestion is, as you claim, "totally unreasonable." That is a rather extreme assertion. It is really just based on no more than the opinion some have that "a doctor wouldn't do that." I think the reasons I gave are reasonable--the emotional trauma of learning about the other shootings could kill her, and she cannot ask about it while the breathing tube remains in. Remember, all she knows is that she was shot, since she was the first one shot. She does not know about her aide being dead, about her friend, Judge Roll, being dead, or about the nine-year-old girl, Christina Green, being dead, or the fact that three others besides died, and 12 more besides Gifford were injured. (I think that was the count--19 total shot.)
[ January 16, 2011, 02:32 PM: Message edited by: Ron Lambert ]
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Ron, an ethical doctor would not do that. It would increase her medical risk for no good reason, and symbolically involve inflicting medical harm on a woman just to shut her up. That's why, at the top of the page, I was amazed that you didn't realize that your suggestion was offensive; it amounts to asserting that her doctors might be unethical -- and stupid (since, after all, there are many ways to keep her from asking questions that would not do her as much harm).
It would be, I believe, a straightforward violation of the Hippocratic Oath to keep a breathing tube in a patient to prevent her from being able to ask awkward questions.
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quote:all she knows is that she was shot, since she was the first one shot
She may not even know this. A trauma like this could prevent the memory from having formed. It's possible that she still has no idea why she's in the hospital bed.
But I would argue that it's her right to know, and on those grounds preventing her from asking questions would be a violation of her rights.
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quote:Originally posted by Ron Lambert: Good points, Glenn. If I remember right, though, the speech center is on the middle side of the left hemisphere, and the bullet would have passed through the frontal lobe entering from her temple to exit at the opposite side of her forehead.
TBI (traumatic brain injury) frequently causes secondary damage to other parts of the brain. Swelling and other issues are common, so a prognosis based solely on where the bullet was is unlikely to be terribly useful.
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There is also the complicating issue that language does not lateralize as neatly as you might think. The Wikipedia article on brain lateralization has pretty good references.
quote:In more than 95% of right-handed men, and more than 90% of right-handed women, language and speech are subserved by the brain's left hemisphere. In left-handed people, the incidence of left-hemisphere language dominance has been reported as 73% and 61%.
That is, somewhere around 5-10% of right-handed people have language primarily lateralized to the right, and somewhere around 25-40% of left-handers do.
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I also am aware of several studies that indicate verbal functions are more delocalized in woman than men. I suspect that finding is somewhat controversial. Even if its true for the typical woman, there is no way to know whether it would be true for a specific individual.
It's also impossible for me to speculate about what delocalized verbal functions would mean for someone with TBI. A function that was delocalized might be more sensitive to damage to any part of the brain but conversely it might make it easier for the brain to compensate for damage in any specific area.
I know 3 people who've experienced TMI. Based on that admittedly limited experience, doctors really don't know enough about the brain to be able to predict how any brain injury will ultimately affect any individuals abilities. You just have to wait and see.
Posts: 12591 | Registered: Jan 2000
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One more thing, its very common for people to have no memory of events surrounding a traumatic personal injury, even when a head injury was not involved. It's relatively unlikely that Rep. Giffords remembers what happened to her.
Posts: 12591 | Registered: Jan 2000
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quote:Originally posted by The Rabbit: Based on that admittedly limited experience, doctors really don't know enough about the brain to be able to predict how any brain injury will ultimately affect any individuals abilities. You just have to wait and see.
Yes. As it is often put, "she will tell us what she can do."
quote:Originally posted by The Rabbit: It's relatively unlikely that Rep. Giffords remembers what happened to her.
I would tend to agree.
Posts: 831 | Registered: Jul 2005
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(Is this my cue to plug the book I think anyone interested in TBI from the perspective of a family that went through it should read?)
Posts: 32919 | Registered: Mar 2003
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quote:Originally posted by Dan_Frank: So I know this is shifting the conversation away from doctors and intubation and all that, but...
I'm baffled by all the people in this thread that keep sticking with the idea that conservative politics is somehow infused with more violence or violent rhetoric than liberal. I mean... genuinely confused.
I'm not currently addressing the issue of whether or not conservatives should embrace or decry the violent rhetoric that really is propagated by their side; for the most part I think that sort of inflammatory language is counterproductive but I don't think any of it, on either side, is perhaps as bad as some of you do. I don't think that rhetoric on either side has anything to do with Loughner's actions, nor do I think it makes sense to use his actions as a reason to bring up this discussion in the first place. But that's really irrelevant to what I actually wanted to comment on.
So many people in this thread keep repeating the narrative that, while both sides might engage in some violent rhetoric, conservatives are obviously the really guilty ones. Really? Are you sure? That hasn't been my perception, certainly.
I think if you look, it won't be hard to find examples of violent sounding rhetoric on the liberal side of the aisle. To me, it's necessarily about being able to come up with 100 incidents over the last 10 years and say "look! they do it too!"
It's about the constant drum beat on the Conservative side. I think they are largely to blame for poisoning politics in to what it has become. They've demonized the entire Democratic party and liberals in general (I mean geez, who made it their life's mission to turn liberal into a dirty word?) as anti-American, anti-Democratic, anti-Freedom, etc. It's not even about the random speech that uses violent metaphors, though I find those especially problematic. It's about a culture of demonization, and you can find a lot of individual examples on the left I'm sure, but you'll likely never be able to convince me that it exists to nearly the same degree as it does on the right. Democrats have been trying to compromise for years, and for years they've gotten slapped down and demonized for it. It's only gotten worse since 2006 when Democrats became the majority, and ever since then, Republicans have generally refused to participate in the process at all except to grind it to a halt, and every word out of their mouths is about how evil Democrats want to take your freedoms and how unAmerican they are. We've been hearing that since around September 12, 2001.
I think part of it is just that Republicans are so damned good at staying on message as a team. They all parrot the same lines that are handed down from on high, and they do it into every microphone that's turned on within speaking distance of them. They saturate the press with it. It's about the national mouthpiece, not just about the fringe elements that both sides have. When it comes to that aspect of national discourse, yes, I think Republicans are far, far worse.
Hm. I know Samp would never agree to this, but you might. Can we agree to disagree?
Because I still totally disagree, and this issue seems to very much be one of perspective. I'm not sure either you or I are very likely to convince the other, since examples on one side or the other do not definitively prove the trend.
I know that I grew up saturated in a culture that seemed to pretty strongly demonize Republicans. There was little talk of compromise, certainly not in a serious way. You mentioned some common labels conservatives throw at liberals, and you are totally right. And those are wrong, I agree. For the record, I don't think you're unAmerican or anti-freedom, Lyrhawn, I just think we disagree about stuff. That's okay. I disagree with most of my friends.
On the flip side, some common labels for conservatives are: racist, bigot, greedy, anti-freedom, fascist, bloodthirsty, ignorant... the list goes on.
I try not to bring too many details of my personal life into these discussions, as a general rule, but I'm going to now:
One of my siblings has a serious drug and alcohol addiction, a plethora of mental disorders, resists treatment, and is still living with my parents at the age of 35. But my parents have told me, with a straight face, that their biggest disappointment as parents is the fact that I somehow ended up a conservative.
It's not uncommon to see people say things like "The world would be a much better place if all the Republicans were dead" (actually the mother of one of my nephew's best friends said this on facebook just a few weeks ago.)
The disclaimer here is, I guess, that I grew up in the SF Bay Area, which is definitely a particularly strong liberal bastion. So maybe they make more extreme statements than most liberals. But this isn't the only place I have lived, and this isn't the only place I've encountered these ideas, so I'm skeptical that it's solely a matter of location.
Posts: 3580 | Registered: Aug 2005
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quote:Giffords had an operation Saturday to replace the breathing tube with a tracheotomy tube in her windpipe. That allows her to breathe better and frees her from the ventilator.
Though Giffords had been breathing on her own since she was shot in the head Jan. 8, doctors had left the breathing tube in as a precaution. A feeding tube was also put in to provide nutrition.
Those procedures are not out of the ordinary for brain-injured patients.
So as a matter of clarification, Giffords is not breathing through the breathing tube, she is breathing through a tracheotomy tube that bypasses the breathing tube. But they have left in the breathing tube for now.
Posts: 3742 | Registered: Dec 2001
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quote:The co-founder of the Tucson Tea Party said he is worried about the threats he is receiving, including a remark by a shooting victim made to him at a televised town hall meeting.
Trent Humphries told The Associated Press on Sunday he was surprised when shooting victim James Eric Fuller took a picture of him and said "you're dead."
The 63-year-old Fuller was arrested Saturday on disorderly conduct and threat charges and taken for a psychiatric exam.
So whose rhetoric likely inflamed this person? He probably believed the propaganda of liberals trying to score political points against conservatives by blaming conservatives for the violence in Tucson, and so now he made direct death threats against a Tea Party leader in public. This is where the attempts of liberals to blame conservatives is leading.
Posts: 3742 | Registered: Dec 2001
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quote:So as a matter of clarification, Giffords is not breathing through the breathing tube, she is breathing through a tracheotomy tube that bypasses the breathing tube. But they have left in the breathing tube for now.
Is this as close as you're going to get to admitting that doctors are unlikely to be deliberately silencing her?
Posts: 37449 | Registered: May 1999
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As a clarification, the only tube for breathing she has in right now is the tracheostomy tube. It "replaced" (see the FOX article***) the endotracheal tube, which goes through the mouth or nose, whereas the tracheostomy tube goes directly through a hole cut in the front of the neck.
Both endotracheal and tracheostomy tubes are types of "tracheal tubes."
quote:They replaced her breathing tube on Saturday with a tracheotomy tube in her windpipe to protect her airways.
Leaving the prior tube in could only lead to problems without adding benefits. You can learn to speak with a tracheostomy tube in place, but it takes time. Reading between the lines, I think this may mean they do not yet have the signs to inspire confidence that she can protect her airway for the foreseeable future. It would not be a good sign, although as The Rabbit noted, it's always a day-by-day game.
Posts: 831 | Registered: Jul 2005
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quote:Originally posted by Dan_Frank: So I know this is shifting the conversation away from doctors and intubation and all that, but...
I'm baffled by all the people in this thread that keep sticking with the idea that conservative politics is somehow infused with more violence or violent rhetoric than liberal. I mean... genuinely confused.
I'm not currently addressing the issue of whether or not conservatives should embrace or decry the violent rhetoric that really is propagated by their side; for the most part I think that sort of inflammatory language is counterproductive but I don't think any of it, on either side, is perhaps as bad as some of you do. I don't think that rhetoric on either side has anything to do with Loughner's actions, nor do I think it makes sense to use his actions as a reason to bring up this discussion in the first place. But that's really irrelevant to what I actually wanted to comment on.
So many people in this thread keep repeating the narrative that, while both sides might engage in some violent rhetoric, conservatives are obviously the really guilty ones. Really? Are you sure? That hasn't been my perception, certainly.
I think if you look, it won't be hard to find examples of violent sounding rhetoric on the liberal side of the aisle. To me, it's necessarily about being able to come up with 100 incidents over the last 10 years and say "look! they do it too!"
It's about the constant drum beat on the Conservative side. I think they are largely to blame for poisoning politics in to what it has become. They've demonized the entire Democratic party and liberals in general (I mean geez, who made it their life's mission to turn liberal into a dirty word?) as anti-American, anti-Democratic, anti-Freedom, etc. It's not even about the random speech that uses violent metaphors, though I find those especially problematic. It's about a culture of demonization, and you can find a lot of individual examples on the left I'm sure, but you'll likely never be able to convince me that it exists to nearly the same degree as it does on the right. Democrats have been trying to compromise for years, and for years they've gotten slapped down and demonized for it. It's only gotten worse since 2006 when Democrats became the majority, and ever since then, Republicans have generally refused to participate in the process at all except to grind it to a halt, and every word out of their mouths is about how evil Democrats want to take your freedoms and how unAmerican they are. We've been hearing that since around September 12, 2001.
I think part of it is just that Republicans are so damned good at staying on message as a team. They all parrot the same lines that are handed down from on high, and they do it into every microphone that's turned on within speaking distance of them. They saturate the press with it. It's about the national mouthpiece, not just about the fringe elements that both sides have. When it comes to that aspect of national discourse, yes, I think Republicans are far, far worse.
Hm. I know Samp would never agree to this, but you might. Can we agree to disagree?
Because I still totally disagree, and this issue seems to very much be one of perspective. I'm not sure either you or I are very likely to convince the other, since examples on one side or the other do not definitively prove the trend.
I know that I grew up saturated in a culture that seemed to pretty strongly demonize Republicans. There was little talk of compromise, certainly not in a serious way. You mentioned some common labels conservatives throw at liberals, and you are totally right. And those are wrong, I agree. For the record, I don't think you're unAmerican or anti-freedom, Lyrhawn, I just think we disagree about stuff. That's okay. I disagree with most of my friends.
On the flip side, some common labels for conservatives are: racist, bigot, greedy, anti-freedom, fascist, bloodthirsty, ignorant... the list goes on.
I try not to bring too many details of my personal life into these discussions, as a general rule, but I'm going to now:
One of my siblings has a serious drug and alcohol addiction, a plethora of mental disorders, resists treatment, and is still living with my parents at the age of 35. But my parents have told me, with a straight face, that their biggest disappointment as parents is the fact that I somehow ended up a conservative.
It's not uncommon to see people say things like "The world would be a much better place if all the Republicans were dead" (actually the mother of one of my nephew's best friends said this on facebook just a few weeks ago.)
The disclaimer here is, I guess, that I grew up in the SF Bay Area, which is definitely a particularly strong liberal bastion. So maybe they make more extreme statements than most liberals. But this isn't the only place I have lived, and this isn't the only place I've encountered these ideas, so I'm skeptical that it's solely a matter of location.
I'm generally fine with agreeing to disagree when it appears the discussion won't go anywhere.
However, I'm not sure we're on the same page. It seems like you're talking more about person to person. What John Smith says to Jane Smith on the corner of Main Street and Washington Ave the day before yesterday, or what Aunt Margaret said to you on Thanksgiving about who you voted for. Is that important? Yes, I think it is, but not as important as what I'm talking about.
What I'm talking about is what national and state level politicians say on 24 hour news, and what major television and radio personalities saturate the airwaves with. Why? Because what John Smith and Aunt Margaret say has an extremely limited ability to reach beyond a very few people, but people with national mouthpieces can affect millions with what they say. It may be that a certain city is a bastion of liberalism or conservatism, but how far beyond their walls does that message really reach? On that level, yes, the labels you've defined DO sound like the sort of things that liberals say about conservatives. Some of them are fair, some of them aren't, though none of them are fair as a blanket label (in other words, they're fair when applied accurately to specific people). But they don't really sound like the sort of things that national level politicians say about Republicans on a regular basis. I don't watch MSNBC, maybe they say it there. Other than that, you aren't going to see that kind of language in the press really either (again, not in any press that has a major mouthpiece).
Do you agree there's a difference?
Incidentally, my family is all over the map politically, but in general, if we're pulling aunts and uncles into the mix, my brother and I are the only liberals in our ENTIRE family. Every single aunt, uncle, and cousin is a hardcore Conservative, and some of them are hardcore Christian fundamentalist conservatives. We've mostly banned politics from the dinner table, but even when we did talk about it on a regular basis, it was generally civil (though I think they're wrong about pretty much everything). I don't think they're evil, and they don't think I am. We're easily able to disassociate a person from his politics. That's something it seems people have a pretty big problem with these days. You know it's actually sort of weird that my brother and I are the liberals of the family. My parents are about as apolitical as it gets. They have their traditional beliefs, but in a million years they'd never even try to sway you in any particular issue. They taught my brother and I right from wrong, to be responsible and polite, but never breathed a word to us about politics. We developed our political beliefs on our own. I think our parents' politics is a much more benign, traditional version of what my brother and I support, but in general I find it interesting.
Out of curiosity, how old are you? I'd say my political identity really started to form around the time of the 2000 election (I was 16 at the time). Before then I never really took the time to become informed about things, and thus my political reality is most heavily informed by post-2000 events. I'm wondering if you're coming at me from an 80s or 90s perspective, and if some of our disconnect might lie there.
Posts: 21898 | Registered: Nov 2004
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quote:Originally posted by jebus202: A sudden moment of clairvoyance has come upon me. I'm seeing... the future! I see... Ron... he's dropping this topic and... he's not posting again in this thread until the discussion has shifted to something entirely different and people have given up trying to show him why what he said is crazy...
Jebus the soothsayer.
Posts: 15421 | Registered: Aug 2005
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Ron, it's a reasonable idea to have, but it isn't feasible or defensible in practice because the situation is much more complicated physiologically than you might think.![[Confused]](confused.gif)
